Jiayan Huo1, Stuart F Quan2,3, Janet Roveda1,4,5, Ao Li6,7. 1. Biomedical Engineering, The University of Arizona, Tucson, AZ, USA. 2. Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 3. Asthma and Airway Disease Research Center, College of Medicine, The University of Arizona, Tucson, AZ, USA. 4. Department of Electrical and Computer Engineering, The University of Arizona, 1230 E Speedway Blvd, Tucson, AZ, 85719, USA. 5. BIO5 Institute, The University of Arizona, Tucson, AZ, USA. 6. Department of Electrical and Computer Engineering, The University of Arizona, 1230 E Speedway Blvd, Tucson, AZ, 85719, USA. aoli1@arizona.edu. 7. BIO5 Institute, The University of Arizona, Tucson, AZ, USA. aoli1@arizona.edu.
Abstract
PURPOSE: This study aimed to develop a machine learning-based questionnaire (BASH-GN) to classify obstructive sleep apnea (OSA) risk by considering risk factor subtypes. METHODS: Participants who met study inclusion criteria were selected from the Sleep Heart Health Study Visit 1 (SHHS 1) database. Other participants from the Wisconsin Sleep Cohort (WSC) served as an independent test dataset. Participants with an apnea hypopnea index (AHI) ≥ 15/h were considered as high risk for OSA. Potential risk factors were ranked using mutual information between each factor and the AHI, and only the top 50% were selected. We classified the subjects into 2 different groups, low and high phenotype groups, according to their risk scores. We then developed the BASH-GN, a machine learning-based questionnaire that consists of two logistic regression classifiers for the 2 different subtypes of OSA risk prediction. RESULTS: We evaluated the BASH-GN on the SHHS 1 test set (n = 1237) and WSC set (n = 1120) and compared its performance with four commonly used OSA screening questionnaires, the Four-Variable, Epworth Sleepiness Scale, Berlin, and STOP-BANG. The model outperformed these questionnaires on both test sets regarding the area under the receiver operating characteristic (AUROC) and the area under the precision-recall curve (AUPRC). The model achieved AUROC (SHHS 1: 0.78, WSC: 0.76) and AUPRC (SHHS 1: 0.72, WSC: 0.74), respectively. The questionnaire is available at https://c2ship.org/bash-gn . CONCLUSION: Considering OSA subtypes when evaluating OSA risk may improve the accuracy of OSA screening.
PURPOSE: This study aimed to develop a machine learning-based questionnaire (BASH-GN) to classify obstructive sleep apnea (OSA) risk by considering risk factor subtypes. METHODS: Participants who met study inclusion criteria were selected from the Sleep Heart Health Study Visit 1 (SHHS 1) database. Other participants from the Wisconsin Sleep Cohort (WSC) served as an independent test dataset. Participants with an apnea hypopnea index (AHI) ≥ 15/h were considered as high risk for OSA. Potential risk factors were ranked using mutual information between each factor and the AHI, and only the top 50% were selected. We classified the subjects into 2 different groups, low and high phenotype groups, according to their risk scores. We then developed the BASH-GN, a machine learning-based questionnaire that consists of two logistic regression classifiers for the 2 different subtypes of OSA risk prediction. RESULTS: We evaluated the BASH-GN on the SHHS 1 test set (n = 1237) and WSC set (n = 1120) and compared its performance with four commonly used OSA screening questionnaires, the Four-Variable, Epworth Sleepiness Scale, Berlin, and STOP-BANG. The model outperformed these questionnaires on both test sets regarding the area under the receiver operating characteristic (AUROC) and the area under the precision-recall curve (AUPRC). The model achieved AUROC (SHHS 1: 0.78, WSC: 0.76) and AUPRC (SHHS 1: 0.72, WSC: 0.74), respectively. The questionnaire is available at https://c2ship.org/bash-gn . CONCLUSION: Considering OSA subtypes when evaluating OSA risk may improve the accuracy of OSA screening.
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