Utilidad diagnóstica del cuestionario STOP-Bang en la apnea del sueño moderada en atención primaria / Diagnostic accuracy of STOP-Bang questionnaire on moderate sleep apnoea in primary care

Objetivo: Validar el cuestionario STOP-Bang para la apnea moderada frente al método de referencia (polisomnografía de tipo I) en atención primaria. Método: Estudio de utilidad diagnóstica en atención primaria con una muestra estimada de 85 casos y 85 controles sanos. Con muestreo por conveniencia, 203 pacientes fueron reclutados por sus médicos en seis centros de salud. Se excluyeron 25 y se analizaron 57 mujeres y 121 hombres, de los cuales 74 tenían un índice de hipopnea-apnea (IHA) ≥15. Se evaluaron el STOP-Bang y el IHA observado en la polisomnografía en cada paciente. El tamaño de la muestra, el análisis de la curva ROC y los puntos de corte óptimos se identificaron con los paquetes easyROC, pROC y OptimalCutpoints del software libre R. Resultados: El área bajo la curva en la apnea moderada (IHA ≥15) del STOP-Bang fue 0,737 (0,667-0,808), con puntos de corte óptimos diferentes por sexo (4 en mujeres y 6 en hombres). En la validación cruzada con k=10, el área bajo la curva para el STOP-Bang fue 0,678. Conclusiones: El STOP-Bang tiene una utilidad diagnóstica moderada para un IHA ≥15, pero superior a la de otras escalas, en una población comunitaria. Su desempeño es más adecuado en las mujeres

Objective: We aimed to compare the diagnostic utility of the STOP-Bang questionnaire for moderate apnoea against the gold standard (type I polysomnography) in a primary care setting. Method: Study of diagnostic utility in primary care. Estimated sample: 85 cases and 85 healthy controls. In convenience sampling, 203 patients were recruited by their physicians at six health centres. Twenty-five were excluded, and 57 women and 121 men, of whom 74 had apnoea-hypopnoea index (AHI) ≥15, were analyzed. STOP-Bang was validated by comparing scores in the same patient with the apnoea-hypopnoea index observed in polysomnography, as a gold standard. Sample size, ROC curve analysis and optimal cut-off points were identified with the easyROC, pROC, and OptimalCutpoints packages. Results: The area under the curve in moderate apnoea (AHI ≥15) of the STOP-Bang was 0.777 (0.667-0.808), with optimal cut-off points different by sex (4 in women and 6 in men). In the cross-validation with k=10, the area under the curve for the STOP-Bang was 0.678. Conclusions: The STOP-Bang presents a diagnostic moderate utility for AHI≥15, but superior to other scales, in a community population. Its performance is more appropriate in women

[Diagnostic accuracy of STOP-Bang questionnaire on moderate sleep apnoea in primary care]. / Utilidad diagnóstica del cuestionario STOP-Bang en la apnea del sueño moderada en atención primaria.

OBJECTIVE: We aimed to compare the diagnostic utility of the STOP-Bang questionnaire for moderate apnoea against the gold standard (type I polysomnography) in a primary care setting. METHOD: Study of diagnostic utility in primary care. Estimated sample: 85 cases and 85 healthy controls. In convenience sampling, 203 patients were recruited by their physicians at six health centres. Twenty-five were excluded, and 57 women and 121 men, of whom 74 had apnoea-hypopnoea index (AHI) ≥15, were analyzed. STOP-Bang was validated by comparing scores in the same patient with the apnoea-hypopnoea index observed in polysomnography, as a gold standard. Sample size, ROC curve analysis and optimal cut-off points were identified with the easyROC, pROC, and OptimalCutpoints packages. RESULTS: The area under the curve in moderate apnoea (AHI ≥15) of the STOP-Bang was 0.777 (0.667-0.808), with optimal cut-off points different by sex (4 in women and 6 in men). In the cross-validation with k=10, the area under the curve for the STOP-Bang was 0.678. CONCLUSIONS: The STOP-Bang presents a diagnostic moderate utility for AHI≥15, but superior to other scales, in a community population. Its performance is more appropriate in women.