scholarly journals 1202 Validation Of A Novel Wearable Home Sleep Testing Device For Assessment Of Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A459-A460
Author(s):  
E Yeh ◽  
E Wong ◽  
K Strohl ◽  
W Gu ◽  
C Tsai ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Left Ventricular ◽  
Clinical Practices ◽  
Obstructive Sleep

Abstract Introduction There is a substantial need for an accurate and easy-to-use tool for obstructive sleep apnea (OSA) assessment. Belun Ring Platform (BRP), a novel photoplethysmography (PPG)-based home sleep apnea testing system with a proprietary deep learning algorithm, has been shown to have good sensitivity and specificity in predicting OSA in subjects without significant comorbidities and medications known to affect heart rate (HR). In this study, we further tested its performance in subjects referred for in-lab polysomnography (PSG) assessment of sleep disorders without excluding those with non-arrhythmia comorbidities or the subjects on HR-affecting medications. Methods PSG was recorded simultaneously with the Ring in the sleep lab and the studies were manually scored by certified sleep technicians according to the AASM Scoring manual version 2.4. Exclusion criteria include age <18, unstable cardiopulmonary status, recent hospitalization within 30 days, significant arrhythmias, baseline HR <50 or >100, home oxygen use, pacemaker/defibrillator, post-cardiac transplantation or Left ventricular assist device. Results A cohort of 78 individuals (26 males and 52 females, age 50.5) were studied with 26 taking HR-affecting medications. Of these, 35 (45%) had AHI < 5; 14 (18%) had AHI 5-15; 15 (19%) had AHI 15-30; 14 (18%) had AHI > 30. The Ring-REI correlated well with the PSG-AHI (r =0.83, P <0.001). The accuracy, sensitivity, specificity in categorizing AHI >15 were 0.808, 0.931, and 0.735 respectively. The positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were 0.675, 0.947, 3.509, and 0.094 respectively. The use of HR-affecting medications did not significantly affect the sensitivity and specificity of BRP in predicting OSA (P =0.16 and 0.44 respectively). Conclusion BRP is promising as a reasonable tool for OSA assessment and can potentially be incorporated into a broad spectrum of clinical practices for identification of patients with OSA. Support This study is supported by a Grant from Belun Technology Company Limited.

STOP-Bang as a predictor of obstructive sleep apnea-hypopnea syndrome in outpatients

Duazary ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 344-349
Author(s):  
John Carlos Pedrozo-Pupo ◽  
Jorge Armando Egurrola-Pedraza ◽  
Adalberto Campo-Arias
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Obstructive Sleep ◽  
Accuracy Study ◽  
Hypopnea Syndrome

The STOP-Bang has been promoted as a valuable tool for identifying obstructive sleep apnea-hypopnea syndrome (OSAHS) in medical and surgical patients. However, its performance in Colombian samples is unknown. The objective of this study was to determine the clinimetric performance of the STOP-Bang index versus the study of polysomnography in patients from Santa Marta, Colombia. An accuracy study of diagnostic tests with a test-based approach was designed. Seven hundred sixty-two adults referred for polysomnography to evaluate OSAHS were included in the research. They were aged between 18 and 94 years old (mean=47.2, SD=13.4), 63.3% were men, and 46.5% were classified as obese. The STOP-Bang performance was compared against the best reference criterion, the hypopnea/apnea index determined by polysomnography. The diagnosis of OSAHS was confirmed in 461 (60.5%) and corroborated in 301 (39.5%). The area under the curve was 0.70 (95%CI 0.66-0.74), and the best cut-off point was 4, with a sensitivity of 79.2%, a specificity of 53.5%, the positive predictive value of 72.2%, the negative predictive value of 62.6%, positive likelihood ratio was 1.70, negative likelihood ratio was 0.39; OR=4.08 (CI95% 2.99-5.56) and Cohen's kappa of 0.33. As conclusions, performance indicators show that STOP-Bang...

scholarly journals Comparison of BISAP and Ranson’s score for predicting severe acute pancreatitis and establish the validity of BISAP score

2020 ◽  
Vol 7 (5) ◽  
pp. 1473
Author(s):  
Amulya Aggarwal ◽  
Alok V. Mathur ◽  
Ram K. Verma ◽  
Megha Gupta ◽  
Dheeraj Raj
Keyword(s):  
Acute Pancreatitis ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
Scoring System ◽  
Treatment Protocol ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Clinical Scoring

Background: Pancreatitis can lead to serious complications with severe morbidity and mortality. So an early, quick and accurate scoring system is necessary to stratify the patients according to their severity so as to enable early initiation of required management and care. Scoring system commonly used have some drawbacks. This study aimed to compare bedside index for severity in acute pancreatitis (BISAP) and Ranson’s score to predict severe acute pancreatitis and establish the validity of a simple and accurate clinical scoring system for stratifying patients.Methods: This is a prospective comparative study on 100 patients diagnosed with acute pancreatitis admitted in department of general surgery. Parameters included in the BISAP and Ranson’s criteria were studied at the time of admission and after 48 hours. Result of these two were compared with that of revised Atlanta classification.Results: As per the BISAP score, the sensitivity and specificity were 95.8 % (95% CI, 76.8-99.8), 94.7 % (95% CI, 86.3-98.3) whereas positive likelihood ratio, negative likelihood ratio 18.21 (95% CI, 6.9-47.44), 0.04 (95% CI, 0.01-0.30) and accuracy was 95 % (95% CI, 88.72%-98.36%). On using Ranson’s score, the sensitivity and specificity were 91.6 (95% CI, 71.5-98.5) and 89.4 (95% CI, 79.8-95) with a positive predictive value 8.71 (95% CI, 4.47-18.96) and negative predictive value of 0.09 (95% CI, 0.02-0.35) and accuracy of 90% (95% CI, 82.38%-95.10%)..Conclusions: BISAP score outperformed Ranson’s score in terms of Sensitivity and specificity of prediction of severe pancreatitis. The authors recommend inclusion of BISAP Scoring system in standard treatment protocol of management of acute pancreatitis.

scholarly journals How to Analyze the Diagnostic Performance of a New Test? Explained with Illustrations

2021 ◽  
Author(s):  
Deepak Dhamnetiya ◽  
Ravi Prakash Jha ◽  
Shalini Shalini ◽  
Krittika Bhattacharyya
Keyword(s):  
Diagnostic Test ◽  
Likelihood Ratio ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Diagnostic Tests ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Classification Model ◽  
Statistical Decision ◽  
Diagnostic Indices

AbstractDiagnostic tests are pivotal in modern medicine due to their applications in statistical decision-making regarding confirming or ruling out the presence of a disease in patients. In this regard, sensitivity and specificity are two most important and widely utilized components that measure the inherent validity of a diagnostic test for dichotomous outcomes against a gold standard test. Other diagnostic indices like positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, accuracy of a diagnostic test, and the effect of prevalence on various diagnostic indices have also been discussed. We have tried to present the performance of a classification model at all classification thresholds by reviewing the receiver operating characteristic (ROC) curve and the depiction of the tradeoff between sensitivity and (1–specificity) across a series of cutoff points when the diagnostic test is on a continuous scale. The area under the ROC (AUROC) and comparison of AUROCs of different tests have also been discussed. Reliability of a test is defined in terms of the repeatability of the test such that the test gives consistent results when repeated more than once on the same individual or material, under the same conditions. In this article, we have presented the calculation of kappa coefficient, which is the simplest way of finding the agreement between two observers by calculating the overall percentage of agreement. When the prevalence of disease in the population is low, prospective study becomes increasingly difficult to handle through the conventional design. Hence, we chose to describe three more designs along with the conventional one and presented the sensitivity and specificity calculations for those designs. We tried to offer some guidance in choosing the best possible design among these four designs, depending on a number of factors. The ultimate aim of this article is to provide the basic conceptual framework and interpretation of various diagnostic test indices, ROC analysis, comparison of diagnostic accuracy of different tests, and the reliability of a test so that the clinicians can use it effectively. Several R packages, as mentioned in this article, can prove handy during quantitative synthesis of clinical data related to diagnostic tests.

scholarly journals Clinical predictors of the presence of obstructive sleep apnea in patients with hypertrophic cardiomyopathy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Haobo Xu ◽  
Juan Wang ◽  
Jiansong Yuan ◽  
Chao Guo ◽  
Fenghuan Hu ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Hypertrophic Cardiomyopathy ◽  
Ventricular Outflow Tract ◽  
Left Ventricular ◽  
Clinical Practices ◽  
Clinical Predictors ◽  
Obstructive Sleep ◽  
Left Ventricular Outflow ◽  
Significant Factors

AbstractObstructive sleep apnea (OSA) is much common and associated with worse clinical outcomes in patients with hypertrophic cardiomyopathy (HCM), however, the diagnosis of OSA in HCM is still insufficient. We aim to investigate the clinical predictors of OSA in a large series of patients with HCM. A total of 589 patients with HCM who underwent sleep evaluations were retrospectively enrolled. Data from clinical characteristics and polysomnography studies were recorded. OSA was present in 346 patients (58.7%). Patients who had OSA were older, more likely to be male and had more clinical comorbidities such as hypertension, atrial fibrillation and cardiac remodeling. Multivariate logistic analyses showed that male, age, body mass index, hypertension and left ventricular outflow tract obstruction were significant factors associated with OSA. The area under the ROC curve (AUC) was 0.78 (95% CI 0.74–0.82; P < 0.001). These factors were also able to identify moderate to severe OSA with an AUC of 0.77 (95% CI 0.73–0.81; P < 0.001). These findings suggest that identifying HCM patients with high risk for OSA is feasible using characteristics from clinical practices and clinicians should have no hesitate to conduct sleep test in these patients.

scholarly journals Exploration of the Efficiency of Radiomics Applied to Left Ventricular Tomograms Obtained From D-SPECT MPI for the Auxiliary Diagnosis of Myocardial Ischemia in CAD

2021 ◽  
Author(s):  
Junpeng Wang ◽  
Xin Fan ◽  
Shanshan Qin ◽  
Han Zhang ◽  
Fei Yu
Keyword(s):  
Myocardial Ischemia ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Roc Curves ◽  
Left Ventricular ◽  
Operating Characteristics ◽  
Evaluation Indexes ◽  
Spect Mpi

Abstract Purpose: To explore the feasibility and efficacy of radiomics with left ventricular tomograms obtained from D-SPECT myocardial perfusion imaging (MPI) for auxiliary diagnosis of myocardial ischemia in coronary artery disease (CAD).Methods: The images of 103 patients with CAD myocardial ischemia between September 2020 and April 2021 were retrospectively selected. After information desensitization processing, format conversion, annotation using the Labelme tool on an open-source platform, lesion classification, and establishment of a database, the images were cropped for analysis. The ResNet18 model was used to automate two steps (classification and segmentation) with five randomization, training and validation steps. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value, Youden’s index, agreement rate, and kappa value were calculated as evaluation indexes of the classification results for each training-validation step; then, receiver operating characteristics (ROC) curves were drawn, and the areas under the curve (AUCs) were calculated. The Dice coefficient, intersection over union, and Hausdorff distance were calculated as evaluation indexes of the segmentation results for each training-validation step; then, the predicted images were exported.Results: Under the existing conditions, the radiomics model can distinguish myocardial ischemia quite accurately, with AUCs all exceeding 0.95, and predict the areas of myocardial ischemia quite accurately; all evaluated indexes were close to those of the gold standard.Conclusion: Radiomics can be feasibly applied to left ventricular tomograms obtained from D-SPECT MPI for auxiliary diagnosis, with quite good results. Patients may benefit from this approach as technology evolves and associated software is developed.

scholarly journals Correlación diagnóstica de la escala RIPASA en pacientes intervenidos quirúrgicamente por apendicitis aguda

2020 ◽  
Vol 112 (2) ◽  
pp. 178-184
Author(s):  
Rodrigo A. Gasque ◽  
◽  
Walter A. Moreno ◽  
Gabriel E. Vigilante
Keyword(s):  
Acute Appendicitis ◽  
Likelihood Ratio ◽  
Clinical Diagnosis ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cross Sectional ◽  
Ripasa Score

Background: Acute appendicitis (AA) is the most common surgical emergency worldwide. Its correct and early diagnosis is essential to avoid unnecessary surgeries and complications associated with its natural history. Objective: The aim of this study was to determine the diagnostic sensitivity and specificity of the RIPASA score in patients with suspected AA. Material and methods: This analytical, cross-sectional, observational and retrospective study included appendectomy specimens of patients of both sexes > 18 years operated on with clinical diagnosis of AA between January 1 and December 31, 2017. The histopathological examination of the appendectomy specimens was considered the gold standard diagnostic test. A score of 7.5 for the RIPASA score was chosen as cut-off value. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results: A total of 68 appendectomies were included; 57 (83.82%) specimens were positive for acute appendicitis. Mean age was 43.32 years. The histological diagnosis of AA was present in 32 (84.21%) men and in 25 (83.33%) women. For the RIPASA score, 54 patients had a true positive result (cut-off point ≥ 7.5 and positive histology for AA) with a sensitivity of 93%, specificity of 40%, PPV of 90%, NPV of 50%, positive likelihood ratio of 1.55 and negative likelihood ratio of 0.175. Conclusion: The RIPASA score has demonstrated excellent sensitivity and specificity for the clinical diagnosis of AA in a fast, simple and non-invasive fashion.

scholarly journals A validation study of an esophageal probe–based polygraph against polysomnography in obstructive sleep apnea

2021 ◽  
Author(s):  
Thorarinn Arnar Olafsson ◽  
Eivind Andreas Steinsvik ◽  
Gregor Bachmann-Harildstad ◽  
Harald Hrubos-Strøm
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Likelihood Ratio ◽  
Saturation Index ◽  
Positive Likelihood Ratio ◽  
Apnea Hypopnea Index ◽  
Respiratory Disturbance Index ◽  
Disturbance Index ◽  
Obstructive Sleep ◽  
Respiratory Disturbance

Abstract Study objectives The aim of this study was to validate the automatically scored results of an esophageal probe–based polygraph system (ApneaGraph® Spiro) against manually scored polysomnography (Nox A1, PSG) results. We compared the apnea–hypopnea index, oxygen saturation index, and respiratory disturbance index of the devices. Methods Consenting patients, referred for obstructive sleep apnea workup, were tested simultaneously with the ApneaGraph® Spiro and Nox A1® polysomnograph. Each participant made one set of simultaneous registrations for one night. PSG results were scored independently. Apnea–hypopnea index, oxygen desaturation index, and respiratory disturbance index were compared using Pearson’s correlation and scatter plots. Sensitivity, specificity, and positive likelihood ratio of all indices at 5, 15, and 30 were calculated. Results A total of 83 participants had successful registrations. The apnea–hypopnea index showed sensitivity of 0.83, specificity of 0.95, and a positive likelihood ratio of 5.11 at an index cutoff of 15. At a cutoff of 30, the positive likelihood ratio rose to 31.43. The respiratory disturbance index showed high sensitivity (> 0.9) at all cutoffs, but specificity was below 0.5 at all cutoffs. Scatterplots revealed overestimation in mild OSA and underestimation in severe OSA for all three indices. Conclusions The ApneaGraph® Spiro performed acceptably when OSA was defined by an AHI of 15. The equipment overestimated mild OSA and underestimated severe OSA, compared to the PSG.

scholarly journals Circulating tumour DNA methylation in hepatocellular carcinoma diagnosis using digital droplet PCR

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199296
Author(s):  
Juan Wang ◽  
Liu Yang ◽  
Yanjun Diao ◽  
Jiayun Liu ◽  
Jinjie Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Dna Methylation ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Control Group ◽  
Control Subjects ◽  
Droplet Pcr ◽  
Healthy Control

Objective To evaluate the performance of a DNA methylation-based digital droplet polymerase chain reaction (ddPCR) assay to detect aberrant DNA methylation in cell-free DNA (cfDNA) and to determine its application in the detection of hepatocellular carcinoma (HCC). Methods The present study recruited patients with liver-related diseases and healthy control subjects. Blood samples were used for the extraction of cfDNA, which was then bisulfite converted and the extent of DNA methylation quantified using a ddPCR platform. Results A total of 97 patients with HCC, 80 healthy control subjects and 46 patients with chronic hepatitis B/C virus infection were enrolled in the study. The level of cfDNA in the HCC group was significantly higher than that in the healthy control group. For the detection of HCC, based on a cut-off value of 15.7% for the cfDNA methylation ratio, the sensitivity and specificity were 78.57% and 89.38%, respectively. The diagnostic accuracy was 85.27%, the positive predictive value was 81.91% and the negative predictive value was 87.20%. The positive likelihood ratio of 15.7% in HCC diagnosis was 7.40, while the negative likelihood ratio was 0.24. Conclusions A sensitive methylation-based assay might serve as a liquid biopsy test for diagnosing HCC.

scholarly journals Association of C1q/TNF-related protein-9 (CTRP9) level with obstructive sleep apnea in patients with coronary artery disease

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
X Wang ◽  
Z Li ◽  
Y Du ◽  
L Jia ◽  
J Fan ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Obstructive Sleep Apnea ◽  
Coronary Artery ◽  
Sleep Apnea ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Funding Source ◽  
Related Protein ◽  
Obstructive Sleep ◽  
Artery Disease

Abstract Background Obstructive sleep apnea (OSA) is closely related to the incidence and progression of coronary artery disease (CAD), but the mechanisms linking OSA and CAD are unclear. C1q/TNF-related protein-9 (CTRP9) is a novel adipokine that protects the heart against ischemic injury and ameliorates cardiac remodeling. Purpose We aimed to ascertain the clinical relevance of CTRP9 with OSA prevalence in patients with CAD. Methods From August 2016 to March 2019, consecutive eligible patients with CAD (n=154; angina pectoris, n=88; acute myocardial infarction [AMI], n=66) underwent cardiorespiratory polygraphy during hospitalization. OSA was defined as an apnea-hypopnea index (AHI) ≥15 events h–1. Plasma CTRP9 concentrations were measured by ELISA method. Results OSA was present in 89 patients (57.8%). CTRP9 levels were significantly decreased in the OSA group than in the non-OSA group (4.7 [4.1–5.2] ng/mL vs. 4.9 [4.4–6.0] ng/mL, P=0.003). The difference between groups was only observed in patients with AMI (3.0 [2.3–4.9] vs. 4.5 [3.2–7.9], P=0.009), but not in patients with AP (5.0 [4.7–5.3] ng/mL vs. 5.1 [4.7–5.9] ng/mL, P=0.571) (Figure 1). Correlation analysis showed that CTRP9 levels were negatively correlated with AHI (r=−0.238, P=0.003) and oxygen desaturation index (r=−0.234, P=0.004), and positively correlated with left ventricular ejection fraction (r=0.251, P=0.004) in all subjects. Multivariate analysis showed that male gender (OR 3.099, 95% CI 1.029–9.330, P=0.044), body mass index (OR 1.148, 95% CI 1.040–1.268, P=0.006), and CTRP9 levels (OR 0.726, 95% CI 0.592–0.890, P=0.002) were independently associated with the prevalence of OSA. Conclusions Plasma CTRP9 levels were independently related to the prevalence of OSA in patients with CAD, suggesting that CTRP9 might play a role in the pathogenesis of CAD exacerbated by OSA. Figure 1. CTRP9 levels in OSA and non-OAS groups Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China

Association between obstructive sleep apnea and persistent-postural perceptual dizziness

2021 ◽  
pp. 1-6
Author(s):  
Anand K. Bery ◽  
Jayson Lee Azzi ◽  
Andre Le ◽  
Naomi S. Spitale ◽  
Judith Leech ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Sensitivity And Specificity ◽  
Berlin Questionnaire ◽  
Future Studies ◽  
Obstructive Sleep ◽  
Chronic Dizziness ◽  
Patients At Risk ◽  
The Mean ◽  
The Relationship

BACKGROUND: Obstructive sleep apnea (OSA) has been linked to vestibular dysfunction, but no prior studies have investigated the relationship between Persistent Postural Perceptual Dizziness (PPPD), a common cause of chronic dizziness, and OSA. OBJECTIVE AND METHODS: We determined the frequency of OSA in an uncontrolled group of PPPD patients from a tertiary dizziness clinic based on polysomnogram (PSG). We then assessed the sensitivity and specificity of common OSA questionnaires in this population. RESULTS: Twenty-five patients with PPPD underwent PSG (mean age 47, 60% female, mean BMI 29.5). A majority, or 56%, of patients were diagnosed with OSA, and in most, the OSA was severe. OSA patients were older (56 years versus 40 years, p = 0.0006) and had higher BMI (32 versus 26, p = 0.0078), but there was no clear gender bias (56% versus 64% female, p = 1.00). The mean sensitivity and specificity of the STOP BANG questionnaire for detecting OSA was 86% and 55%, respectively. Sensitivity and specificity of the Berlin Questionnaire was 79% and 45%, respectively. CONCLUSIONS: The prevalence of OSA was much higher in our small PPPD group than in the general population. Screening questionnaires appear to demonstrate good sensitivity to detect PPPD patients at risk of OSA in this small study. Future studies should confirm these findings and determine whether treatment of OSA improves symptoms in PPPD.

Sign in / Sign up

Export Citation Format

Share Document