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Diagnosis and Treatment of Obstructive Sleep Apnea in Adults

Slide: 17 of 32

Effectiveness of Questionnaires and Clinical Prediction Rules

There is a low strength of evidence that the Berlin Questionnaire is moderately accurate (has high sensitivity and specificity) to screen for obstructive sleep apnea (OSA). The strength of evidence is insufficient to evaluate other questionnaires, but one study found that STOP-Banga questionnaire may have high enough sensitivity to accurately screen for OSA. The strength of evidence is also insufficient to determine the utility of phased testing or preoperative sleep apnea screening. There is a low strength of evidence that some clinical prediction rules (a morphometric model and a pulmonary function data model) may be useful in the prediction of a diagnosis of OSA, but these tools have not been validated externally. Nine clinical prediction rules have been used for the prediction of a diagnosis of OSA (using different criteria). The oropharyngeal morphometric model gave near perfect discrimination (area under the curve [AUC] = 0.996) to predict the diagnosis of OSA, and the pulmonary function data model had 100 percent sensitivity with 84 percent specificity to predict diagnosis of OSA. The remaining models reported diagnostic lower sensitivities and specificities.

a. STOP-Bang = Snoring, Tiredness during daytime, Observed apnea, and high blood Pressure plus body mass index, age, neck circumference, and gender variables.