Hui Jin1, Li-Ang Lee2, Lijuan Song1, Yanmei Li1, Jianxin Peng3, Nanshan Zhong4, Hsueh-Yu Li2, Xiaowen Zhang1. 1. Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China. 2. Department of Otolaryngology, Sleep Center, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan. 3. Department of Physics, School of Science, South China University of Technology, Guangzhou, China. 4. State Key Laboratory of Respiratory Disease, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
Abstract
BACKGROUND: Snoring is a common symptom of obstructive sleep apnea syndrome (OSA) and has recently been considered for diagnosis of OSA. OBJECTIVES: The goal of the current study was to systematically determine the accuracy of acoustic analysis of snoring in the diagnosis of OSA using a meta-analysis. METHODS: PubMed, Cochrane Library database, and EMBASE were searched up to July 15, 2014. A systematic review and meta-analysis of sensitivity, specificity, and other measures of accuracy of acoustic analysis of snoring in the diagnosis of OSA were conducted. The median of apneahypopnea index threshold was 10 events/h, range: 5-15 or 10-15 if aforementioned suggestion is adopted. RESULTS: A total of seven studies with 273 patients were included in the meta-analysis. The pooled estimates were as follows: sensitivity, 88% (95% confidence interval [CI]: 82-93%); specificity, 81% (95% CI: 72-88%); positive likelihood ratio (PLR), 4.44 (95% CI: 2.39-8.27); negative likelihood ratio (NLR), 0.15 (95% CI: 0.10-0.24); and diagnostic odds ratio (DOR), 32.18 (95% CI: 13.96-74.81). χ(2) values of sensitivity, specificity, PLR, NLR, and DOR were 2.37, 10.39, 12.57, 3.79, and 6.91 respectively (All p > 0.05). The area under the summary receiver operating characteristic curve was 0.93. Sensitivity analysis demonstrated that the pooled estimates were stable and reliable. The results of publication bias were not significant (p = 0.30). CONCLUSIONS: Acoustic analysis of snoring is a relatively accurate but not a strong method for diagnosing OSA. There is an urgent need for rigorous studies involving large samples and single snore event tests with an efficacy criterion that reflects the particular features of snoring acoustics for OSA diagnosis.
BACKGROUND: Snoring is a common symptom of obstructive sleep apnea syndrome (OSA) and has recently been considered for diagnosis of OSA. OBJECTIVES: The goal of the current study was to systematically determine the accuracy of acoustic analysis of snoring in the diagnosis of OSA using a meta-analysis. METHODS: PubMed, Cochrane Library database, and EMBASE were searched up to July 15, 2014. A systematic review and meta-analysis of sensitivity, specificity, and other measures of accuracy of acoustic analysis of snoring in the diagnosis of OSA were conducted. The median of apneahypopnea index threshold was 10 events/h, range: 5-15 or 10-15 if aforementioned suggestion is adopted. RESULTS: A total of seven studies with 273 patients were included in the meta-analysis. The pooled estimates were as follows: sensitivity, 88% (95% confidence interval [CI]: 82-93%); specificity, 81% (95% CI: 72-88%); positive likelihood ratio (PLR), 4.44 (95% CI: 2.39-8.27); negative likelihood ratio (NLR), 0.15 (95% CI: 0.10-0.24); and diagnostic odds ratio (DOR), 32.18 (95% CI: 13.96-74.81). χ(2) values of sensitivity, specificity, PLR, NLR, and DOR were 2.37, 10.39, 12.57, 3.79, and 6.91 respectively (All p > 0.05). The area under the summary receiver operating characteristic curve was 0.93. Sensitivity analysis demonstrated that the pooled estimates were stable and reliable. The results of publication bias were not significant (p = 0.30). CONCLUSIONS: Acoustic analysis of snoring is a relatively accurate but not a strong method for diagnosing OSA. There is an urgent need for rigorous studies involving large samples and single snore event tests with an efficacy criterion that reflects the particular features of snoring acoustics for OSA diagnosis.
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