Agreement in the Scoring of Respiratory Events and Sleep Among International Sleep Centers
Identifieur interne : 004849 ( Main/Exploration ); précédent : 004848; suivant : 004850Agreement in the Scoring of Respiratory Events and Sleep Among International Sleep Centers
Auteurs : Ulysses J. Magalang [États-Unis] ; Ning-Hung Chen [Taïwan] ; Peter A. Cistulli [Australie] ; Annette C. Fedson [États-Unis] ; Thorarinn Gíslason [Islande] ; David Hillman [Australie] ; Thomas Penzel [Allemagne] ; Renaud Tamisier [France] ; Sergio Tufik [Brésil] ; Gary Phillips [États-Unis] ; Allan I. Pack [États-Unis]Source :
- Sleep [ 0161-8105 ] ; 2013.
Abstract
The American Academy of Sleep Medicine (AASM) guidelines for polysomnography (PSG) scoring are increasingly being adopted worldwide, but the agreement among international centers in scoring respiratory events and sleep stages using these guidelines is unknown. We sought to determine the interrater agreement of PSG scoring among international sleep centers.
Prospective study of interrater agreement of PSG scoring.
Nine center-members of the Sleep Apnea Genetics International Consortium (SAGIC).
Fifteen previously recorded deidentified PSGs, in European Data Format, were scored by an experienced technologist at each site after they were imported into the locally used analysis software. Each 30-sec epoch was manually scored for sleep stage, arousals, apneas, and hypopneas using the AASM recommended criteria. The computer-derived oxygen desaturation index (ODI) was also recorded. The primary outcome for analysis was the intraclass correlation coefficient (ICC) of the apnea-hypopnea index (AHI). The ICCs of the respiratory variables were: AHI = 0.95 (95% confidence interval: 0.91-0.98), total apneas = 0.77 (0.56-0.87), total hypopneas = 0.80 (0.66-0.91), and ODI = 0.97 (0.93-0.99). The kappa statistics for sleep stages were: wake = 0.78 (0.77-0.79), nonrapid eye movement = 0.77 (0.76-0.78), N1 = 0.31 (0.30-0.32), N2 = 0.60 (0.59-0.61), N3 = 0.67 (0.65-0.69), and rapid eye movement = 0.78 (0.77-0.79). The ICC of the arousal index was 0.68 (0.50-0.85).
There is strong agreement in the scoring of respiratory events among the SAGIC centers. There is also substantial epoch-by-epoch agreement in scoring sleep variables. Our results suggest that centralized scoring of PSGs may not be necessary in future research collaboration among international sites where experienced, well-trained scorers are involved.
Magalang UJ; Chen NH; Cistulli PA; Fedson AC; Gíslason T; Hillman D; Penzel T; Tamisier R; Tufik S; Phillips G; Pack AI. Agreement in the scoring of respiratory events and sleep among international sleep centers.
Url:
DOI: 10.5665/sleep.2552
PubMed: 23565005
PubMed Central: 3612261
Affiliations:
- Allemagne, Australie, Brésil, France, Islande, Taïwan, États-Unis
- Auvergne-Rhône-Alpes, Berlin, Nouvelle-Galles du Sud, Ohio, Pennsylvanie, Rhône-Alpes, État de São Paulo
- Berlin, Grenoble, Sydney, São Paulo
- Université de Sydney
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Pack</name><affiliation wicri:level="2"><nlm:aff id="aff4">Center for Sleep and Circadian Neurobiology, Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Center for Sleep and Circadian Neurobiology, Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23565005</idno><idno type="pmc">3612261</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612261</idno><idno type="RBID">PMC:3612261</idno><idno type="doi">10.5665/sleep.2552</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">001C32</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001C32</idno><idno type="wicri:Area/Pmc/Curation">001A90</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001A90</idno><idno type="wicri:Area/Pmc/Checkpoint">001C65</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001C65</idno><idno type="wicri:Area/Ncbi/Merge">001203</idno><idno type="wicri:Area/Ncbi/Curation">001203</idno><idno type="wicri:Area/Ncbi/Checkpoint">001203</idno><idno type="wicri:doubleKey">0161-8105:2013:Magalang U:agreement:in:the</idno><idno type="wicri:Area/Main/Merge">004969</idno><idno type="wicri:Area/Main/Curation">004849</idno><idno type="wicri:Area/Main/Exploration">004849</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Agreement in the Scoring of Respiratory Events and Sleep Among International Sleep Centers</title><author><name sortKey="Magalang, Ulysses J" sort="Magalang, Ulysses J" uniqKey="Magalang U" first="Ulysses J." last="Magalang">Ulysses J. Magalang</name><affiliation wicri:level="2"><nlm:aff id="aff1">Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus</wicri:cityArea></affiliation></author><author><name sortKey="Chen, Ning Hung" sort="Chen, Ning Hung" uniqKey="Chen N" first="Ning-Hung" last="Chen">Ning-Hung Chen</name><affiliation wicri:level="1"><nlm:aff id="aff2">Division of Pulmonary, Critical Care, and Sleep Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan</nlm:aff><country xml:lang="fr">Taïwan</country><wicri:regionArea>Division of Pulmonary, Critical Care, and Sleep Medicine, Chang Gung Memorial Hospital, Taoyuan</wicri:regionArea><wicri:noRegion>Taoyuan</wicri:noRegion></affiliation></author><author><name sortKey="Cistulli, Peter A" sort="Cistulli, Peter A" uniqKey="Cistulli P" first="Peter A." last="Cistulli">Peter A. Cistulli</name><affiliation wicri:level="4"><nlm:aff id="aff3">Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, and University of Sydney, Sydney, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>Centre for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, and University of Sydney, Sydney</wicri:regionArea><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region><settlement type="city">Sydney</settlement></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Fedson, Annette C" sort="Fedson, Annette C" uniqKey="Fedson A" first="Annette C." last="Fedson">Annette C. Fedson</name><affiliation wicri:level="2"><nlm:aff id="aff4">Center for Sleep and Circadian Neurobiology, Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Center for Sleep and Circadian Neurobiology, Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia</wicri:cityArea></affiliation></author><author><name sortKey="Gislason, Thorarinn" sort="Gislason, Thorarinn" uniqKey="Gislason T" first="Thorarinn" last="Gíslason">Thorarinn Gíslason</name><affiliation wicri:level="1"><nlm:aff id="aff5">Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik, Iceland</nlm:aff><country xml:lang="fr">Islande</country><wicri:regionArea>Department of Respiratory Medicine and Sleep, Landspitali University Hospital, Reykjavik</wicri:regionArea><wicri:noRegion>Reykjavik</wicri:noRegion></affiliation></author><author><name sortKey="Hillman, David" sort="Hillman, David" uniqKey="Hillman D" first="David" last="Hillman">David Hillman</name><affiliation wicri:level="1"><nlm:aff id="aff6">West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, Australia</nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea>West Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands</wicri:regionArea><wicri:noRegion>Nedlands</wicri:noRegion></affiliation></author><author><name sortKey="Penzel, Thomas" sort="Penzel, Thomas" uniqKey="Penzel T" first="Thomas" last="Penzel">Thomas Penzel</name><affiliation wicri:level="3"><nlm:aff id="aff7">Center of Sleep Medicine, Charité University Hospital, Berlin, Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Center of Sleep Medicine, Charité University Hospital, Berlin</wicri:regionArea><placeName><region type="land" nuts="3">Berlin</region><settlement type="city">Berlin</settlement></placeName></affiliation></author><author><name sortKey="Tamisier, Renaud" sort="Tamisier, Renaud" uniqKey="Tamisier R" first="Renaud" last="Tamisier">Renaud Tamisier</name><affiliation wicri:level="3"><nlm:aff id="aff8">Inserm U1042-HP2 Laboratory (Hypoxia & Pathophysiology), Joseph Fourier University, Grenoble, France</nlm:aff><country xml:lang="fr">France</country><wicri:regionArea>Inserm U1042-HP2 Laboratory (Hypoxia & Pathophysiology), Joseph Fourier University, Grenoble</wicri:regionArea><placeName><region type="region">Auvergne-Rhône-Alpes</region><region type="old region">Rhône-Alpes</region><settlement type="city">Grenoble</settlement></placeName></affiliation></author><author><name sortKey="Tufik, Sergio" sort="Tufik, Sergio" uniqKey="Tufik S" first="Sergio" last="Tufik">Sergio Tufik</name><affiliation wicri:level="3"><nlm:aff id="aff9">Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Disciplina de Medicina e Biologia do Sono, Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName></affiliation></author><author><name sortKey="Phillips, Gary" sort="Phillips, Gary" uniqKey="Phillips G" first="Gary" last="Phillips">Gary Phillips</name><affiliation wicri:level="2"><nlm:aff id="aff10">Center for Biostatistics, The Ohio State University, Columbus, OH</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Ohio</region></placeName><wicri:cityArea>Center for Biostatistics, The Ohio State University, Columbus</wicri:cityArea></affiliation></author><author><name sortKey="Pack, Allan I" sort="Pack, Allan I" uniqKey="Pack A" first="Allan I." last="Pack">Allan I. Pack</name><affiliation wicri:level="2"><nlm:aff id="aff4">Center for Sleep and Circadian Neurobiology, Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Center for Sleep and Circadian Neurobiology, Division of Sleep Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia</wicri:cityArea></affiliation></author></analytic><series><title level="j">Sleep</title><idno type="ISSN">0161-8105</idno><idno type="eISSN">1550-9109</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Study Objectives:</title><p>The American Academy of Sleep Medicine (AASM) guidelines for polysomnography (PSG) scoring are increasingly being adopted worldwide, but the agreement among international centers in scoring respiratory events and sleep stages using these guidelines is unknown. We sought to determine the interrater agreement of PSG scoring among international sleep centers.</p></sec><sec><title>Design:</title><p>Prospective study of interrater agreement of PSG scoring.</p></sec><sec><title>Setting:</title><p>Nine center-members of the Sleep Apnea Genetics International Consortium (SAGIC).</p></sec><sec><title>Measurements and Results:</title><p>Fifteen previously recorded deidentified PSGs, in European Data Format, were scored by an experienced technologist at each site after they were imported into the locally used analysis software. Each 30-sec epoch was manually scored for sleep stage, arousals, apneas, and hypopneas using the AASM recommended criteria. The computer-derived oxygen desaturation index (ODI) was also recorded. The primary outcome for analysis was the intraclass correlation coefficient (ICC) of the apnea-hypopnea index (AHI). The ICCs of the respiratory variables were: AHI = 0.95 (95% confidence interval: 0.91-0.98), total apneas = 0.77 (0.56-0.87), total hypopneas = 0.80 (0.66-0.91), and ODI = 0.97 (0.93-0.99). The kappa statistics for sleep stages were: wake = 0.78 (0.77-0.79), nonrapid eye movement = 0.77 (0.76-0.78), N1 = 0.31 (0.30-0.32), N2 = 0.60 (0.59-0.61), N3 = 0.67 (0.65-0.69), and rapid eye movement = 0.78 (0.77-0.79). The ICC of the arousal index was 0.68 (0.50-0.85).</p></sec><sec><title>Conclusion:</title><p>There is strong agreement in the scoring of respiratory events among the SAGIC centers. There is also substantial epoch-by-epoch agreement in scoring sleep variables. Our results suggest that centralized scoring of PSGs may not be necessary in future research collaboration among international sites where experienced, well-trained scorers are involved.</p></sec><sec><title>Citation:</title><p>Magalang UJ; Chen NH; Cistulli PA; Fedson AC; Gíslason T; Hillman D; Penzel T; Tamisier R; Tufik S; Phillips G; Pack AI. Agreement in the scoring of respiratory events and sleep among international sleep centers. <italic>SLEEP</italic> 2013;36(4):591-596.</p></sec></div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>Brésil</li><li>France</li><li>Islande</li><li>Taïwan</li><li>États-Unis</li></country><region><li>Auvergne-Rhône-Alpes</li><li>Berlin</li><li>Nouvelle-Galles du Sud</li><li>Ohio</li><li>Pennsylvanie</li><li>Rhône-Alpes</li><li>État de São Paulo</li></region><settlement><li>Berlin</li><li>Grenoble</li><li>Sydney</li><li>São Paulo</li></settlement><orgName><li>Université de Sydney</li></orgName></list><tree><country name="États-Unis"><region name="Ohio"><name sortKey="Magalang, Ulysses J" sort="Magalang, Ulysses J" uniqKey="Magalang U" first="Ulysses J." last="Magalang">Ulysses J. Magalang</name></region><name sortKey="Fedson, Annette C" sort="Fedson, Annette C" uniqKey="Fedson A" first="Annette C." last="Fedson">Annette C. Fedson</name><name sortKey="Pack, Allan I" sort="Pack, Allan I" uniqKey="Pack A" first="Allan I." last="Pack">Allan I. Pack</name><name sortKey="Phillips, Gary" sort="Phillips, Gary" uniqKey="Phillips G" first="Gary" last="Phillips">Gary Phillips</name></country><country name="Taïwan"><noRegion><name sortKey="Chen, Ning Hung" sort="Chen, Ning Hung" uniqKey="Chen N" first="Ning-Hung" last="Chen">Ning-Hung Chen</name></noRegion></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Cistulli, Peter A" sort="Cistulli, Peter A" uniqKey="Cistulli P" first="Peter A." last="Cistulli">Peter A. Cistulli</name></region><name sortKey="Hillman, David" sort="Hillman, David" uniqKey="Hillman D" first="David" last="Hillman">David Hillman</name></country><country name="Islande"><noRegion><name sortKey="Gislason, Thorarinn" sort="Gislason, Thorarinn" uniqKey="Gislason T" first="Thorarinn" last="Gíslason">Thorarinn Gíslason</name></noRegion></country><country name="Allemagne"><region name="Berlin"><name sortKey="Penzel, Thomas" sort="Penzel, Thomas" uniqKey="Penzel T" first="Thomas" last="Penzel">Thomas Penzel</name></region></country><country name="France"><region name="Auvergne-Rhône-Alpes"><name sortKey="Tamisier, Renaud" sort="Tamisier, Renaud" uniqKey="Tamisier R" first="Renaud" last="Tamisier">Renaud Tamisier</name></region></country><country name="Brésil"><region name="État de São Paulo"><name sortKey="Tufik, Sergio" sort="Tufik, Sergio" uniqKey="Tufik S" first="Sergio" last="Tufik">Sergio Tufik</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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