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Development and external validation of a Nomogram to predict obstructive sleep apnea in Children
Yuqi Yuan1, Lina Ma1, Huanhuan Chang1,2
1Department of Otorhinolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
European Journal of Pediatrics
|November 29, 2024
Summary
A new nomogram model accurately predicts obstructive sleep apnea (OSA) in children. This tool helps identify children at risk, enabling timely treatment and preventing complications associated with pediatric OSA.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Medical Informatics
Background:
- Obstructive sleep apnea (OSA) is prevalent in children but often underdiagnosed due to limited polysomnography (PSG) use.
- Early identification and treatment of pediatric OSA are crucial to prevent multi-system dysfunction and long-term complications.
Purpose of the Study:
- To develop and externally validate a predictive nomogram model for obstructive sleep apnea in children.
- To provide a tool for risk assessment to guide PSG recommendations and timely intervention.
Main Methods:
- A predictive nomogram was developed using logistic regression and least absolute shrinkage and selection operator (LASSO) on data from 864 children (training/internal validation cohorts).
- External validation was performed on 292 children from a separate hospital.
- The nomogram's performance was assessed using discrimination, calibration, and clinical utility, and compared against the OSA-18 questionnaire.
Main Results:
- Six key features were identified: adenoid hypertrophy, tonsil size (grades 2 and 3), birth weight, total sleep time, and lowest oxygen saturation.
- The nomogram demonstrated robust predictive performance across training, internal, and external validation cohorts (AUCs ranging from 0.780 to 0.784).
- Performance remained stable across subgroups, outperforming the OSA-18 questionnaire.
Conclusions:
- A validated nomogram model effectively predicts the risk of obstructive sleep apnea in children.
- This nomogram serves as a reliable tool for risk stratification, aiding in the management of pediatric OSA.
