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Tytuł:
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A new tool to screen patients with severe obstructive sleep apnea in the primary care setting: a prospective multicenter study.
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Autorzy:
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Peñacoba P; Sleep Unit, Department of Respiratory Diseases, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain. .; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. .
Llauger MA; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; Equip d'Atenció Primària Encants, Centre d'Atenció Primària (CAP) Maragall, Institut Català de La Salut, Barcelona, Spain.
Fortuna AM; Sleep Unit, Department of Respiratory Diseases, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
Flor X; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; CAP Chafarinas, Institut Català de La Salut, Barcelona, Spain.
Sampol G; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; Sleep Unit, Service of Pneumology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.; Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de Investigación Carlos III, Madrid, Spain.
Pedro-Pijoan AM; Àrea Bàsica de Salut Gaudí, Consorci Sanitari Integral, Barcelona, Spain.
Grau N; Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de Investigación Carlos III, Madrid, Spain.; Sleep Unit, Department of Respiratory Medicine, Parc de Salut Mar-IMIM, Hospital del Mar, Barcelona, Spain.
Santiveri C; Service of Pneumology, Hospital Dos de Maig, Consorci Sanitari Integral, Barcelona, Spain.
Juvanteny J; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; CAP Trinitat Vella, Institut Català de La Salut, Barcelona, Spain.
Aoiz JI; CAP El Clot, Institut Català de La Salut, Barcelona, Spain.
Bayó J; CAP El Clot, Institut Català de La Salut, Barcelona, Spain.
Lloberes P; Sleep Unit, Service of Pneumology, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain.; Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de Investigación Carlos III, Madrid, Spain.
Mayos M; Sleep Unit, Department of Respiratory Diseases, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; Centro de Investigación Biomédica en Red Enfermedades Respiratorias (CIBERES), Instituto de Investigación Carlos III, Madrid, Spain.
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Corporate Authors:
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PASHOS Working Group
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Źródło:
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BMC pulmonary medicine [BMC Pulm Med] 2022 Jan 15; Vol. 22 (1), pp. 38. Date of Electronic Publication: 2022 Jan 15.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: London : BioMed Central, [2001]-
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MeSH Terms:
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Diagnostic Techniques and Procedures*
Health Status Indicators*
Sleep Apnea, Obstructive/*diagnosis
Adolescent ; Adult ; Aged ; Continuous Positive Airway Pressure ; Female ; Humans ; Male ; Middle Aged ; Polysomnography ; Primary Health Care ; Prospective Studies ; Referral and Consultation/statistics & numerical data ; Sleep Apnea, Obstructive/therapy ; Spain ; Young Adult
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References:
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Grant Information:
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PI 14/01985 fondo de investigaciones sanitarias
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Contributed Indexing:
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Investigator: L Domínguez Olivera; P Valverde Trillo; M Santos Santos; MDM Farga Martínez; M Reverté Simó; N Argemí Saburit; C Medrano Medrano; M Puig García
Keywords: Continuous positive airway pressure (CPAP); Home sleep apnea test; Obstructive sleep apnea; Primary healthcare; Screening model; Sleep unit
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Molecular Sequence:
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ClinicalTrials.gov NCT02591979
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Entry Date(s):
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Date Created: 20220116 Date Completed: 20220209 Latest Revision: 20220209
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Update Code:
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20240105
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PubMed Central ID:
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PMC8761286
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DOI:
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10.1186/s12890-022-01827-0
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PMID:
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35033055
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Background: The coordination between different levels of care is essential for the management of obstructive sleep apnea (OSA). The objective of this multicenter project was to develop a screening model for OSA in the primary care setting.
Methods: Anthropometric data, clinical history, and symptoms of OSA were recorded in randomly selected primary care patients, who also underwent a home sleep apnea test (HSAT). Respiratory polygraphy or polysomnography were performed at the sleep unit to establish definite indication for continuous positive airway pressure (CPAP). By means of cross-validation, a logistic regression model (CPAP yes/no) was designed, and with the clinical variables included in the model, a scoring system was established using the β coefficients (PASHOS Test). In a second stage, results of HSAT were added, and the final accuracy of the model was assessed.
Results: 194 patients completed the study. The clinical test included the body mass index, neck circumference and observed apneas during sleep (AUC 0.824, 95% CI 0.763-0.886, P < 0.001). In a second stage, the oxygen desaturation index (ODI) of 3% (ODI3% ≥ 15%) from the HSAT was added (AUC 0.911, 95% CI 0.863-0.960, P < 0.001), with a sensitivity of 85.5% (95% CI 74.7-92.1) and specificity of 67.8% (95% CI 55.1-78.3).
Conclusions: The use of this model would prevent referral to the sleep unit for 55.1% of the patients. The two-stage PASHOS model is a useful and practical screening tool for OSA in primary care for detecting candidates for CPAP treatment. Clinical Trial Registration Registry: ClinicalTrials.gov; Name: PASHOS Project: Advanced Platform for Sleep Apnea Syndrome Assessment; URL: https://clinicaltrials.gov/ct2/show/NCT02591979 ; Identifier: NCT02591979. Date of registration: October 30, 2015.
(© 2022. The Author(s).)
