Tanphaichitr Archwin, Chuenchod Pitchayanan, Ungkanont Kitirat, Banhiran Wish, Vathanophas Vannipa, Gozal David
Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Otorhinolaryngology, Koh Samui Hospital, Surat Thani, Thailand.
Pediatr Pulmonol. 2021 Sep;56(9):2979-2986. doi: 10.1002/ppul.25534. Epub 2021 Jun 23.
Obstructive sleep apnea (OSA) is highly prevalent in children and requires an expensive and relatively unavailable sleep study for diagnosis. This study was undertaken to translate the previously validated pediatric OSA screening tool (POSAST) to the Thai language and assess its accuracy and test-retest reliability in at-risk symptomatic children.
Prospective cross-sectional cohort study.
Pediatric patients clinically referred for suspected OSA who underwent overnight polysomnography (PSG) were recruited, and caregivers completed the Thai version of the POSAST. The same questionnaire was completed again after 2-4 weeks. The reliability of the questionnaire was determined by internal consistency and test-retest reliability. The validity of the questionnaire was assessed by constructing receiver operating characteristic (ROC) curves to identify the equation-derived score and total additive score cutoff points that identify high risk for moderate and severe OSA (AHI of ≥ 5 events/h).
One hundred and ten subjects completed the study. The mean age was 8.4 ± 2.9 years. The mean apnea-hypopnea index (AHI) was 10.9 ± 11.9 events/h. Test-retest reliability (Pearson correlation coefficient = 0.96, p < .001) and internal consistency between each question (Cronbach's alpha coefficient = 0.82, p < .001) were excellent. An equation-derived score cut-off of 1.9 yielded 78.4% sensitivity, 50.0% specificity, 76.3% positive predictive value (PPV), and 52.9% negative predictive value (NPV), while a total additive score cut-off of 8 corresponded to 81.1% sensitivity, 52.8% specificity, 77.9% PPV, and 57.6% NPV for diagnosing moderate and severe OSA (AHI ≥ 5 events/h).
The internal consistency and reproducibility of the Thai version of the POSAST are satisfactory, display acceptable validity, and the instrument can be used for screening symptomatic Thai children for OSA.
阻塞性睡眠呼吸暂停（OSA）在儿童中非常普遍，诊断需要进行昂贵且相对难以获得的睡眠研究。本研究旨在将先前验证的儿科OSA筛查工具（POSAST）翻译成泰语，并评估其在有症状风险儿童中的准确性和重测信度。
前瞻性横断面队列研究。
招募临床诊断为疑似OSA并接受过夜多导睡眠图（PSG）检查的儿科患者，其照顾者完成泰语版POSAST。2至4周后再次完成相同问卷。通过内部一致性和重测信度确定问卷的信度。通过构建受试者工作特征（ROC）曲线来评估问卷的效度，以确定用于识别中度和重度OSA（呼吸暂停低通气指数[AHI]≥5次/小时）高风险的方程推导分数和总加分分数截断点。
110名受试者完成了研究。平均年龄为8.4±2.9岁。平均呼吸暂停低通气指数（AHI）为10.9±11.9次/小时。重测信度（Pearson相关系数=0.96，p<.001）和各问题之间的内部一致性（Cronbach'sα系数=0.82，p<.001）非常好。方程推导分数截断值为1.9时，灵敏度为78.4%，特异度为50.0%，阳性预测值（PPV）为76.3%。阴性预测值（NPV）为52.9%；而总加分分数截断值为8时，诊断中度和重度OSA（AHI≥5次/小时）的灵敏度为81.1%，特异度为52.8%，PPV为77.9%，NPV为57.6%。
泰语版POSAST的内部一致性和可重复性令人满意，显示出可接受的效度，该工具可用于筛查有症状的泰国儿童是否患有OSA。
