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Agreement in the Scoring of Respiratory Events Among International Sleep Centers for Home Sleep Testing.

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Authors
Magalang, Ulysses J
Arnardottir, Erna S
Chen, Ning-Hung
Cistulli, Peter A
Gíslason, Thorarinn
Lim, Diane
Penzel, Thomas
Schwab, Richard
Tufik, Sergio
Pack, Allan I
Issue Date
2016-01

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Agreement in the Scoring of Respiratory Events Among International Sleep Centers for Home Sleep Testing. 2016, 12 (1):71-7 J Clin Sleep Med
Abstract
Home sleep testing (HST) is used worldwide to confirm the presence of obstructive sleep apnea (OSA). We sought to determine the agreement of HST scoring among international sleep centers.
Fifteen HSTs, previously recorded using a type 3 monitor, were deidentified and saved in European Data Format. The studies were scored by nine technologists from the sleep centers of the Sleep Apnea Global Interdisciplinary Consortium (SAGIC) using the locally available software. Each study was scored separately using one of three different airflow signals: nasal pressure (NP), transformed (square root) nasal pressure signal (transformed NP), and uncalibrated respiratory inductive plethysmography (RIP) flow. Only one of the three airflow signals was visible to the scorer at each scoring session. The scoring procedure was repeated to determine the intrarater reliability.
The intraclass correlation coefficients (ICCs) using the NP were: apnea-hypopnea index (AHI) = 0.96 (95% confidence interval [CI]: 0.93-0.99); apnea index = 0.91 (0.83-0.96); and hypopnea index = 0.75 (0.59-0.89). The ICCs using the transformed NP were: AHI = 0.98 (0.96-0.99); apnea index = 0.95 (0.90-0.98); and hypopnea index = 0.90 (0.82-0.96). The ICCs using the RIP flow were: AH I = 0.98 (0.96-0.99); apnea index = 0.66 (0.48-0.84); and hypopnea index = 0.78 (0.63-0.90). The mean difference of first and second scoring sessions of the same respiratory variables ranged from -1.02 to 0.75/h.
There is a strong agreement in the scoring of the respiratory events for HST among international sleep centers. Our results suggest that centralized scoring of HSTs may not be necessary in future research collaboration among international sites.
A commentary on this article appears in this issue on page 7.
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To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.
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http://dx.doi.org/ 10.5664/jcsm.5398
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4702196/
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Archived with thanks to Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine
ae974a485f413a2113503eed53cd6c53
10.5664/jcsm.5398
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