A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Temporal and sleep stage‐dependent agreement in manual scoring of respiratory events
Tekijät: Pitkänen, Minna; Pitkänen, Henna; Nath, Rajdeep Kumar; Nikkonen, Sami; Kainulainen, Samu; Korkalainen, Henri; Ólafsdóttir, Kristín Anna; Arnardottir, Erna Sif; Sigurdardottir, Sigridur; Penzel, Thomas; Fanfulla, Francesco; Anttalainen, Ulla; Saaresranta, Tarja; Grote, Ludger; Hedner, Jan; Staats, Richard; Töyräs, Juha; Leppänen, Timo
Kustantaja: Wiley
Julkaisuvuosi: 2025
Journal: Journal of Sleep Research
Tietokannassa oleva lehden nimi: Journal of Sleep Research
Artikkelin numero: e14391
Vuosikerta: 34
Numero: 3
ISSN: 0962-1105
eISSN: 1365-2869
DOI: https://doi.org/10.1111/jsr.14391
Verkko-osoite: http://doi.org/10.1111/jsr.14391
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/470969970
Obstructive sleep apnea diagnosis is based on the manual scoring of respiratory events. The agreement in the manual scoring of the respiratory events lacks an in-depth investigation as most of the previous studies reported only the apnea-hypopnea index or overall agreement, and not temporal, second-by-second or event subtype agreement. We hypothesized the temporal and subtype agreement to be low because the event duration or subtypes are not generally considered in current clinical practice. The data comprised 50 polysomnography recordings scored by 10 experts. The respiratory event agreement between the scorers was calculated using kappa statistics in a second-by-second manner. Obstructive sleep apnea severity categories (no obstructive sleep apnea/mild/moderate/severe) were compared between scorers. The Fleiss' kappa value for binary (event/no event) respiratory event scorings was 0.32. When calculated separately within N1, N2, N3 and R, the Fleiss' kappa values were 0.12, 0.23, 0.22 and 0.23, respectively. Binary analysis conducted separately for the event subtypes showed the highest Fleiss' kappa for hypopneas to be 0.26. In 34% of the participants, the obstructive sleep apnea severity category was the same regardless of the scorer, whereas in the rest of the participants the category changed depending on the scorer. Our findings indicate that the agreement of manual scoring of respiratory events depends on the event type and sleep stage. The manual scoring has discrepancies, and these differences affect the obstructive sleep apnea diagnosis. This is an alarming finding, as ultimately these differences in the scorings affect treatment decisions.
Ladattava julkaisu This is an electronic reprint of the original article. |
Julkaisussa olevat rahoitustiedot:
This research was supported by research funding from the European Union's Horizon 2020 research and innovation programme under grant agreement no. 965417, Finnish Cultural Foundation – Central Fund, the State Research Funding for university-level health research, Kuopio University Hospital, Wellbeing Service County of North Savo (5041794, 5041797, 5041803, 5041804, 5041809, 5041812), the Magnus Ehrnrooth Foundation, and Sigrid Jusélius Foundation (230216). LG was supported by the Swedish Heart and Lung Foundation (20210529) and the ALF Agreement (ALFGBG966283).