研究目的
To determine which statistical parameters from overnight pulse oximetry monitoring are most suitable for diagnosing childhood obstructive sleep apnea and to evaluate its diagnostic performance.
研究成果
The standard deviation of SpO2 is a useful, simple, and practical parameter for screening childhood obstructive sleep apnea, particularly for moderate to severe cases (AHI ≥5 events/h). A cutoff of SD ≥1.06 provides high specificity and positive predictive value, aiding in treatment decisions and reducing the need for polysomnography in some cases. Future studies should explore combinations with other parameters and home-based applications.
研究不足
1. The proportion of children with normal PSG findings was small, potentially affecting predictive values. 2. The study used only the Masimo SET pulse oximeter, so findings may not generalize to other brands. 3. The combination of SD with other parameters was not explored, which could improve sensitivity. 4. The study was conducted in a sleep laboratory with technicians, so data quality may differ in unattended home settings.
1：Experimental Design and Method Selection:
The study was conducted in two phases. Phase 1 was prospective to determine the best statistical parameter from pulse oximetry data for diagnosing OSA, using the area under the ROC curve (AUC) as the assessment metric. Phase 2 was retrospective to validate the chosen parameter (standard deviation of SpO2) in a larger population by comparing it with polysomnography results.
2：Sample Selection and Data Sources:
In Phase 1, children aged 1-15 years with snoring and adenotonsillar hypertrophy referred for PSG were recruited, excluding those with conditions affecting respiratory systems. In Phase 2, raw SpO2 data were extracted from previous PSG records of children with habitual snoring, excluding those with underlying diseases.
3：List of Experimental Equipment and Materials:
Pulse oximeter (Masimo SET Radical-7), polysomnography system (Grael system; Compumedics), software (Masimo software program, SPSS Statistics version 17).
4：7). Experimental Procedures and Operational Workflow:
4. Experimental Procedures and Operational Workflow: Subjects were monitored with pulse oximetry during PSG for at least 6 hours. Statistical parameters (minimum, maximum, mean, median, standard deviation, standard error, skewness, kurtosis) were calculated automatically or manually. Data were analyzed using ROC curves and correlation analyses.
5：Data Analysis Methods:
Statistical analysis was performed using SPSS Statistics version 17.0, including descriptive statistics, chi-squared tests, ANOVA, Mann-Whitney tests, Kruskal-Wallis tests, Pearson correlation, and diagnostic performance metrics (sensitivity, specificity, PPV, NPV, LR+, LR-, accuracy, AUC).
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