Duarte Ricardo Lm, Magalhães-da-Silveira Flavio J, Oliveira-E-Sá Tiago S, Silva Joana A, Mello Fernanda Cq, Gozal David
Sleep - Laboratório de Estudo dos Distúrbios do Sono, Centro Médico BarraShopping, Rio de Janeiro, Brazil.
Instituto de Doenças do Tórax, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Nat Sci Sleep. 2020 Jan 23;12:57-67. doi: 10.2147/NSS.S238255. eCollection 2020.
Obstructive sleep apnea (OSA) is a very prevalent disorder. Here, we aimed to develop and validate a practical questionnaire with yes-or-no answers, and to compare its performance with other well-validated instruments: No-Apnea, STOP-Bang, and NoSAS.
A cross-sectional study containing consecutively selected sleep-lab subjects underwent full polysomnography. A 4-item model, named GOAL questionnaire (gender, obesity, age, and loud snoring), was developed and subsequently validated, with item-scoring of 0-4 points (≥2 points indicating high risk for OSA). Discrimination was assessed by area under the curve (AUC), while predictive parameters were calculated using contingency tables. OSA severity was classified based on conventionally accepted apnea/hypopnea index thresholds: ≥5.0/h (OSA), ≥15.0/h (OSA), and ≥30.0/h (OSA).
Overall, 7377 adults were grouped into two large and independent cohorts: derivation (n = 3771) and validation (n = 3606). In the derivation cohort, screening of OSA, OSA, and OSA revealed that GOAL questionnaire achieved sensitivity ranging from 83.3% to 94.0% and specificity ranging from 62.4% to 38.5%. In the validation cohort, screening of OSA, OSA, and OSA, corroborated validation steps with sensitivity ranging from 83.7% to 94.2% and specificity from 63.4% to 37.7%. In both cohorts, discriminatory ability of GOAL questionnaire for screening of OSA, OSA, and OSA was similar to No-Apnea, STOP-Bang or NoSAS.
All four instruments had similar performance, leading to a possible greater practical implementation of the GOAL questionnaire, a simple instrument with only four parameters easily obtained during clinical evaluation.
阻塞性睡眠呼吸暂停（OSA）是一种非常普遍的疾病。在此，我们旨在开发并验证一份具有是或否答案的实用问卷，并将其性能与其他经过充分验证的工具进行比较：无呼吸问卷、STOP-Bang问卷和NoSAS问卷。
一项横断面研究连续选取睡眠实验室受试者进行全夜多导睡眠监测。开发了一个名为GOAL问卷（性别、肥胖、年龄和大声打鼾）的4项模型，随后进行验证，项目评分范围为0至4分（≥2分表明OSA风险高）。通过曲线下面积（AUC）评估辨别力，同时使用列联表计算预测参数。根据传统公认的呼吸暂停/低通气指数阈值对OSA严重程度进行分类：≥5.0次/小时（轻度OSA）、≥15.0次/小时（中度OSA）和≥30.0次/小时（重度OSA）。
总体而言，7377名成年人被分为两个大型独立队列：推导队列（n = 3771）和验证队列（n = 3606）。在推导队列中，对轻度OSA、中度OSA和重度OSA的筛查显示，GOAL问卷的敏感性范围为83.3%至94.0%，特异性范围为62.4%至38.5%。在验证队列中，对轻度OSA、中度OSA和重度OSA的筛查证实了验证步骤，敏感性范围为83.7%至94.2%，特异性范围为63.4%至37.7%。在两个队列中，GOAL问卷对轻度OSA、中度OSA和重度OSA筛查的辨别能力与无呼吸问卷、STOP-Bang问卷或NoSAS问卷相似。
所有四种工具的性能相似，这可能导致GOAL问卷在实际应用中得到更广泛的采用，GOAL问卷是一种简单的工具，在临床评估中只需轻松获取四个参数。
