在手动评分呼吸事件的时间和睡眠阶段依赖的协议
Minna Pitkänen1,2, Henna Pitkänen1,2, Rajdeep Kumar Nath1,3
1Department of Technical Physics, University of Eastern Finland, Kuopio, Finland.
Journal of sleep research
|November 4, 2024
概括
阻塞性睡眠呼吸暂停诊断的手动评分显示专家之间很少达成一致,特别是在事件时间和亚型方面. 这些差异显著影响患者的诊断和治疗决策.
科学领域:
- 睡眠医学 睡眠医学
- 呼吸系统生理学 呼吸系统生理学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 阻塞性睡眠呼吸暂停 (OSA) 诊断依赖于通过多睡眠学对呼吸事件的手动评分.
- 以前的研究经常报告了有限的协议指标,忽视了时间和事件亚型一致性.
研究的目的:
- 调查OSA中呼吸事件的手动评分中时间和事件亚型的一致性.
- 评估分数变化的影响对OSA严重程度分类的影响.
主要方法:
- 分析了50个由10名专家评分的多睡眠记录.
- 使用秒比秒的Fleiss' kappa统计数据计算得分者之间的协议.
- 由不同得分器分配的OSA严重程度类别的比较.
主要成果:
- 整体二进制事件协议 (Fleiss' kappa) 是0.32.
- 根据睡眠阶段 (N1:0.12,N2:0.23,N3:0.22,R:0.23) 和事件亚型 (低睡眠:0.26) 的不同.
- 在66%的参与者中,OSA严重程度分类在得分者之间存在差异.
结论:
- 在OSA中手动评分呼吸事件显示出显著的得分器间变异性,受事件类型和睡眠阶段的影响.
- 评分的差异会影响OSA的诊断,并可能改变治疗决策.
- 这些发现凸显了在OSA诊断得分中令人担忧的缺乏标准化.
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