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- Title
The Generalizability of the Clinical Assessment Score-15 for Pediatric Sleep-Disordered Breathing.
- Authors
Goldstein, Nira A.; Friedman, Norman R.; Nardone, Heather C.; Aljasser, Abdullah; Tobey, Allison B.J.; Don, Debra; Baroody, Fuad M.; Lam, Derek J.; Goudy, Steven; Ishman, Stacey L.; Arganbright, Jill M.; Baldassari, Cristina; Schreinemakers, J.B.S.; Wine, Todd M.; Ruszkay, Nicole J.; Alammar, Ahmed; Shaffer, Amber D.; Koempel, Jeffrey A.; Weedon, Jeremy
- Abstract
<bold>Objective: </bold>The Clinical Assessment Score-15 (CAS-15) has been validated as an office-based assessment for pediatric sleep-disordered breathing in otherwise healthy children. Our objective was to determine the generalizability of the CAS-15 in a multi-institutional fashion.<bold>Methods: </bold>Five hundred and thirty children from 13 sites with suspected sleep-disordered breathing were recruited, and the investigators completed the CAS-15. Based on decisions made in the course of clinical care, investigators recommended overnight polysomnography, observation, medical therapy, and/or surgery. Two hundred and forty-seven subjects had a follow-up CAS-15.<bold>Results: </bold>Mean age was 5.1 (2.6) years; 54.2% were male; 39.1% were white; and 37.0% were African American. Initial mean (standard deviation [SD]) CAS-15 was 37.3 (12.7), n = 508. Spearman correlation between the initial CAS-15 and the initial apnea-hypopnea index (AHI) was 0.41 (95% confidence interval [CI], 0.29, 0.51), n = 212, P < .001. A receiver-operating characteristic curve predicting positive polysomnography (AHI > 2) had an area under the curve of 0.71 (95% CI, 0.63, 0.80). A score ≥ 32 had a sensitivity of 69.0% (95% CI, 61.7, 75.5), a specificity of 63.4% (95% CI, 47.9, 76.6), a positive predictive value of 88.7% (95% CI, 82.1, 93.1), and a negative predictive value of 32.9% (95% CI, 23.5, 44.0) in predicting positive polysomnography. Among children who underwent surgery, the mean change (SD) score was 30.5 (12.6), n = 201, t = 36.85, P < .001, effect size = 3.1.<bold>Conclusion: </bold>This study establishes the generalizability of the CAS-15 as a useful office tool for the evaluation of pediatric sleep-disordered breathing.<bold>Level Of Evidence: </bold>2B Laryngoscope, 130:2256-2262, 2020.
- Subjects
SLEEP apnea syndromes; STANDARD deviations; RANK correlation (Statistics); NONPARAMETRIC statistics; RESEARCH; PREDICTIVE tests; RESEARCH evaluation; RESEARCH methodology; POLYSOMNOGRAPHY; EVALUATION research; MEDICAL cooperation; SEVERITY of illness index; COMPARATIVE studies; SYMPTOMS; RESEARCH funding; RECEIVER operating characteristic curves
- Publication
Laryngoscope, 2020, Vol 130, Issue 9, p2256
- ISSN
0023-852X
- Publication type
journal article
- DOI
10.1002/lary.28428