Agreement in the Scoring of Respiratory Events and Sleep Among International Sleep Centers

Agreement in the Scoring of Respiratory Events and Sleep Among International Sleep Centers

Author Magalang, Ulysses J. Google Scholar
Chen, Ning-Hung Google Scholar
Cistulli, Peter A. Google Scholar
Fedson, Annette C. Google Scholar
Gislason, Thorarinn Google Scholar
Hillman, David Google Scholar
Penzel, Thomas Google Scholar
Tamisier, Renaud Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Phillips, Gary Google Scholar
Pack, Allan I. Google Scholar
SAGIC Investigators Google Scholar
Institution Ohio State Univ
Chang Gung Mem Hosp
Royal N Shore Hosp
Univ Sydney
Univ Penn
Landspitali Univ Hosp
Sir Charles Gairdner Hosp
Univ Grenoble 1
Universidade Federal de São Paulo (UNIFESP)
Abstract Study Objectives: the American Academy of Sleep Medicine (AASM) guidelines for polysomnography (PSG) scoring are increasingly being adopted worldwide, but the agreement among international centers in scoring respiratory events and sleep stages using these guidelines is unknown. We sought to determine the interrater agreement of PSG scoring among international sleep centers.Design: Prospective study of interrater agreement of PSG scoring.Setting: Nine center-members of the Sleep Apnea Genetics International Consortium (SAGIC).Measurements and Results: Fifteen previously recorded deidentified PSGs, in European Data Format, were scored by an experienced technologist at each site after they were imported into the locally used analysis software. Each 30-sec epoch was manually scored for sleep stage, arousals, apneas, and hypopneas using the AASM recommended criteria. the computer-derived oxygen desaturation index (ODI) was also recorded. the primary outcome for analysis was the intraclass correlation coefficient (ICC) of the apnea-hypopnea index (AHI). the ICCs of the respiratory variables were: AHI = 0.95 (95% confidence interval: 0.91-0.98), total apneas = 0.77 (0.56-0.87), total hypopneas = 0.80 (0.66-0.91), and ODI = 0.97 (0.93-0.99). the kappa statistics for sleep stages were: wake = 0.78 (0.77-0.79), nonrapid eye movement = 0.77 (0.76-0.78), N1 = 0.31 (0.30-0.32), N2 = 0.60 (0.59-0.61), N3 = 0.67 (0.65-0.69), and rapid eye movement = 0.78 (0.77-0.79). the ICC of the arousal index was 0.68 (0.50-0.85).Conclusion: There is strong agreement in the scoring of respiratory events among the SAGIC centers. There is also substantial epoch-by-epoch agreement in scoring sleep variables. Our results suggest that centralized scoring of PSGs may not be necessary in future research collaboration among international sites where experienced, well-trained scorers are involved.
Keywords General
Language English
Sponsor NHLBI
Tzagournis Medical Research Endowment Funds of the Ohio State University
Grant number NHLBI: P01 HL094307
NHLBI: HL093463
Date 2013-04-01
Published in Sleep. Westchester: Amer Acad Sleep Medicine, v. 36, n. 4, p. 591-596, 2013.
ISSN 0161-8105 (Sherpa/Romeo, impact factor)
Publisher Amer Acad Sleep Medicine
Extent 591-596
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000316939000019

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