Validity and reliability of the Japanese version of the severity hierarchy score for pediatric obstructive sleep...

Area of Science:

• Pediatric Sleep Medicine
• Respiratory Health
• Diagnostic Tool Validation

Background:

• Obstructive sleep apnea (OSA) is a prevalent condition in children, impacting their health and development.
• Accurate and accessible screening tools are crucial for early detection and intervention in pediatric OSA.
• The Severity Hierarchy Score (SHS) is a potential screening instrument, but its validity in Japanese pediatric populations requires evaluation.

Purpose of the Study:

• To assess the reliability and validity of the Japanese version of the Severity Hierarchy Score (J-SHS) for screening pediatric obstructive sleep apnea (OSA) in community-dwelling Japanese children.
• To determine the J-SHS's discriminative ability in identifying children at risk for OSA.

Main Methods:

• A cohort of 922 elementary school children in Tokyo participated.
• Parents completed the J-SHS questionnaire, and children underwent overnight Tracheal Sound (TS) recording.
• Reliability was assessed using Cronbach's alpha and Spearman's correlation; construct validity was evaluated via factor analysis; diagnostic accuracy was determined using ROC curves.

Main Results:

• The J-SHS demonstrated good internal consistency (Cronbach's alpha = 0.80) and a clear two-factor structure.
• A J-SHS score >1.88 showed 60% sensitivity and 93% specificity for an apnea-hypopnea index (AHI) ≥5/h (AUC=0.78).
• For children with frequent snoring, a J-SHS score >2.06 yielded 75% sensitivity and 84% specificity for AHI ≥3/h (AUC=0.84).

Conclusions:

• The J-SHS is a valid and reliable screening tool for pediatric OSA in Japanese children.
• It provides a quick and straightforward method for identifying children at risk for OSA.
• The findings support the J-SHS's utility in clinical and community settings for early OSA detection.