0
Sleep Disorders |

Screening for Obstructive Sleep Apnea in Veterans With Ischemic Heart Disease Using a Computer-Based Clinical Decision Support System

Ali El Solh*, MD; Rachel Laporta, MS; Morohunfolu Akinnusi, MD
Author and Funding Information

SUNY at Buffalo, Buffalo, NY


Chest. 2012;142(4_MeetingAbstracts):1047A. doi:10.1378/chest.1383306
Text Size: A A A
Published online

Abstract

SESSION TYPE: Sleep I

PRESENTED ON: Sunday, October 21, 2012 at 10:30 AM - 11:45 AM

PURPOSE: To assess the validity of a handheld clinical decision-support system (CDSS) in detecting OSA in veterans with ischemic heart disease against polysomnography (PSG) and to compare the diagnostic accuracy of the CDSS versus the Berlin questionnaire.

METHODS: We enrolled prospectively 143 patients with underlying ischemic heart disease. Veterans with history of neurologic disease, systolic congestive heart failure, or receiving opiates were excluded from participation. Participants were asked to complete the Berlin Questionnaire and to answer all eight questions of CDSS-software. At the end of the interview, veterans were scheduled for an in-laboratory polysomnogram.

RESULTS: Ninety one patients completed the study. The prevalence of OSA (AHI ≥ 5/hr) was 74.7% with a median AHI of 11.5/hr (range 0-90). When compared to PSG, the CDSS and the Berlin questionnaire achieved a sensitivity of 98.5% (95% confidence interval [CI] 92.1-100) and 80.9% (95% CI 69.5-89.4) and a specificity of 86.9% (95% CI 66.4-97.2) and 39.1% (95% CI 19.7-61.5) at a threshold value of AHI ≥5 with a corresponding area under the curve (AUC) of 0.93 (95% CI 0.85-0.97) and 0.60 (95% CI 0.49-0.70); respectively.

CONCLUSIONS: CDSS is a superior screening tool for identifying cardiac Veterans with undiagnosed OSA than the BQ.

CLINICAL IMPLICATIONS: The availability of a CSDD offers healthcare providers a superior tool for screening of OSA in this population. The implementation of such a tool may provide sufficient lead time to impact the progression of cardiovascular diseases.

DISCLOSURE: The following authors have nothing to disclose: Ali El Solh, Rachel Laporta, Morohunfolu Akinnusi

No Product/Research Disclosure Information

SUNY at Buffalo, Buffalo, NY

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
PubMed Articles
Guidelines
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543