Evaluating the diagnostic accuracy of smartphone video clips against polysomnography for paediatric obstructive sleep

Cal McLean1, Zachary Jones2, Joseph Eliahoo3

  • 1Paediatric Sleep and Respiratory, Imperial College Healthcare NHS Trust, London, UK cal.mclean1@nhs.net.

Insights

A new video analysis tool, VAPS, shows promise for diagnosing paediatric obstructive sleep apnoea syndrome (OSAS). This method may help triage children for further sleep studies, improving early detection and management of OSAS.

Area of Science:

  • Pediatric Sleep Medicine
  • Diagnostic Accuracy Studies
  • Respiratory Medicine

Background:

  • Overnight polysomnography (PSG) is the gold standard for diagnosing paediatric obstructive sleep apnoea syndrome (OSAS).
  • Validated screening tools for paediatric OSAS are limited.
  • Parent-recorded videos offer a potential avenue for capturing OSAS-indicative behaviours.

Purpose of the Study:

  • To compare the diagnostic accuracy of a standardized sleep video analysis tool, Videosomnography Analysis for Paediatric Sleep Apnoea (VAPS), against PSG for paediatric OSAS.
  • To evaluate VAPS as a potential screening and triage tool for paediatric OSAS.

Main Methods:

  • Children aged 2-12 years with suspected OSAS underwent PSG.
  • Parents recorded 1-minute videos of their child during sleep (in-hospital and at home).
  • Videos were scored using VAPS for nine OSAS-indicative behaviours and compared with PSG results.

Main Results:

  • The VAPS Score demonstrated good discriminatory ability (AUC=81.99%) between clinically significant and non-significant OSAS.
  • A VAPS Score of ≥3 showed high sensitivity (92%) for detecting OSAS.
  • When parents captured worst breathing, AUC increased to 85.45%, with a VAPS Score of ≥3 achieving 96% sensitivity.

Conclusions:

  • The VAPS Score shows potential as a useful tool for triaging children with suspected paediatric OSAS.
  • VAPS can help direct patients towards appropriate sleep investigations or treatment.
  • A VAPS score of ≤2 (low risk), 3-6 (medium risk), and ≥7 (high risk) may guide clinical decisions.
Abstract

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