COMPARING THE BERLIN QUESTIONNAIRE, STOP, STOP-BANG, ASA CHECKLIST, AND EPWORTH SLEEPINESS SCALE TO IDENTIFY PATIENTS WITH OSA HYPOPNEA SYNDROME

Abstract

SESSION TITLE: Clinical Prediction and Diagnosis of OSA SESSION TYPE: Original Investigations PRESENTED ON: 10/23/2019 10:45 AM - 11:45 AM PURPOSE: Background: Obstructive sleep apnea syndrome is a common disorder with significant morbidity and mortality. Different questionnaires have been used to evaluate patients with Obstructive sleep apnea/hypopnea syndrome. Standard polysomnography (PSG) is diagnostic gold standard for OSA. PSG is expensive, time consuming and not available everywhere. OBJECTIVE: The aim of the study was to evaluate the clinical utility of different questionnaires: Stop, Stop Bang, Berlin questionnaire, ASA checklist, Epworth Sleepiness Scale to identify patients at high risk for OSAHS compared with in-laboratory PSG and to identify the best OSA questionnaire for screening. METHODS: This prospective cross-sectional study was conducted on 170 patients, suspected to have OSAHS recruited from sleep clinic, (66% were females, with mean age 46±13 years, & BMI 39±8.3kg/m2) and divided into group of non OSA (n=70) and group of OSA (n=100).. All patients completed five questionnaires ( STOP, STOP-Bang, Berlin questionnaire, ASA chicketlist and ESS score), For each questionnaire, patients were divided into high risk and low risk. Then, PSG was performed for all patients. Apnea-Hypopnea Index was calculated to assess the diagnosis and severity of OSA. Severity of OSA was categorized as none (AHI < 5/h), mild (AHI ≥ 5 to < 15/h), moderate-to-severe (≥ 15 to < 30/h), and severe (AHI ≥ 30/h). Estimated OSA risk was compared to a diagnosis of OSA. The sensitivity, specificity,PPV, and NPV were calculated for each questionnaire. RESULTS: The prevalence of OSA was 12.5% using an AHI ≥5/h, 6.5% for an AHI ≥15/h and 40% for an AHI≥30/h. The STOP-Bang, Berlin questionnaires & ESS had a high sensitivity (90%,85% & 91% for AHI ≥15/h, and 91.2%,87% & 84% for AHI ≥30/h respectively), but the specificity was low (57%, 48% & 38% and 44%, 41% & 41%, respectively). In contrast, the sensitivity of the ASA checklist was not high enough (61% for AHI ≥15/h, 65% for AHI ≥30/h) to be useful in a clinical setting, whereas the specificity was relatively good (80% and 41%, respectively). The sensitivity and specificity values of the STOP questionnaire (for AHI ≥15/h, for AHI ≥30/h) fell between those of the STOP-Bang and the Berlin questionnaire.PPV (92%,86%, 85%, 92.5% & 89% for AHI ≥15/h and (83%, 76%, 75%, 85% & 77.5% AHI≥30/h,NPV 60%,46%,53%, 34% & 43% ≥15/h and 70%,59%,54%,49%,& 57%,AHI ≥30/h and area under the ROC curve at AHI≥ 15 was and 0.81,0.67,0.68,0.73, &0.78 and 0.77,0.64,0.66,0.71, &0.70 AHI ≥ 30. CONCLUSIONS: This study suggested that Berlin and STOP-BANG are more sensitive and accurate than ESS, ASA checklist & STOP questionnaire for OSA screening & severity prediction of OSA. CLINICAL IMPLICATIONS: : STOP-BANG and Berlin questionnaires are considered valid tools for the diagnosis and severity prediction of OSA with high sensitivity and specificity in comparison with PSG, and hence the number of patients referred for PSG could be decreased. DISCLOSURES: no disclosure on file for Hend Abd-rlrahiem; no disclosure on file for Azza Ahmad; no disclosure on file for Fatma Mohamed; No relevant relationships by Hamdy Mohammadien, source=Web Response no disclosure on file for Abd-elbast Saleh