The Generalizability of the Clinical Assessment Score-15 for Pediatric Sleep-Disordered Breathing.
The Generalizability of the Clinical Assessment Score-15 for Pediatric Sleep-Disordered Breathing.
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小儿睡眠呼吸障碍临床评估评分 15 的普遍性。
DOI：
10.1002/lary.28428
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发表时间：
2020
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作者：
Goldstein,NiraA;Friedman,NormanR;Nardone,HeatherC;Aljasser,Abdullah;Tobey,AllisonBJ;Don,Debra;Baroody,FuadM;Lam,DerekJ;Goudy,Steven;Ishman,StaceyL;Arganbright,JillM;Baldassari,Cristina;Schreinemakers,JBS;Wine,ToddM;
临床评估评分-15（CAS-15）已被验证为儿科睡眠呼吸障碍的办公室评估，其他健康儿童。我们的目标是确定CAS-15的普遍性在多机构fashion.MethodsFive百和30名儿童从13个网站与疑似睡眠呼吸障碍被招募，研究人员完成了CAS-15。根据临床护理过程中做出的决定，研究者建议进行整夜多导睡眠图、观察、药物治疗和/或手术。247例受试者接受了CAS-15随访。结果平均年龄为5. 1（2. 6）岁; 54. 2%为男性; 39. 1%为白色; 37. 0%为非洲裔美国人。初始平均值（标准差[SD]）CAS-15为37.3（12.7），n = 508。初始CAS-15和初始呼吸暂停低通气指数（AHI）之间的斯皮尔曼相关性为0.41（95%置信区间[CI]，0.29，0.51），n = 212，P<0.001。预测阳性多导睡眠图（AHI > 2）的受试者工作特征曲线的曲线下面积为0.71（95% CI，0.63，0.80）。A评分≥ 32分的敏感性为69.0%（95% CI，61.7，75.5），特异性为63.4%（95% CI，47.9，76.6），阳性预测值为88.7%（95%CI，82.1，93.1），预测阳性多导睡眠图的阴性预测值为32.9%（95%CI，23.5，44.0）。在接受手术的儿童中，平均变化（SD）评分为30.5（12.6），n = 201，t= 36.85，P <0.001，效应量= 3.1.ConclusionThis study established the generalizability of CAS-15 as a useful office tool for evaluation of pediatric sleep‐disordered breathing.Level of Evidence 2B Laryngoscope，130：2256-2262，2020
ObjectiveThe Clinical Assessment Score‐15 (CAS‐15) has been validated as an office‐based assessment for pediatric sleep‐disordered breathing in otherwise healthy children. Our objective was to determine the generalizability of the CAS‐15 in a multi‐institutional fashion.MethodsFive hundred and thirty children from 13 sites with suspected sleep‐disordered breathing were recruited, and the investigators completed the CAS‐15. Based on decisions made in the course of clinical care, investigators recommended overnight polysomnography, observation, medical therapy, and/or surgery. Two hundred and forty‐seven subjects had a follow‐up CAS‐15.ResultsMean age was 5.1 (2.6) years; 54.2% were male; 39.1% were white; and 37.0% were African American. Initial mean (standard deviation [SD]) CAS‐15 was 37.3 (12.7), n = 508. Spearman correlation between the initial CAS‐15 and the initial apnea‐hypopnea index (AHI) was 0.41 (95% confidence interval [CI], 0.29, 0.51), n = 212,P< .001. A receiver‐operating characteristic curve predicting positive polysomnography (AHI > 2) had an area under the curve of 0.71 (95% CI, 0.63, 0.80). A score ≥ 32 had a sensitivity of 69.0% (95% CI, 61.7, 75.5), a specificity of 63.4% (95% CI, 47.9, 76.6), a positive predictive value of 88.7% (95% CI, 82.1, 93.1), and a negative predictive value of 32.9% (95% CI, 23.5, 44.0) in predicting positive polysomnography. Among children who underwent surgery, the mean change (SD) score was 30.5 (12.6), n = 201,t= 36.85,P< .001, effect size = 3.1.ConclusionThis study establishes the generalizability of the CAS‐15 as a useful office tool for the evaluation of pediatric sleep‐disordered breathing.Level of Evidence2BLaryngoscope, 130:2256–2262, 2020