Department of Pulmonology, Medisch Spectrum Twente, Onderzoeksbureau Longgeneeskunde, P.O. Box 50000, 7500 KA, Enschede, the Netherlands.
Technical Medicine, Faculty of Science and Technology, University of Twente, Enschede, the Netherlands.
Sleep Breath. 2019 Mar;23(1):57-63. doi: 10.1007/s11325-018-1654-2. Epub 2018 Mar 21.
Obstructive sleep apnea (OSA) is common, and diagnosis requires expensive and laborious testing to assess the apnea hypopnea index (AHI). We performed an analysis to explore the relationship between the oxygen desaturation index (ODI) as measured with pulse oximetry and the AHI in our large portable monitoring (PM) database to find an optimal cutoff value for the ODI in order to be able to exclude AHI ≥ 5 on PM.
Three thousand four hundred thirteen PM recordings were randomly divided into a training set (N = 2281) and a test set (N = 1132). The optimal cutoff for the ODI to exclude an AHI ≥ 5 on PM was determined in the training set and subsequently validated in the test set.
Area under the curve of the ODI to exclude an AHI ≥ 5 on PM was 0.997 in the training set and 0.996 in the test set. In the training set, the optimal cutoff to predict an AHI < 5 was an ODI < 5. Using this cutoff in the test set provided a sensitivity of 97.7%, a specificity of 97.0%, a positive predictive value of 99.2%, and a negative predictive value of 91.4%.
An ODI < 5 predicts an AHI < 5 with high sensitivity and specificity when measured simultaneously using the same oximeter during PM recording.
阻塞性睡眠呼吸暂停（OSA）较为常见，其诊断需要昂贵且繁琐的测试来评估呼吸暂停低通气指数（AHI）。我们进行了一项分析，旨在探索脉氧仪测量的氧减指数（ODI）与我们的大型便携式监测（PM）数据库中的 AHI 之间的关系，以找到 ODI 的最佳截断值，从而能够在 PM 上排除 AHI≥5。
将 3413 次 PM 记录随机分为训练集（N=2281）和测试集（N=1132）。在训练集中确定 ODI 的最佳截断值以排除 PM 上的 AHI≥5，并随后在测试集中进行验证。
ODI 排除 PM 上 AHI≥5 的曲线下面积在训练集和测试集中分别为 0.997 和 0.996。在训练集中，预测 AHI<5 的最佳截断值为 ODI<5。在测试集中使用该截断值可提供 97.7%的敏感性、97.0%的特异性、99.2%的阳性预测值和 91.4%的阴性预测值。
在使用同一台血氧计同时进行 PM 记录时，ODI<5 可高度敏感且特异地预测 AHI<5。
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