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dc.contributor.authorMagalang, Ulysses J
dc.contributor.authorChen, Ning-Hung
dc.contributor.authorCistulli, Peter A
dc.contributor.authorFedson, Annette C
dc.contributor.authorGíslason, Thorarinn
dc.contributor.authorHillman, David
dc.contributor.authorPenzel, Thomas
dc.contributor.authorTamisier, Renaud
dc.contributor.authorTufik, Sergio
dc.contributor.authorPhillips, Gary
dc.contributor.authorPack, Allan I
dc.date.accessioned2014-02-14T11:59:46Z
dc.date.available2014-02-14T11:59:46Z
dc.date.issued2013-04
dc.date.submitted2014-02-14
dc.identifier.citationSleep 2013, 36(4):591-6en
dc.identifier.issn1550-9109
dc.identifier.pmid23565005
dc.identifier.doi10.5665/sleep.2552
dc.identifier.urihttp://hdl.handle.net/2336/312865
dc.descriptionTo access publisher's full text version of this article. Please click on the hyperlink in Additional Links field.en
dc.description.abstractAbstract STUDY OBJECTIVES: The American Academy of Sleep Medicine (AASM) guidelines for polysomnography (PSG) scoring are increasingly being adopted worldwide, but the agreement among international centers in scoring respiratory events and sleep stages using these guidelines is unknown. We sought to determine the interrater agreement of PSG scoring among international sleep centers. DESIGN: Prospective study of interrater agreement of PSG scoring. SETTING: Nine center-members of the Sleep Apnea Genetics International Consortium (SAGIC). MEASUREMENTS AND RESULTS: Fifteen previously recorded deidentified PSGs, in European Data Format, were scored by an experienced technologist at each site after they were imported into the locally used analysis software. Each 30-sec epoch was manually scored for sleep stage, arousals, apneas, and hypopneas using the AASM recommended criteria. The computer-derived oxygen desaturation index (ODI) was also recorded. The primary outcome for analysis was the intraclass correlation coefficient (ICC) of the apnea-hypopnea index (AHI). The ICCs of the respiratory variables were: AHI = 0.95 (95% confidence interval: 0.91-0.98), total apneas = 0.77 (0.56-0.87), total hypopneas = 0.80 (0.66-0.91), and ODI = 0.97 (0.93-0.99). The kappa statistics for sleep stages were: wake = 0.78 (0.77-0.79), nonrapid eye movement = 0.77 (0.76-0.78), N1 = 0.31 (0.30-0.32), N2 = 0.60 (0.59-0.61), N3 = 0.67 (0.65-0.69), and rapid eye movement = 0.78 (0.77-0.79). The ICC of the arousal index was 0.68 (0.50-0.85). CONCLUSION: There is strong agreement in the scoring of respiratory events among the SAGIC centers. There is also substantial epoch-by-epoch agreement in scoring sleep variables. Our results suggest that centralized scoring of PSGs may not be necessary in future research collaboration among international sites where experienced, well-trained scorers are involved.
dc.description.sponsorshipNHLBI P01 HL094307 HL093463 Tzagournis Medical Research Endowment Funds of The Ohio State Universityen
dc.language.isoenen
dc.publisherAssociated Professional Sleep Societiesen
dc.relation.urlhttp://dx.doi.org/10.5665/sleep.2552en
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612261/en
dc.rightsArchived with thanks to Sleepen
dc.subject.meshHumansen
dc.subject.meshObserver Variationen
dc.subject.meshPolysomnographyen
dc.subject.meshProspective Studiesen
dc.subject.meshReproducibility of Resultsen
dc.subject.meshSleep Apnea Syndromesen
dc.subject.meshSoftwareen
dc.titleAgreement in the scoring of respiratory events and sleep among international sleep centers.en
dc.typeArticleen
dc.identifier.journalSleepen
dc.rights.accessOpen Access - Opinn aðganguren
html.description.abstractAbstract STUDY OBJECTIVES: The American Academy of Sleep Medicine (AASM) guidelines for polysomnography (PSG) scoring are increasingly being adopted worldwide, but the agreement among international centers in scoring respiratory events and sleep stages using these guidelines is unknown. We sought to determine the interrater agreement of PSG scoring among international sleep centers. DESIGN: Prospective study of interrater agreement of PSG scoring. SETTING: Nine center-members of the Sleep Apnea Genetics International Consortium (SAGIC). MEASUREMENTS AND RESULTS: Fifteen previously recorded deidentified PSGs, in European Data Format, were scored by an experienced technologist at each site after they were imported into the locally used analysis software. Each 30-sec epoch was manually scored for sleep stage, arousals, apneas, and hypopneas using the AASM recommended criteria. The computer-derived oxygen desaturation index (ODI) was also recorded. The primary outcome for analysis was the intraclass correlation coefficient (ICC) of the apnea-hypopnea index (AHI). The ICCs of the respiratory variables were: AHI = 0.95 (95% confidence interval: 0.91-0.98), total apneas = 0.77 (0.56-0.87), total hypopneas = 0.80 (0.66-0.91), and ODI = 0.97 (0.93-0.99). The kappa statistics for sleep stages were: wake = 0.78 (0.77-0.79), nonrapid eye movement = 0.77 (0.76-0.78), N1 = 0.31 (0.30-0.32), N2 = 0.60 (0.59-0.61), N3 = 0.67 (0.65-0.69), and rapid eye movement = 0.78 (0.77-0.79). The ICC of the arousal index was 0.68 (0.50-0.85). CONCLUSION: There is strong agreement in the scoring of respiratory events among the SAGIC centers. There is also substantial epoch-by-epoch agreement in scoring sleep variables. Our results suggest that centralized scoring of PSGs may not be necessary in future research collaboration among international sites where experienced, well-trained scorers are involved.


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