title: The Prioritization of Clinical Risk Factors of Obstructive Sleep Apnea Severity Using Fuzzy Analytic Hierarchy Process.
abstract: Recently, there has been a problem of shortage of sleep laboratories that can accommodate the patients in a timely manner. Delayed diagnosis and treatment may lead to worse outcomes particularly in patients with severe obstructive sleep apnea (OSA). For this reason, the prioritization in polysomnography (PSG) queueing should be endorsed based on disease severity. To date, there have been conflicting data whether clinical information can predict OSA severity. The 1,042 suspected OSA patients underwent diagnostic PSG study at Siriraj Sleep Center during 2010-2011. A total of 113 variables were obtained from sleep questionnaires and anthropometric measurements. The 19 groups of clinical risk factors consisting of 42 variables were categorized into each OSA severity. This study aimed to array these factors by employing Fuzzy Analytic Hierarchy Process approach based on normalized weight vector. The results revealed that the first rank of clinical risk factors in Severe, Moderate, Mild, and No OSA was nighttime symptoms. The overall sensitivity/specificity of the approach to these groups was 92.32%/91.76%, 89.52%/88.18%, 91.08%/84.58%, and 96.49%/81.23%, respectively. We propose that the urgent PSG appointment should include clinical risk factors of Severe OSA group. In addition, the screening for Mild from No OSA patients in sleep center setting using symptoms during sleep is also recommended (sensitivity = 87.12% and specificity = 72.22%).
authors.affiliation: Department of Mathematics, King Mongkut's University of Technology Thonburi, Bangkok 10140, Thailand.
authors.forename: Thaya
authors.initials: T
authors.lastname: Maranate
authors.affiliation: Department of Mathematics, King Mongkut's University of Technology Thonburi, Bangkok 10140, Thailand.
authors.forename: Adisak
authors.initials: A
authors.lastname: Pongpullponsak
authors.affiliation: Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
authors.forename: Pimon
authors.initials: P
authors.lastname: Ruttanaumpawan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000886:Anthropometry; D001835:Body Weight; D005163:Factor Analysis, Statistical; D005260:Female; D017143:Fuzzy Logic; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D017286:Polysomnography; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012890:Sleep; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000473:pathology*; D011795:Surveys and Questionnaires; D055815:Young Adult