American Academy of Sleep Medicine, Darien, IL 60561, USA.
J Clin Sleep Med. 2013 Jan 15;9(1):81-7. doi: 10.5664/jcsm.2350.
The program provides a unique opportunity to compare a large number of scorers with varied levels of experience to determine sleep stage scoring agreement. The objective is to examine areas of disagreement to inform future revisions of the AASM Manual for the Scoring of Sleep and Associated Events.
The sample included 9 record fragments, 1,800 epochs and more than 3,200,000 scoring decisions. More than 2,500 scorers, most with 3 or more years of experience, participated. The analysis determined agreement with the score chosen by the majority of scorers.
Sleep stage agreement averaged 82.6%. Agreement was highest for stage R sleep with stages N2 and W approaching the same level. Scoring agreement for stage N3 sleep was 67.4% and was lowest for stage N1 at 63.0%. Scorers had particular difficulty with the last epoch of stage W before sleep onset, the first epoch of stage N2 after stage N1 and the first epoch of stage R after stage N2. Discrimination between stages N2 and N3 was particularly difficult for scorers.
These findings suggest that with current rules, inter-scorer agreement in a large group is approximately 83%, a level similar to that reported for agreement between expert scorers. Agreement in the scoring of stages N1 and N3 sleep was low. Modifications to the scoring rules to improve scoring during sleep stage transitions may result in improvement.
该项目提供了一个独特的机会，可以比较大量具有不同经验水平的评分者，以确定睡眠分期评分的一致性。目的是检查意见不一致的领域，为未来修订《睡眠和相关事件的 AASM 手册》提供信息。
样本包括 9 个记录片段、1800 个时相和超过 3200000 个评分决策。有 2500 多名评分者参与，他们大多有 3 年以上的经验。分析确定了与大多数评分者选择的评分的一致性。
睡眠分期的平均一致性为 82.6%。R 期睡眠的一致性最高，N2 和 W 期接近相同水平。N3 期睡眠的评分一致性为 67.4%，N1 期睡眠的评分一致性最低，为 63.0%。评分者在睡眠开始前的 W 期最后一个时相、N1 期后第一个 N2 期和 N2 期后第一个 R 期时特别难以确定。N2 和 N3 期之间的区分对评分者来说特别困难。
这些发现表明，在当前规则下，大量评分者之间的组内一致性约为 83%，与专家评分者之间的一致性水平相似。N1 和 N3 期睡眠的评分一致性较低。对评分规则进行修改以改善睡眠分期过渡期间的评分可能会有所改善。
