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Validation of the sleep-EVAL system against clinical assessments of sleep disorders and polysomnographic data
M M Ohayon1, C Guilleminault, J Zulley
1Philippe Pinel Research Center of Montreal, Quebec, Canada. mrcohayon@aol.com
Objectives:
To validate the Sleep-EVAL expert system, a computerized tool designed for the assessment of sleep disorders, against polysomnographic data and clinical assessments by sleep specialists.
Design:
Patients were interviewed twice, once by a physician using Sleep-EVAL and again by a sleep specialist. Polysomnographic data were also recorded to ascertain diagnoses. Agreement between diagnoses generated by Sleep-EVAL and those formulated by sleep specialists was determined via the kappa statistic.
Settings:
Sleep disorder centers at Stanford University (USA) and Regensburg University (Germany).
Patients:
105 patients aged 18 years or over.
Interventions:
NA.
Results:
Sleep-EVAL made an average of 1.32 diagnoses per patient, compared with 0.93 for the sleep specialists. Overall agreement on any sleep-breathing disorder was 96.9% (Kappa .94). More than half of the patients were diagnosed with obstructive sleep apnea syndrome (OSAS); the agreement rate for this specific diagnosis was 96.7% (Kappa .93).
Conclusions:
The findings indicate that the Sleep-EVAL system is a valid instrument for the recognition of major sleep disorders, particularly insomnia and OSAS.