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Prediction of obstructive sleep apnea using visual photographic analysis
- Source :
- Journal of clinical anesthesia. 32
- Publication Year :
- 2013
-
Abstract
- Obstructive sleep apnea (OSA) has been historically underdiagnosed and may be associated with grave perioperative complications. The ASA and American Academy of Sleep Medicine recommend OSA screening prior to surgery; however, only a minority of patients are screened. The objective of this study was to determine the proficiency of anesthesiologists, otolaryngologists, and internists at predicting the presence of OSA by visual photographic analysis without the use of a computer program to assist, and determine if prediction accuracy varies by provider type.Prospective case seriesTertiary care hospital-based academic centerFifty-six consecutive patients presenting to the sleep laboratory undergoing polysomnography had frontal and lateral photographs of the face and torso taken.Not applicable.Polysomnography outcomes and physician ratings. An obstructive apnea hypopnea index (oAHI) ≥15 was considered "positive." Twenty anesthesiologists, 10 otolaryngologists, and 11 internists viewed patient photographs and scored them as OSA "positive" or "negative" before and after being informed of patient comorbidities.Nineteen patients had an oAHI15, 18 were ≥15 but30, and 19 were ≥30. The mean oAHI was 28.7 ± 26.7 events/h (range, 0-125.7), and the mean body mass index was 34.1 ± 9.7 kg/m(2) (range, 17.4-63.7). Overall, providers predicted the correct answer with 61.8% accuracy without knowledge of comorbidities and 62.6% with knowledge (P.0001). There was no difference between provider groups (P = .307). Prediction accuracy was unrelated to patient age (P = .067), gender (P = .306), or race (P = .087), but was related to body mass index (P = .0002).The ability to predict OSA based on visual inspection of frontal and lateral photographs is marginally superior to chance and did not differ by provider type. Knowledge of comorbidities did not improve prediction accuracy.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Polysomnography
Sleep medicine
03 medical and health sciences
Young Adult
0302 clinical medicine
030202 anesthesiology
medicine
Photography
Humans
Prospective Studies
Prospective cohort study
Aged
Aged, 80 and over
Sleep Apnea, Obstructive
medicine.diagnostic_test
business.industry
Sleep apnea
Reproducibility of Results
Torso
Perioperative
Middle Aged
medicine.disease
Obstructive sleep apnea
Anesthesiology and Pain Medicine
Face
Physical therapy
Female
business
Hypopnea
Body mass index
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 18734529
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Journal of clinical anesthesia
- Accession number :
- edsair.doi.dedup.....fee0e11a042365723defee41028e5a96