Related Experiment Video
Updated: Jan 2, 2026
Use of a Video Scoring Anchor for Rapid Serial Assessment of Social Communication in Toddlers
Published on: March 14, 2018
The Generalizability of the Clinical Assessment Score-15 for Pediatric Sleep-Disordered Breathing
Nira A Goldstein1, Norman R Friedman2, Heather C Nardone3
1Division of Pediatric Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York.
Insights
The Clinical Assessment Score-15 (CAS-15) is a reliable tool for assessing pediatric sleep-disordered breathing across multiple institutions. This validated score aids in clinical decision-making for children with suspected breathing issues during sleep.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Clinical Assessment Tools
Background:
- The Clinical Assessment Score-15 (CAS-15) is a validated office-based tool for evaluating pediatric sleep-disordered breathing (SDB) in healthy children.
- The generalizability of the CAS-15 across different institutions was previously unconfirmed.
Purpose of the Study:
- To determine the generalizability of the CAS-15 in a multi-institutional setting for pediatric SDB assessment.
- To validate the CAS-15's utility in diverse clinical environments.
Main Methods:
- A multi-institutional study recruited 530 children with suspected SDB across 13 sites.
- Investigators completed the CAS-15, with 247 subjects having a follow-up assessment.
- Clinical decisions for polysomnography, medical therapy, or surgery were based on investigator recommendations.
Main Results:
- The study included 530 children (mean age 5.1 years; 54.2% male).
- Initial CAS-15 scores showed a moderate correlation (Spearman's rho=0.41) with the apnea-hypopnea index (AHI).
- A CAS-15 score ≥32 demonstrated a sensitivity of 69.0% and specificity of 63.4% for predicting positive polysomnography (AHI > 2).
Conclusions:
- The CAS-15 is a generalizable and useful office-based tool for evaluating pediatric sleep-disordered breathing.
- The findings support the widespread adoption of CAS-15 in clinical practice for pediatric SDB assessment.
Objective:
The Clinical Assessment Score-15 (CAS-15) has been validated as an office-based assessment for pediatric sleep-disordered breathing in otherwise healthy children. Our objective was to determine the generalizability of the CAS-15 in a multi-institutional fashion.
Methods:
Five hundred and thirty children from 13 sites with suspected sleep-disordered breathing were recruited, and the investigators completed the CAS-15. Based on decisions made in the course of clinical care, investigators recommended overnight polysomnography, observation, medical therapy, and/or surgery. Two hundred and forty-seven subjects had a follow-up CAS-15.
Results:
Mean age was 5.1 (2.6) years; 54.2% were male; 39.1% were white; and 37.0% were African American. Initial mean (standard deviation [SD]) CAS-15 was 37.3 (12.7), n = 508. Spearman correlation between the initial CAS-15 and the initial apnea-hypopnea index (AHI) was 0.41 (95% confidence interval [CI], 0.29, 0.51), n = 212, P < .001. A receiver-operating characteristic curve predicting positive polysomnography (AHI > 2) had an area under the curve of 0.71 (95% CI, 0.63, 0.80). A score ≥ 32 had a sensitivity of 69.0% (95% CI, 61.7, 75.5), a specificity of 63.4% (95% CI, 47.9, 76.6), a positive predictive value of 88.7% (95% CI, 82.1, 93.1), and a negative predictive value of 32.9% (95% CI, 23.5, 44.0) in predicting positive polysomnography. Among children who underwent surgery, the mean change (SD) score was 30.5 (12.6), n = 201, t = 36.85, P < .001, effect size = 3.1.
Conclusion:
This study establishes the generalizability of the CAS-15 as a useful office tool for the evaluation of pediatric sleep-disordered breathing.
Level Of Evidence:
2B Laryngoscope, 130:2256-2262, 2020.
More Related Videos
04:33Author Spotlight: Unveiling the Connection Between Sleep Disorders and Cognitive Symptoms in Depression
Published on: April 26, 2024
07:54Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Related Concept Videos
01:30Assessment of Airway, Skin Color, and Use of Accessory Muscles
Introduction
The initial evaluation of a patient's respiratory system...
01:23Assessment of Respiration
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...