Derivation and validation of a clinical prediction rule for sleep apnoea syndrome for use in primary care
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Le résumé fourni par la source
BACKGROUND: Several clinical prediction rules (CPRs) are available for sleep apnoea-hypopnoea syndrome (OSAH), but they are difficult to apply in primary care (PC). AIM: Derivation and validation of a CPR using simple measurements available in PC. DESIGN & SETTING: A prospective study conducted in health centres from the area of influence of three Spanish hospitals. METHOD: Patients (aged 18-70 years) who attended for any reason; who presented with at least one of the three key symptoms for OSAH (snoring, breathing pauses while sleeping, and daytime sleepiness); and who were not undergoing non-invasive ventilation or prior treatment with continuous positive airway pressure (CPAP) were included. Anthropometric data, smoking habit, comorbidities, and Epworth test were collected. Patients were subsequently referred to the sleep unit (SU), where the decision was taken whether or not to instigate treatment. A multivariate logistic model was constructed using a sub-sample and scores assigned based on the regression coefficients; the CPR was validated with the remaining sample. Both receiver operating characteristic (ROC) curves were plotted and the sensitivity, specificity, and predictive values calculated. RESULTS: The derivation sample comprised 352 patients, with 260 in the validation sample. The final factors (arterial hypertension [AHT], age, body mass index [BMI], and sex) were used to develop a rule with scores ranging from 0.00-5.50. The cut-off point that optimises the area under the curve (AUC) is ≥2.50 points (AUC = 0.78; sensitivity = 86%; specificity = 54%; positive predictive value [PPV] = 45%; negative predictive value [NPV] = 90%; likelihood ratio [LR] = 0.26). The properties for the validation sample with this cut-off point are as follows: AUC = 0.68; sensitivity = 81%; specificity = 43%; PPV = 61%; NPV = 68%; LR = 0.44. CONCLUSION: As in similar cases, the specificity is low, meaning that healthy people are referred to a specialist. A negative result rules out the disease in most cases.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Derivation and validation of a clinical prediction rule for sleep apnoea syndrome for use in primary care
- Date Crossref
- 15/05/2018
- Éditeur
- Royal College of General Practitioners
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Hospital Universitario Araba pays non établi dans la noticeÉtablissement de santé
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Guilford Press (United States) pays non établi dans la noticeEntreprise
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Centro de Tecnologías Aeronauticas (Spain) pays non établi dans la noticeEntreprise
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Hospital de Galdakao pays non établi dans la noticeÉtablissement de santé
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Marqués de Valdecilla University Hospital Sleep Unit pays non établi dans la noticeÉtablissement de santé
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Araba University Hospital Araba Research Unit pays non établi dans la noticeUniversité ou école supérieure
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Araba Research Unit Research Fellow pays non établi dans la noticeStructure de recherche
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GP Graduate pays non établi dans la noticeInstitution
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Central Services pays non établi dans la noticeInstitution
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Lakuabizkarra Health Centre GP Graduate pays non établi dans la noticeÉtablissement de santé
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OSI-Araba pays non établi dans la noticeInstitution
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Galdakao-Usansolo Hospital Sleep Unit pays non établi dans la noticeÉtablissement de santé
Hospital Universitario Araba, Guilford Press (United States) et Centro de Tecnologías Aeronauticas (Spain), avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.