Journal article
The generalizability of the clinical assessment score-15 for pediatric sleep-disordered breathing
LARYNGOSCOPE, v 130(9), pp 2256-2262
Sep 2020
PMID: 31782808
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective 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. Methods 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. Results 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. Conclusion This study establishes the generalizability of the CAS-15 as a useful office tool for the evaluation of pediatric sleep-disordered breathing. Level of Evidence 2B Laryngoscope, 2019
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Details
- Title
- The generalizability of the clinical assessment score-15 for pediatric sleep-disordered breathing
- Publication Details
- LARYNGOSCOPE, v 130(9), pp 2256-2262
- Publisher
- WILEY; HOBOKEN
- Number of pages
- 0
- Grant note
- Drs. Lam and Ishman are site principal investigators and grant recipients from Inspire for a multicenter clinical trial of the hypoglossal nerve stimulator. Dr. Ishman serves as a consultant for Medtronic and Genus Life Sciences. Dr. Shaffer receives salary support from the National Institute on Deafness and Other Communication Disorders (NIDCD) (grant 1R21DC017553-01) for device-assisted exercises for improving Eustachian tube function; and the National Institute on Deafness and Other Communication Disorders (NIDCD) (grant 1U01DC014706-01A1) for a randomized controlled trial of Vancyclovir for CMV hearing impaired infants. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:000499275900001
- Scopus ID
- 2-s2.0-85076432939
- Other Identifier
- 991021860682104721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Medicine, Research & Experimental
- Otorhinolaryngology