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Title: [The accuracy of STOP-Bang questionnaire in the screening of patients with obstructive sleep apnea].
Author: Li Z, Tang XD.
Journal: Zhonghua Yi Xue Za Zhi; 2020 Apr 14; 100(14):1057-1062. PubMed ID: 32294866.
Abstract:
Objective: To evaluate the accuracy of STOP-Bang (SBQ) questionnaire in the screening of patients with obstructive sleep apnea (OSA). Methods: The data were collected from September, 2011 to May, 2012 at the Sleep Medicine Center of West China Hospital, Sichuan University. A total of 350 consecutive patients (302 males and 48 females, 19-68 years old, average (42.9±11.0) years old) with suspected OSA who underwent an overnight polysomnography (PSG) were recruited into this study. SBQ questionnaire was completed. Based on the severity of OSA which were determined by apnea-hypopnea index (AHI), the patients were classified into four groups of primary snoring (<5 events/h), mild (5-14 events/h), moderate (15-29 events/h) and severe OSA (≥30 events/h). To evaluate the accuracy of SBQ, sensitivity, specificity, positive predictive values, negative predictive values and the area under the receiver operating characteristics curve of SBQ questionnaire were calculated. Results: Of the subjects, 322 (92.0%) were classified as high risk based on the questionnaire. With mild+moderate+severe OSA (AHI≥5 events/h), moderate+severe OSA (AHI≥15 events/h), and severe OSA as cutoffs, the sensitivity of SBQ questionnaire were 94.0%, 94.1%, and 95.3%; the specificity were 25.7%, 15.2%, and 13.2%; the positive predictive values were 91.9%, 79.2%, and 63.4%; the negative predictive values were 32.1%, 42.9%, and 64.3%, respectively. When variable BMI and age cutoffs (BMI≥24 kg/m(2) and age>42 years old), the questionnaire had the highest sensitivity (98.4%, 98.2%, and 99.5%, respectively) and the lowest specificity (8.6%, 3.8%, and 5.2%, respectively). Conclusions: When BMI and/or age cutoff values gradually decline, the sensitivity of SBQ questionnaire are increased, but the specificity and positive predictive values are declined. Lowering BMI and/or age cutoffs possibly does not improve questionnaire accuracy. 目的： 评估STOP-Bang（SBQ）问卷筛查阻塞性睡眠呼吸暂停（OSA）患者的准确性。 方法： 连续纳入2011年9月至2012年5月在四川大学华西医院睡眠医学中心就诊的可疑OSA患者350例，其中男302例，女48例；年龄（42.9±11.0）岁（范围：19~68岁）。患者均行整夜多导睡眠监测（PSG），并填写SBQ问卷。依据呼吸暂停低通气指数（AHI）将患者分为单纯鼾症组（<5次/h）、轻度OSA组（5~14次/h）、中度OSA组（15~29次/h）、重度OSA组（≥30次/h）。计算不同体质指数（BMI）和年龄界值下SBQ问卷的灵敏度、特异度、阳性预测值、阴性预测值，并绘制受试者工作特征（ROC）曲线，评价SBQ问卷的准确性。 结果： SBQ问卷评估的高危组有322例（92.0%）。SBQ问卷判断轻+中+重度OSA（AHI≥5次/h）、中+重度OSA（AHI≥15次/h）、重度OSA的灵敏度分别为94.0%、94.1%、95.3%，特异度分别为25.7%、15.2%、13.2%；阳性预测值分别为91.9%、79.2%、63.4%；阴性预测值分别为32.1%、42.9%、64.3%。同时调整BMI和年龄（即BMI界值≥24 kg/m(2)及年龄>42岁）后，SBQ问卷的灵敏度最高（分别为98.4%、98.2%、99.5%），特异度最低（分别为8.6%、3.8%、5.2%）。 结论： 随着BMI和年龄界值降低，SBQ问卷灵敏度逐步提高，但特异度及阳性预测值降低。调整BMI和年龄的取值界限或许不能提高SBQ问卷的准确性。.

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