Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic

Background. There is a growing number of patients with sleep-disordered breathing (SDB) referred to sleep clinics. Therefore, a simple but useful screening tool is urgent. The NoSAS score, containing only five items, has been developed and validated in population-based studies. Aim. To evaluate the...

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Main Authors: Yi Rong, Shihan Wang, Hui Wang, Feng Wang, Jingjing Tang, Xiuhong Kang, Guangxi Li, Zhiguo Liu
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Canadian Respiratory Journal
Online Access:http://dx.doi.org/10.1155/2020/4936423
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author Yi Rong
Shihan Wang
Hui Wang
Feng Wang
Jingjing Tang
Xiuhong Kang
Guangxi Li
Zhiguo Liu
author_facet Yi Rong
Shihan Wang
Hui Wang
Feng Wang
Jingjing Tang
Xiuhong Kang
Guangxi Li
Zhiguo Liu
author_sort Yi Rong
collection DOAJ
description Background. There is a growing number of patients with sleep-disordered breathing (SDB) referred to sleep clinics. Therefore, a simple but useful screening tool is urgent. The NoSAS score, containing only five items, has been developed and validated in population-based studies. Aim. To evaluate the performance of the NoSAS score for the screening of SDB patients from a sleep clinic in China, and to compare the predictive value of the NoSAS score with the STOP-Bang questionnaire. Methods. We enrolled consecutive patients from a sleep clinic who had undergone apnea-hypopnea index (AHI) testing by type III portable monitor device at the hospital and completed the STOP-Bang questionnaire. The NoSAS score was assessed by reviewing medical records. Sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) of both screening tools were calculated at different AHI cutoffs to compare the performance of SDB screening. Results. Of the 596 eligible patients (397 males and 199 female), 514 were diagnosed with SDB. When predicting overall (AHI ≥ 5), moderate-to-severe (AHI ≥ 15), and severe (AHI ≥ 30) SDB, the sensitivity and specificity of the NoSAS score were 71.2, 80.4, and 83.1% and 62.4, 49.3, and 40.7%, respectively. At all AHI cutoffs, the AUC ranged from 0.688 to 0.715 for the NoSAS score and from 0.663 to 0.693 for the STOP-Bang questionnaire. The NoSAS score had the largest AUC (0.715, 95% CI: 0.655–0.775) of diagnosing SDB at AHI cutoff of ≥5 events/h. NoSAS performed better in discriminating moderate-to-severe SDB than STOP-Bang with a marginally significantly higher AUC (0.697 vs. 0.663, P=0.046). Conclusion. The NoSAS score had good performance on the discrimination of SDB patients in sleep clinic and can be utilized as an effective screening tool in clinical practice.
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spelling doaj-art-b2f048ee74a64bf691105440c80fc1a92025-08-20T02:23:27ZengWileyCanadian Respiratory Journal1198-22411916-72452020-01-01202010.1155/2020/49364234936423Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep ClinicYi Rong0Shihan Wang1Hui Wang2Feng Wang3Jingjing Tang4Xiuhong Kang5Guangxi Li6Zhiguo Liu7Guang’anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100053, ChinaGuang’anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100053, ChinaSchool of Management, Beijing University of Chinese Medicine, Beijing 100029, ChinaDepartment of Respiratory and Critical Care Medicine, Beijing Chaoyang Hospital, Beijing Institute of Respiratory Medicine and Capital Medical University, Beijing 100020, ChinaGuang’anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100053, ChinaGuang’anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100053, ChinaGuang’anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100053, ChinaGuang’anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100053, ChinaBackground. There is a growing number of patients with sleep-disordered breathing (SDB) referred to sleep clinics. Therefore, a simple but useful screening tool is urgent. The NoSAS score, containing only five items, has been developed and validated in population-based studies. Aim. To evaluate the performance of the NoSAS score for the screening of SDB patients from a sleep clinic in China, and to compare the predictive value of the NoSAS score with the STOP-Bang questionnaire. Methods. We enrolled consecutive patients from a sleep clinic who had undergone apnea-hypopnea index (AHI) testing by type III portable monitor device at the hospital and completed the STOP-Bang questionnaire. The NoSAS score was assessed by reviewing medical records. Sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC) of both screening tools were calculated at different AHI cutoffs to compare the performance of SDB screening. Results. Of the 596 eligible patients (397 males and 199 female), 514 were diagnosed with SDB. When predicting overall (AHI ≥ 5), moderate-to-severe (AHI ≥ 15), and severe (AHI ≥ 30) SDB, the sensitivity and specificity of the NoSAS score were 71.2, 80.4, and 83.1% and 62.4, 49.3, and 40.7%, respectively. At all AHI cutoffs, the AUC ranged from 0.688 to 0.715 for the NoSAS score and from 0.663 to 0.693 for the STOP-Bang questionnaire. The NoSAS score had the largest AUC (0.715, 95% CI: 0.655–0.775) of diagnosing SDB at AHI cutoff of ≥5 events/h. NoSAS performed better in discriminating moderate-to-severe SDB than STOP-Bang with a marginally significantly higher AUC (0.697 vs. 0.663, P=0.046). Conclusion. The NoSAS score had good performance on the discrimination of SDB patients in sleep clinic and can be utilized as an effective screening tool in clinical practice.http://dx.doi.org/10.1155/2020/4936423
spellingShingle Yi Rong
Shihan Wang
Hui Wang
Feng Wang
Jingjing Tang
Xiuhong Kang
Guangxi Li
Zhiguo Liu
Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic
Canadian Respiratory Journal
title Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic
title_full Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic
title_fullStr Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic
title_full_unstemmed Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic
title_short Validation of the NoSAS Score for the Screening of Sleep-Disordered Breathing in a Sleep Clinic
title_sort validation of the nosas score for the screening of sleep disordered breathing in a sleep clinic
url http://dx.doi.org/10.1155/2020/4936423
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