Biernacka H, Douglas N J
Respiratory Medicine Unit, University of Edinburgh, City Hospital.
Thorax. 1993 Mar;48(3):280-3. doi: 10.1136/thx.48.3.280.
Manual analysis of sleep, breathing, and oxygenation records is the "gold standard" for diagnosing sleep abnormalities but is time consuming and cumbersome. The accuracy and cost of a computerised sleep analysis system have therefore been investigated.
Manual and computerised (CNS Sleep Lab) scores from 43 consecutive clinical sleep studies were prospectively compared for accuracy and the time and costs were recorded.
There were good correlations and no systematic differences between manual and computer scoring for total sleep time, sleep onset latency, and duration of REM sleep. There was a small but clinically insignificant systematic difference in breathing pattern analysis, the number of hypopnoeas/hour being lower with manual than with computer scoring (13 (SE 3) v 15 (SE 3)/hour). There was no difference between computer and manual scoring of the frequency of apnoeas, so the frequency of apnoeas + hypopnoeas was clinically insignificantly higher with computer scoring with a highly significant correlation between the two techniques. The time taken to perform the analyses was not different between the two methods (manual 83 (SE 8) v computer 86 (SE 8) minutes). The computer system was six times more expensive than the manual system and annual running costs, including full maintenance contract and 15% depreciation, were twice as great.
The CNS Sleep Lab is sufficiently accurate for use in clinical sleep studies but is significantly more expensive and does not save technician time.
对睡眠、呼吸及氧合记录进行人工分析是诊断睡眠异常的“金标准”，但耗时且繁琐。因此，人们对计算机化睡眠分析系统的准确性和成本进行了研究。
前瞻性比较了43例连续临床睡眠研究的人工评分和计算机化（CNS睡眠实验室）评分的准确性，并记录了时间和成本。
总睡眠时间、入睡潜伏期和快速眼动睡眠持续时间的人工评分与计算机评分之间具有良好的相关性，且无系统性差异。呼吸模式分析存在微小但临床意义不大的系统性差异，人工评分的每小时呼吸暂停低通气指数低于计算机评分（分别为13（标准误3）次/小时和15（标准误3）次/小时）。呼吸暂停频率的计算机评分与人工评分之间无差异，因此计算机评分的呼吸暂停加呼吸暂停低通气指数在临床上略高，且两种技术之间具有高度显著的相关性。两种方法进行分析所需的时间无差异（人工分析83（标准误8）分钟，计算机分析86（标准误8）分钟）。计算机系统的成本是人工系统的6倍，包括全面维护合同和15%折旧在内的年度运行成本是人工系统的两倍。
CNS睡眠实验室在临床睡眠研究中的准确性足够，但成本显著更高，且不能节省技术人员时间。
