Modification of McGill Oximetry Score in Improving the Diagnostic Capability of Paediatric OSA
Document Type
Article
Publication Date
11-1-2024
Abstract
Objectives This study aimed to devise a modified oximetry scoring system and calculate its diagnostic accuracy in detecting paediatric obstructive sleep apnoea syndrome (OSAS). Study Design This prospective diagnostic accuracy study was divided into two phases. Setting The study was conducted at a quaternary teaching hospital. Methods Polysomnograms performed from 1 April 2014 to 31 December 2021 were included. In Phase 1, the parameters of 95 oximetry trend graphs were evaluated, and a modified scoring system was constructed. In Phase 2, the modified scoring system was employed in 272 oximetry trend graphs, and its diagnostic accuracy was determined. A logistic regression model was used to assess the ability of each scoring system to predict paediatric OSAS. Results A total of 367 patients were recruited. In Phase 1, a four-tier severity classification system was constructed. In Phase 2, its diagnostic accuracy was found to be 53.3% sensitive, 97% specific, with positive predictive value of 98.5% and negative predictive value of 34.6%. The lowest detectable apnoea-hypopnoea index (AHI) was 4.5. The inter-rater reliability calculated was 80%. Logistic regression was applied to assess associations of the modified McGill score (MMS) or McGill oximetry score (MOS) with OSAS. The area under the receiver operating characteristic curve was higher for the MMS than for MOS (0.78 95% CI 0.73-0.84] vs. 0.59 95% CI 0.51-0.66]). Conclusion This study demonstrated that our modified scoring system had increased sensitivity at detecting OSAS at a much lower AHI and showed a much greater ability to predict paediatric OSAS.
Keywords
obstructive sleep apnoea, paediatric, pulse oximetry, sensitivity, specificity
Divisions
otorhino,paediatrics
Publication Title
Clinical Otolaryngology
Volume
49
Issue
6
Publisher
Wiley
Publisher Location
111 RIVER ST, HOBOKEN 07030-5774, NJ USA