Eijsvogel et al proposed a two-stage screening protocol for detection of obstructive sleep apnea syndrome (OSAS). The authors are from multiple institutions in The Netherlands, Belgium and Germany.
Stages:
(1) probability of OSAS
(2) nasal flow recording for a person classified as intermediate risk by the probability score
Parameters:
(1) Athens Insomnia Scale, from 0 to 24
(2) STOPBANG questionnaire, from 0 to 8
(3) Berlin questionnaire
(4) age in years
(5) breathing stops (question 5 from the Berlin questionnaire)
Parameter
Finding
Points
Athens Insomnia Scale
0 to 9
2.828
>= 10
0
STOPBANG
low risk (<= 1)
0
intermediate risk (2 to 4)
0.965
high risk (>= 5)
2.745
Berlin questionnaire
low
0
intermediate
1.584
high
4.64
age
<= 45 years
0
> 45 years
0.79
breathing stops
no
0
yes
0.810
value of X =
= SUM(points for all 5 parameters) - 6.322
probability of sleep apnea =
= 1 / (1 + EXP((-1) * X))
Probability of Apnea
Risk Group
0 to 34%
low
35 to 54%
intermediate
>= 55%
high
Performance:
• The area under the ROC curve is 0.81.
• The sensitivity was 63% and specificity 90%
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