Jeon Hong Jun, Bang Young Rong, Yoon In-Young
Department of Psychiatry, Konkuk University Medical Center, Seoul, South Korea.
Department of Psychiatry, Dong-A University Hospital, Busan, South Korea.
Sleep Breath. 2019 Sep;23(3):969-977. doi: 10.1007/s11325-018-1748-x. Epub 2018 Nov 17.
Obstructive sleep apnea (OSA) is highly prevalent and causes serious cardiovascular complications. Several screening questionnaires for OSA have been introduced, but only few validation studies have been conducted in general population. The aim of the present study was to assess the diagnostic value of three OSA screening questionnaires (Berlin Questionnaire, BQ; STOP-Bang Questionnaire, STOP-B; Four-Variable Screening Tool, Four-V) in a Korean community sample.
A total of 1148 community-dwelling participants completed the BQ, STOP-B, and Four-V. An overnight in-laboratory polysomnography (PSG) was conducted in randomly selected 116 participants. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and area under the curve (AUC) were calculated.
The Four-V with cutoff ≥ 8 showed high sensitivity for overall OSA (69.4%), and the Four-V with cutoff ≥ 9 showed high specificity for both overall OSA (81.5%) and moderate to severe OSA (69.0%). On the other hand, the STOP-B showed acceptable sensitivity and specificity for both overall OSA (61.3 and 79.6%, respectively) and moderate to severe OSA (72.4 and 67.8%, respectively). The STOP-Bang also showed the largest area under the receiver-operator characteristic curve for both overall OSA (0.752) and moderate to severe OSA (0.750). The BQ showed the lowest performance in predicting OSA.
Among the three questionnaires, the STOP-B was revealed as the most useful screening tool for OSA in terms of sensitivity, specificity, and area under the receiver-operator characteristic curve in the population of South Korea.
阻塞性睡眠呼吸暂停（OSA）非常普遍，并会引发严重的心血管并发症。已经推出了几种OSA筛查问卷，但在普通人群中进行的验证研究却很少。本研究的目的是评估三种OSA筛查问卷（柏林问卷，BQ；STOP-Bang问卷，STOP-B；四变量筛查工具，Four-V）在韩国社区样本中的诊断价值。
共有1148名社区居民参与者完成了BQ、STOP-B和Four-V问卷。对随机选取的116名参与者进行了夜间实验室多导睡眠图（PSG）检查。计算了敏感性、特异性、阳性预测值、阴性预测值、阳性似然比、阴性似然比和曲线下面积（AUC）。
截断值≥8时，Four-V对总体OSA显示出高敏感性（69.4%），截断值≥9时，Four-V对总体OSA（敏感性81.5%）和中重度OSA（敏感性69.0%）均显示出高特异性。另一方面，STOP-B对总体OSA（分别为61.3%和79.6%）和中重度OSA（分别为72.4%和67.8%）均显示出可接受的敏感性和特异性。STOP-Bang在总体OSA（曲线下面积为0.752）和中重度OSA（曲线下面积为0.750）的受试者工作特征曲线下面积也最大。BQ在预测OSA方面表现最差。
在这三种问卷中，就敏感性、特异性和受试者工作特征曲线下面积而言，STOP-B被证明是韩国人群中最有用的OSA筛查工具。
