Irish journal of medical science · 2025
Validation of the STOP-bang tool and prevalence of undiagnosed obstructive sleep apnoea in an irish tertiary cardiology outpatient setting.
СтатьяВалидационное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Mannion James, Murray Cian, Binalialsharabi Wail, Caples Norma, Foley Susan, Rogan Mark, Owens Patrick
Аннотация
BACKGROUND: Obstructive sleep apnoea (OSA) is prevalent among patients with cardiovascular disease and is associated with adverse outcomes. The STOP-Bang questionnaire is a validated screening tool for OSA.
AIMS: This study aimed to estimate prevalence of undiagnosed OSA in a general cardiology outpatient population, and validate the tool by correlating results with sleep studies.
METHODS: STOP-Bang analyses were conducted on 250 sequential patients in a general cardiology clinic, with informed consent for sleep studies. 50 patients were selected from for sleep studies.
RESULTS: Among the 245 eligible participants, 118 (48.1%) were classified as high risk for moderate-severe OSA. Of patients deemed "high-risk" on the questionnaire (score ≥ 3), this score had a sensitivity of 68% and a specificity of 80%, a positive predictive value (PPV) of 77.3% and a negative predictive value (NPV) of 71.4% for detecting moderate to severe OSA (Apnoea Hypoxia Index (AHI) ≥ 15). A STOP-Bang score of ≥ 5 was identified as the optimal cut-off for detecting moderate to severe OSA in this population, providing a favourable balance of high specificity (92.9%) and PPV (88.9%), while maintaining reasonable sensitivity (72.7%). The area under the receiver operating characteristic (ROC) curve for predicting AHI was 0.79 (95% confidence interval [CI] 0.62-0.92).
CONCLUSIONS: This study highlights the significant prevalence of undiagnosed OSA within the general cardiology population, emphasising the need for efficient and reliable screening methods. The STOP-Bang questionnaire cut off of ≥ 5 is a useful screening tool with high specificity for OSA. Routine screening of all referrals to cardiology clinics would dramatically reduce the rates of undiagnosed OSA and improve mortality.
AIMS: This study aimed to estimate prevalence of undiagnosed OSA in a general cardiology outpatient population, and validate the tool by correlating results with sleep studies.
METHODS: STOP-Bang analyses were conducted on 250 sequential patients in a general cardiology clinic, with informed consent for sleep studies. 50 patients were selected from for sleep studies.
RESULTS: Among the 245 eligible participants, 118 (48.1%) were classified as high risk for moderate-severe OSA. Of patients deemed "high-risk" on the questionnaire (score ≥ 3), this score had a sensitivity of 68% and a specificity of 80%, a positive predictive value (PPV) of 77.3% and a negative predictive value (NPV) of 71.4% for detecting moderate to severe OSA (Apnoea Hypoxia Index (AHI) ≥ 15). A STOP-Bang score of ≥ 5 was identified as the optimal cut-off for detecting moderate to severe OSA in this population, providing a favourable balance of high specificity (92.9%) and PPV (88.9%), while maintaining reasonable sensitivity (72.7%). The area under the receiver operating characteristic (ROC) curve for predicting AHI was 0.79 (95% confidence interval [CI] 0.62-0.92).
CONCLUSIONS: This study highlights the significant prevalence of undiagnosed OSA within the general cardiology population, emphasising the need for efficient and reliable screening methods. The STOP-Bang questionnaire cut off of ≥ 5 is a useful screening tool with high specificity for OSA. Routine screening of all referrals to cardiology clinics would dramatically reduce the rates of undiagnosed OSA and improve mortality.