在睡眠革命中的多中心兴奋评分协议
Henna Pitkänen1,2, Sami Nikkonen1,2, Marika Rissanen1,3
1Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
Journal of sleep research
|December 27, 2023
概括
在多睡眠学中,激发得分的inter-scorer可靠性很低,特别是在自发性兴奋和清醒期间. 目前的手动兴奋评分方法可能缺乏临床和研究应用所需的一致性.
科学领域:
- 睡眠医学 睡眠医学
- 神经科学是一个神经科学.
- 生物医学工程 生物医学工程
背景情况:
- 多睡眠学 (PSG) 对于诊断睡眠障碍至关重要.
- 准确的唤醒评分对于评估睡眠质量和睡眠碎片化至关重要.
- 在手动唤醒得分中,得分者之间的可靠性一直是一个持续的挑战.
研究的目的:
- 为了评估专家得分者在全夜多睡眠记录期间手动唤醒得分的协议.
- 评估唤醒指数 (ArI) 和秒比秒评分在不同睡眠阶段和唤醒类型的可靠性.
- 确定有助于低得分协议的特定条件.
主要方法:
- 来自七个中心的十名专家得分者分析了50个全夜PSG录音.
- 评分者遵循美国睡眠医学学会 (AASM) 关于兴奋注释的指导方针.
- 协议量化使用ArIs和kappa统计数据的类内相关系数 (ICC) 进行秒比秒评分.
主要成果:
- 总体而言,ARI协议是公平的 (ICC = 0.41),得分对之间的差异很大 (ICC = 0.04-0.88).
- 对呼吸道唤起 (ICC = 0.65) 的一致性高于自发唤起 (ICC = 0.23).
- 总体而言,秒比秒的一致性是公平的 (Fleiss' kappa = 0.40),在觉醒阶段最低 (0.25),在N3睡眠中最高 (0.53).
- 超过一半的兴奋群体得分仅由一个或两个得分者得分.
结论:
- 手动唤醒得分显示得分者,睡眠阶段和唤醒类型之间低至公平的协议.
- 自发性唤醒和在清醒期间得分的,具有最显著的得分不确定性.
- 目前的手动评分实践可能对临床诊断或研究不够可靠,需要改善睡眠碎片化评估.
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