Validation of the STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea among Different Populations: A Systematic Review and Meta-Analysis.
Validation of the STOP-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea among Different Populations: A Systematic Review and Meta-Analysis.
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DOI：
10.1371/journal.pone.0143697
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Chung F
中科院分区：
文献类型：
--
作者：
Nagappa M;Liao P;Wong J;Auckley D;Ramachandran SK;Memtsoudis S;Mokhlesi B;Chung F
诊断阻塞性睡眠呼吸暂停 (OSA) 具有临床意义，因为未经治疗的 OSA 与发病率和死亡率增加有关。 STOP-Bang 问卷是经过验证的 OSA 筛查工具。我们进行了系统回顾和荟萃分析，以确定 STOP-Bang 对筛查疑似患有 OSA 的患者的有效性，并预测其确定不同人群中 OSA 严重程度的准确性。对文献数据库进行了检索。纳入标准为： 1) 使用 STOP-Bang 问卷作为成人受试者（>18 岁）OSA 筛查工具的研究； 2) STOP-Bang 问卷的准确性通过多导睡眠图（诊断 OSA 的金标准）进行了验证； 3）OSA明确定义为呼吸暂停/呼吸不足指数（AHI）或呼吸障碍指数（RDI）≥5； 4) 英文出版物。根据筛查和诊断测试的 Cochrane 方法组明确描述和编码了研究的质量。包括 9,206 名患者在内的 17 项研究符合系统评价的标准。在睡眠诊所人群中，检测任何 OSA (AHI ≥ 5)、中度至重度 OSA (AHI ≥15) 和重度 OSA (AHI ≥30) 的敏感性分别为 90%、94% 和 96%。相应的净现值分别为46%、75%和90%。在手术人群中也发现了类似的趋势。在睡眠诊所人群中，STOP-Bang 评分为 3 分的严重 OSA 概率为 25%。随着 STOP-Bang 分数逐步增加到 4、5、6 和 7/8，概率分别按比例增加到 35%、45%、55% 和 75%。在手术人群中，STOP-Bang 评分为 3 分的严重 OSA 概率为 15%。随着 STOP-Bang 分数逐步增加到 4、5、6 和 7/8，概率分别增加到 25%、35%、45% 和 65%。这项荟萃分析证实了 STOP-Bang 问卷在睡眠诊所和手术人群中筛查 OSA 的高性能。 STOP-Bang 分数越高，中度至重度 OSA 的可能性就越大。
Diagnosing obstructive sleep apnea (OSA) is clinically relevant because untreated OSA has been associated with increased morbidity and mortality. The STOP-Bang questionnaire is a validated screening tool for OSA. We conducted a systematic review and meta-analysis to determine the effectiveness of STOP-Bang for screening patients suspected of having OSA and to predict its accuracy in determining the severity of OSA in the different populations. A search of the literature databases was performed. Inclusion criteria were: 1) Studies that used STOP-Bang questionnaire as a screening tool for OSA in adult subjects (>18 years); 2) The accuracy of the STOP-Bang questionnaire was validated by polysomnography—the gold standard for diagnosing OSA; 3) OSA was clearly defined as apnea/hypopnea index (AHI) or respiratory disturbance index (RDI) ≥ 5; 4) Publications in the English language. The quality of the studies were explicitly described and coded according to the Cochrane Methods group on the screening and diagnostic tests. Seventeen studies including 9,206 patients met criteria for the systematic review. In the sleep clinic population, the sensitivity was 90%, 94% and 96% to detect any OSA (AHI ≥ 5), moderate-to-severe OSA (AHI ≥15), and severe OSA (AHI ≥30) respectively. The corresponding NPV was 46%, 75% and 90%. A similar trend was found in the surgical population. In the sleep clinic population, the probability of severe OSA with a STOP-Bang score of 3 was 25%. With a stepwise increase of the STOP-Bang score to 4, 5, 6 and 7/8, the probability rose proportionally to 35%, 45%, 55% and 75%, respectively. In the surgical population, the probability of severe OSA with a STOP-Bang score of 3 was 15%. With a stepwise increase of the STOP-Bang score to 4, 5, 6 and 7/8, the probability increased to 25%, 35%, 45% and 65%, respectively. This meta-analysis confirms the high performance of the STOP-Bang questionnaire in the sleep clinic and surgical population for screening of OSA. The higher the STOP-Bang score, the greater is the probability of moderate-to-severe OSA.