Gislason T, Taube A
Department of Lung Medicine, Akademiska Sjukhuset, Uppsala, Sweden.
Ups J Med Sci. 1987;92(2):193-203. doi: 10.3109/03009738709178689.
This article describes stepwise the methodological and statistical considerations made in the planning of an epidemiological survey of the prevalence of the sleep apnea syndrome (SAS) in the municipality of Uppsala in Sweden. The investigation had to be confined to 60 subjects, since all-night polysomnographic studies are required for an unequivocal diagnosis of SAS. It was decided to investigate men 30 to 69 years old. Initially, the possibility of taking a simple random sample (SRS) was considered, but statistical calculations showed that for prevalences between 1-3% this would lead to totally unacceptable results. A postal questionnaire, sent to the total population of 35,779 men in this age group, was then considered and, depending on their replies, they would be divided into low-risk and high-risk stratums of SAS. Optimal numbers would then be called from each group for polysomnographic studies. This also proved impossible, as the lowest possible standard error was still too large and the samples would contain unacceptably few cases of SAS. We therefore decided to concentrate on the highrisk stratum, obtaining an estimated under limit of the prevalence. For economical reasons, we could not send a questionnaire to all the 35,779 individuals, but based the investigation on a SRS of 4,000 men, post-stratified in a high-risk and a low-risk group. From the high-risk group, 60 men were then selected for polysomnographic studies.
本文逐步阐述了在瑞典乌普萨拉市开展睡眠呼吸暂停综合征（SAS）患病率流行病学调查规划过程中所涉及的方法学和统计学考量。由于明确诊断SAS需要进行整夜多导睡眠图研究，此次调查不得不限定在60名受试者。研究决定调查年龄在30至69岁之间的男性。最初，考虑了采用简单随机抽样（SRS）的可能性，但统计计算表明，对于患病率在1%至3%之间的情况，这样做会得出完全不可接受的结果。随后考虑向该年龄组的35779名男性总人口发放邮政问卷，并根据他们的回答将其分为SAS的低风险和高风险分层。然后从每组中抽取最佳数量的人员进行多导睡眠图研究。但这也被证明是不可能的，因为可能的最低标准误差仍然太大，而且样本中SAS病例数量少得令人无法接受。因此，我们决定专注于高风险分层，以获得患病率的估计下限。出于经济原因，我们无法向所有35779人发放问卷，而是基于对4000名男性的简单随机抽样进行调查，并将其再分层为高风险组和低风险组。然后从高风险组中挑选60名男性进行多导睡眠图研究。
