Title
The Generalizability of the Clinical Assessment Score-15 for Pediatric Sleep-Disordered Breathing.
Document Type
Article
Publication Date
9-2020
Identifier
DOI: 10.1002/lary.28428
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, 130:2256-2262, 2020.
Journal Title
The Laryngoscope
Volume
130
Issue
9
First Page
2256
Last Page
2262
Keywords
Sleep-disordered breathing; diagnosis; obstructive sleep apnea; pediatric; polysomnography
Recommended Citation
Goldstein, N. A., Friedman, N. R., Nardone, H. C., Aljasser, A., Tobey, A. B., Don, D., Baroody, F. M., Lam, D. J., Goudy, S., Ishman, S. L., Arganbright, J. M., Baldassari, C., Schreinemakers, J., Wine, T. M., Ruszkay, N. J., Alammar, A., Shaffer, A. D., Koempel, J. A., Weedon, J. The Generalizability of the Clinical Assessment Score-15 for Pediatric Sleep-Disordered Breathing. The Laryngoscope 130, 2256-2262 (2020).
Comments
Grant support