Navarrete-Martínez Esther, Muñoz-Gómez Rafaela, Serrano-Merino Jesús, Perula-de Torres Luis Angel, Vaquero-Abellán Manuel, Silva-Gil Fátima, Roldán-Villalobos Ana, Martín-Rioboó Enrique, Ruiz-Moruno Javier, Romero-Rodríguez Esperanza, González-Lama Jesús, Montes-Redondo Gertrudis
Marchena Health Center, Osuna Sanitary Area, Seville, Spain.
Maimonides Institute for Biomedical Research of Córdoba (IMIBIC)/Reina Sofía Hospital/University of Córdoba, Córdoba, Spain.
Front Med (Lausanne). 2023 Aug 14;10:1229972. doi: 10.3389/fmed.2023.1229972. eCollection 2023.
The obstructive sleep apnea syndrome (OSA) is a highly prevalent condition. In Spain and other countries, only 5%-9% of patients with OSA have been diagnosed and treated. The lack of accessibility to diagnosis is considered the main cause of this situation through easy-to-use screening instruments, it is necessary to check their validity and reliability in the context where they are to be used.
To validate the Spanish translation of the Berlin questionnaire for screening for moderate or severe OSA in patients aged 40 years or more detected in primary care.
A descriptive observational study, with a first qualitative phase of transcultural adaptation to Spanish using the translation-back-translation method. Setting: primary care level of the Spanish National Health System. A total of 255 patients recruited from 7 healthcare centers completed the study. The Berlin questionnaire was administered to the recruited patients, and subsequently, a respiratory polygraphy was performed to confirm the diagnosis of OSA. The concurrent criterion validity of the questionnaire and its reliability in terms of internal consistency and reproducibility (intra-observer agreement) were analyzed.
The patients' mean age was 54.76 years (SD: 6.57; 95% CI: 53.53-54.99), and 54.12% were men (95% CI: 47.96-60.27). We found that 61.57% (95% CI: 55.57-67.57) presented OSA (apnea-hypopnea index-AHI >5), and 45.5% (95% CI: 17.05-57.92) presented moderate or severe (AHI >15) OSA. The Berlin questionnaire, with a cut-off point of 4.5, showed a sensitivity of 76.77% (95% CI: 67.94-85.59), a specificity of 74.49% (95% CI: 65.35-83.63), a positive predictive value of 75.25% (95% CI: 66.34-84.16), a negative predictive value of 76.04% (95% CI: 66.98-85.10), and an area under the curve of 0.786 (95% CI: 0.721-0.851). Cronbach's alpha coefficient was 0.730 (95% CI: 0.668-0.784), and the Kappa index was 0.739 (95% CI, 0.384-1.000).
The Spanish adaptation of the Berlin questionnaire has good validity and reliability as a test for the diagnostic screening of moderate or severe OSA in patients aged 40 years or older. The findings of our study confirm that primary care physicians should use such screening tools to predict OSA.
阻塞性睡眠呼吸暂停综合征（OSA）是一种高度流行的疾病。在西班牙和其他国家，只有5%-9%的OSA患者得到了诊断和治疗。诊断途径难以获取被认为是造成这种情况的主要原因，通过易于使用的筛查工具来检查其在使用环境中的有效性和可靠性是很有必要的。
验证用于在初级保健中筛查40岁及以上患者中度或重度OSA的柏林问卷的西班牙语翻译版本。
一项描述性观察性研究，首先采用翻译-回译法对西班牙语进行跨文化适应性的定性阶段。研究地点：西班牙国家卫生系统的初级保健层面。从7个医疗中心招募的255名患者完成了该研究。对招募的患者进行柏林问卷测试，随后进行呼吸多导睡眠监测以确诊OSA。分析了问卷的并行标准效度及其在内部一致性和可重复性（观察者间一致性）方面的可靠性。
患者的平均年龄为54.76岁（标准差：6.57；95%置信区间：53.53-54.99），54.12%为男性（95%置信区间：47.96-60.27）。我们发现61.57%（95%置信区间：55.57-67.57）的患者患有OSA（呼吸暂停低通气指数-AHI>5），45.5%（95%置信区间：17.05-57.92）的患者患有中度或重度（AHI>15）OSA。截断值为4.5的柏林问卷显示，敏感性为76.77%（95%置信区间：67.94-85.59），特异性为74.49%（95%置信区间：65.35-83.63），阳性预测值为75.25%（95%置信区间：66.34-84.16），阴性预测值为76.04%（95%置信区间：66.98-85.10），曲线下面积为0.786（95%置信区间：0.721-0.851）。克朗巴哈α系数为0.730（95%置信区间：0.668-0.784），卡帕指数为0.739（95%置信区间：0.384-1.000）。
柏林问卷的西班牙语改编版本作为40岁及以上患者中度或重度OSA诊断筛查测试具有良好的效度和信度。我们的研究结果证实，初级保健医生应使用此类筛查工具来预测OSA。
