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Model for prediction of pediatric OSA : Proposal for a clinical decision rule
Author(s) -
Certal Victor,
Silva Hélder,
Carvalho Carlos,
CostaPereira Altamiro,
Azevedo Inês,
Winck João,
Capasso Robson,
Camacho Macario
Publication year - 2015
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.25438
Subject(s) - medicine , clinical prediction rule , confidence interval , obstructive sleep apnea , receiver operating characteristic , otorhinolaryngology , logistic regression , body mass index , odds ratio , stepwise regression , tonsillectomy , pediatrics , prospective cohort study , polysomnography , tonsil , apnea , surgery
Objectives/Hypothesis Obstructive sleep apnea (OSA) is a syndrome frequently diagnosed in children; however, it lacks optimal diagnostic methods. This study aimed to provide a clinical decision rule for predicting pediatric OSA using commonly available clinical information. Study Design A prospective cohort study. Methods Children between the ages of 3 to 6 years‐old, referred for an otorhinolaryngology consultation due to clinical suspicion of OSA, were recruited from January to June 2014. At baseline age, weight, height, gender, body mass index, Pediatric Sleep Questionnaire (PSQ) scores, tonsil size, and oxygen desaturation index (ODI) were assessed. A logistic regression modeling was used with backward stepwise elimination to develop a prediction model. Results Sixty‐seven children were included with a mean age of 4.51 years. Of the 67 children included in this study, 25 (37.3%) subjects were diagnosed with pediatric OSA. Significant predictors of pediatric OSA in the final model (odds ratio, 95% confidence interval) included PSQ score (5.12; 3.3–6.5), ODI (1.34; 1.0–1.79) and tonsil size (6.7; 3.22–9.75). The final decision rule had a sensitivity of 88% and a specificity of 86%. The area under the receiver operating characteristic curve was 0.897. Conclusion The proposed clinical decision rule, based on three readily available variables, is a promising discriminating instrument for prediction of OSA among children between 3 and 6 years. Level of Evidence 2b. Laryngoscope , 125:2823–2827, 2015