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JOSAQ: Development and Delphi-Vignette evaluation of a craniofacial-focused screening tool for obstructive sleep
Anuj Jain1,2,3
1Department of Oral and Maxillofacial Surgery, Geetanjali Dental and Research Institute, Geetanjali University, Udaipur, India.
Background:
Undiagnosed obstructive sleep apnoea (OSA) presents risks in oral and maxillofacial surgery (OMFS), yet tools such as STOP-Bang often underperform in non-obese patients with craniofacial anomalies. This study aimed to develop and preliminarily assess the Jain's Obstructive Sleep Apnoea Questionnaire (JOSAQ), a craniofacial-focused screening tool tailored for OMFS practice.
Methods:
JOSAQ, a two-stage, 20-item instrument combining patient-reported symptoms and clinician-assessed craniofacial features, underwent Delphi consensus and vignette-based comparison with STOP-Bang. Fifteen experts participated in the Delphi process, and 20 clinicians rated 25 standardized clinical vignettes.
Results:
Content validity was high (S-CVI = 0.89). JOSAQ identified more high-risk cases than STOP-Bang (62% vs 44%, p < .01) with higher Inter-rater reliability (κ = 0.72 vs 0.64), and better clarity scores. Completion times were similar.
Conclusion:
JOSAQ enhances screening sensitivity and inter-rater reliability without increasing assessment time, particulary benefiting non-obese patients with craniofacial anomalies. Multicentre validation against polysomnography is recommended.
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