Vaz A P, Drummond M, Mota P Caetano, Severo M, Almeida J, Winck J Carlos
Department of Pulmonology, H.S. Joao, Porto, Portugal.
Rev Port Pneumol. 2011 Mar-Apr;17(2):59-65.
Berlin Questionnaire (BQ), an English language screening tool for obstructive sleep apnea (OSA) in primary care, has been applied in tertiary settings, with variable results.
Development of BQ Portuguese version and evaluation of its utility in a sleep disordered breathing clinic (SDBC).
BQ was translated using back translation methodology and prospectively applied, previously to cardiorespiratory sleep study, to 95 consecutive subjects, referred to a SDBC, with OSA suspicion. OSA risk assessment was based on responses in 10 items, organized in 3 categories: snoring and witnessed apneas (category 1), daytime sleepiness (category 2), high blood pressure (HBP)/obesity (category 3).
In the studied sample, 67.4 % were males, with a mean age of 51 ± 13 years. Categories 1, 2 and 3 were positive in 91.6, 24.2 and 66.3 %, respectively. BQ identified 68.4 % of the patients as being in the high risk group for OSA and the remaining 31.6 % in the low risk. BQ sensitivity and specificity were 72.1 and 50 %, respectively, for an apnea-hipopnea index (AHI) > 5, 82.6 and 44.8 % for AHI > 15, 88.4 and 39.1 % for AHI > 30. Being in the high risk group for OSA did not influence significantly the probability of having the disease (positive likelihood ratio [LR] between 1.44-1.49). Only the items related to snoring loudness, witnessed apneas and HBP/obesity presented a statistically positive association with AHI, with the model constituted by their association presenting a greater discrimination capability, especially for an AHI > 5 (sensitivity 65.2 %, specificity 80 %, positive LR 3.26).
The BQ is not an appropriate screening tool for OSA in a SDBC, although snoring loudness, witnessed apneas, HBP/obesity have demonstrated being significant questionnaire elements in this population.
柏林问卷（BQ）是一种用于基层医疗中阻塞性睡眠呼吸暂停（OSA）的英语筛查工具，已在三级医疗机构中应用，结果各异。
开发BQ葡萄牙语版本并评估其在睡眠呼吸障碍诊所（SDBC）中的效用。
采用回译方法对BQ进行翻译，并前瞻性地应用于95名连续转诊至SDBC且怀疑患有OSA的受试者，在进行心肺睡眠研究之前。OSA风险评估基于10个项目的回答，分为3类：打鼾和观察到的呼吸暂停（第1类）、日间嗜睡（第2类）、高血压（HBP）/肥胖（第3类）。
在研究样本中，67.4%为男性，平均年龄51±13岁。第1、2和3类的阳性率分别为91.6%、24.2%和66.3%。BQ将68.4%的患者识别为OSA高风险组，其余31.6%为低风险组。对于呼吸暂停低通气指数（AHI）>5，BQ的敏感性和特异性分别为72.1%和50%；对于AHI>15，分别为82.6%和44.8%；对于AHI>30，分别为88.4%和39.1%。处于OSA高风险组对患该病的概率没有显著影响（阳性似然比[LR]在1.44 - 1.49之间）。只有与打鼾响度、观察到的呼吸暂停以及HBP/肥胖相关的项目与AHI存在统计学上的正相关，由它们的关联构成的模型具有更大的辨别能力，尤其是对于AHI>5（敏感性65.2%，特异性80%，阳性LR 3.26）。
尽管打鼾响度、观察到的呼吸暂停、HBP/肥胖已证明是该人群中重要的问卷要素，但BQ并非SDBC中OSA的合适筛查工具。
