PURPOSE: Portable Monitoring (PM) type 3 device is a viable option for evaluating patients with clinical suspicion for sleep-disordered breathing (SDB), as an alternative to full Polisomnography, helping to reduce sleep labs waiting lists. Although the interobserver reliability of the scoring of these studies has not been described. The purpose of this study is to describe the interobserver agreement among different sleep scorers in a population with suspected SDB using a PM device.
METHODS: Twenty consecutive patients, older than 18ys, with suspected SDB were studied with a PM device (Stardust II, Respironics). Scoring was performed manually by 2 experienced physician specialized in sleep medicine (A-B) and an in-training sleep technician (C), using scoring criteria consistent with current published AASM standards. No scorer had knowledge of any other scorers’ results. Agreement was tabulated for total and partial amount of respiratory events and for every respective index. The severity of SDB was establish according the AHI level, normal < 5 ev/h; mild 5–14.9 ev/h; moderate 15–29.9 ev/h and severe ≥ 30 ev/h. The interobserver variability was assessed with percentage of agreement and kappa coefficient, a kappa value > 0.7 was considered acceptable. One way ANOVA was used to analyze mean differences between scorers.
RESULTS: 13/20 males; age 48.1±17.3 ys; BMI 28.6±5. The mean difference in AHI (apnoea hypopnoea index) calculated for every patient between both experienced scorers was 3.32±3.78 ev/h. If compare with the in-training technician the mean differences were 4.81±5.55 and 1.49±4.74 (F=2.46; p=>0.09; ns). When the severity level of diagnosis was compared, the agreement/kappa were: A-B=85%/0.77; A-C=75%/0.63 and B-C=80%/0.71.
CONCLUSION: The level of agreement between experienced manual scorers in a population with suspicion for SDB studied with PM was in the range of acceptable to excellent and similar to those described in previous studies with full PSG. The in-training observer has a lesser level of agreement with each experienced scorers, more accumulate experienced could be required.
CLINICAL IMPLICATIONS: Interobserver agreement is acceptable for PM in experienced scorers.
DISCLOSURE: Facundo Nogueira, No Financial Disclosure Information; No Product/Research Disclosure Information