Daphné Michelet1, Florence Julien-Marsollier2, Thomas Vacher3, Myriam Bellon4, Alia Skhiri5, Béatrice Bruneau6, Julien Fournier7, Thierno Diallo8, Virginie Luce9, Christopher Brasher10, Souhayl Dahmani11. 1. Department of Anesthesia and Intensive Care, Robert Debre University Hospital, Paris, France; Paris Diderot University, 10 Avenue de Verdun, 75010, Paris, France. Electronic address: daphnemichelet@gmail.com. 2. Department of Anesthesia and Intensive Care, Robert Debre University Hospital, Paris, France; Paris Diderot University, 10 Avenue de Verdun, 75010, Paris, France. Electronic address: florencejulien@yahoo.fr. 3. Department of Anesthesia and Intensive Care, Robert Debre University Hospital, Paris, France; Paris Diderot University, 10 Avenue de Verdun, 75010, Paris, France. Electronic address: toto.vacher@hotmail.fr. 4. Department of Anesthesia and Intensive Care, Robert Debre University Hospital, Paris, France; Paris Diderot University, 10 Avenue de Verdun, 75010, Paris, France. Electronic address: myriam.bellon@gmail.com. 5. Department of Anesthesia and Intensive Care, Robert Debre University Hospital, Paris, France; Paris Diderot University, 10 Avenue de Verdun, 75010, Paris, France. Electronic address: alia_skhiri@yahoo.fr. 6. Department of Anesthesia and Intensive Care, Robert Debre University Hospital, Paris, France; Paris Diderot University, 10 Avenue de Verdun, 75010, Paris, France. Electronic address: beatrice.bruneau@aphp.fr. 7. Department of Anesthesia and Intensive Care, Robert Debre University Hospital, Paris, France; Paris Diderot University, 10 Avenue de Verdun, 75010, Paris, France. Electronic address: fournier.j@me.com. 8. Department of Anesthesia and Intensive Care, Robert Debre University Hospital, Paris, France; Paris Diderot University, 10 Avenue de Verdun, 75010, Paris, France. Electronic address: thiernomd13@gmail.com. 9. Department of Anesthesia and Intensive Care, Robert Debre University Hospital, Paris, France; Paris Diderot University, 10 Avenue de Verdun, 75010, Paris, France. Electronic address: vlgarnier@gmail.com. 10. Department of Anaesthesia and Pain Management, Royal Children's Hospital, Melbourne, Australia; Anesthesia and Pain Management Research Group, Murdoch Children's Research Institute, Australia. Electronic address: Christopher.Brasher@rch.org.au. 11. Department of Anesthesia and Intensive Care, Robert Debre University Hospital, Paris, France; Paris Diderot University, 10 Avenue de Verdun, 75010, Paris, France; DHU PROTECT, INSERM U1141, Robert Debre University Hospital, Paris, France. Electronic address: souhayl.dahmani@aphp.fr.
Abstract
OBJECTIVES: The main objective of this meta-analysis was to assess the accuracy of the Sleep-Related Breathing Disorder (SRBD) Scale in the diagnosis of obstructive sleep apnea syndrome (OSAS) in children. PATIENTS/ METHODS: A literature search of studies comparing SRBD to polysomnography for the diagnosis of OSAS in children was performed. Risks of biases were quantified using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Analyses determined the summary receiver operator characteristic area under the curve (SROC), the pooled sensitivity (Se), the specificity (Sp), and the positive and negative likelihood ratios (LR+ and LR-). Results were graded and are expressed as means [95% confidence interval]. Post-test probabilities were computed for various populations. RESULTS: Eleven studies were included; and two were considered to have high risk of bias. The SROC was 0.73 [CI: 0.63; 0.82]. The combined Se, Sp, LR+ and LR- were: 0.72 [CI: 0.68; 0.77], 0.59 [CI: 0.56; 0.63], 1.74 [CI: 1.32; 2.30], 0.53 [CI: 0.39; 0.71], respectively. Sub-group analyses displayed similar results in comparison to overall results. GRADE evidence for the overall analysis was low to moderate. Finally, pre-test to post-test probabilities were estimated to be: 3.5%-1%, 50%-30% and 75%-30%, for the general population, the obese patients and the patients assigned for surgical treatment of OSAS, respectively. CONCLUSIONS: The current meta-analysis indicates that the SRBD scale has acceptable accuracy in detecting patients with OSAS. It may be useful when evaluating patients with suspected OSAS before surgery. STUDY REGISTRATION: PROSPERO database (CRD42018088216).
OBJECTIVES: The main objective of this meta-analysis was to assess the accuracy of the Sleep-Related Breathing Disorder (SRBD) Scale in the diagnosis of obstructive sleep apnea syndrome (OSAS) in children. PATIENTS/ METHODS: A literature search of studies comparing SRBD to polysomnography for the diagnosis of OSAS in children was performed. Risks of biases were quantified using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Analyses determined the summary receiver operator characteristic area under the curve (SROC), the pooled sensitivity (Se), the specificity (Sp), and the positive and negative likelihood ratios (LR+ and LR-). Results were graded and are expressed as means [95% confidence interval]. Post-test probabilities were computed for various populations. RESULTS: Eleven studies were included; and two were considered to have high risk of bias. The SROC was 0.73 [CI: 0.63; 0.82]. The combined Se, Sp, LR+ and LR- were: 0.72 [CI: 0.68; 0.77], 0.59 [CI: 0.56; 0.63], 1.74 [CI: 1.32; 2.30], 0.53 [CI: 0.39; 0.71], respectively. Sub-group analyses displayed similar results in comparison to overall results. GRADE evidence for the overall analysis was low to moderate. Finally, pre-test to post-test probabilities were estimated to be: 3.5%-1%, 50%-30% and 75%-30%, for the general population, the obesepatients and the patients assigned for surgical treatment of OSAS, respectively. CONCLUSIONS: The current meta-analysis indicates that the SRBD scale has acceptable accuracy in detecting patients with OSAS. It may be useful when evaluating patients with suspected OSAS before surgery. STUDY REGISTRATION: PROSPERO database (CRD42018088216).
Authors: Lucia V Torres-Lopez; Cristina Cadenas-Sanchez; Jairo H Migueles; Irene Esteban-Cornejo; Pablo Molina-Garcia; Charles H Hillman; Andres Catena; Francisco B Ortega Journal: Eur J Pediatr Date: 2022-02-10 Impact factor: 3.183