title: Clinical risk assessment model for pediatric obstructive sleep apnea.
abstract: To develop a clinical risk prediction model that identifies children with obstructive sleep apnea (OSA) in a clinical setting by examining the symptoms, physical status, and OSA-18 questionnaire results.
  
  
  
  Single institutional, cross-sectional study.
  
  
  
  Children aged 2 to 18 years with symptoms of OSA were enrolled. Pediatric OSA was diagnosed through full-night polysomnography. Clinical data, namely demographics, symptoms, OSA-18 survey results, tonsil and adenoid sizes, and the weight of each child, were examined for constructing a simple point-based clinical model for OSA prediction. Variables for the risk model were selected using multivariable logistic regression analyses.
  
  
  
  Of the 310 participants (mean age, 7.6 ± 3.7 years; boys, 67%), 170 (55%) experienced OSA. Modeling variables were determined using several univariate logistic regression analyses, followed by multivariable logistic regression analyses. A point-based clinical model incorporating the age, tonsil size (5 points maximum), adenoid size (5 and 20 points for age > 6 years and < 6 years, respectively), obesity (5 points for age > 6 years), and breathing pauses (5 points) was developed (area under the curve = 0.832). Moreover, the optimal cutoff points for predicting the apnea-hypopnea index of > 1 and > 5 were 10 (sensitivity, 72.9%; specificity, 65.0%) and 12 (sensitivity, 77.5%; specificity, 56.9%), respectively. Internal validation using the bootstrap method revealed no apparent overfitting problem.
  
  
  
  A novel clinical prediction model was developed for determining the risk of pediatric OSA; the model can be useful in identifying high-risk patients among those with sleep disturbances.
  
  
  
  4. Laryngoscope, 126:2403-2409, 2016.
authors.affiliation: Department of Otolaryngology, National Taiwan University Hospital, Taipei.|Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University Hospital, Taipei.|Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.
authors.forename: Kun-Tai
authors.initials: KT
authors.lastname: Kang
authors.affiliation: Sleep Center, National Taiwan University Hospital, Taipei.|Department of Pediatrics, National Taiwan University Hospital, Taipei.
authors.forename: Wen-Chin
authors.initials: WC
authors.lastname: Weng
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University Hospital, Taipei.|Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan.
authors.forename: Chia-Hsuan
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, National Taiwan University Hospital, Taipei.
authors.forename: Tzu-Yu
authors.initials: TY
authors.lastname: Hsiao
authors.affiliation: Sleep Center, National Taiwan University Hospital, Taipei.|Department of Internal Medicine, National Taiwan University Hospital, Taipei.
authors.forename: Pei-Lin
authors.initials: PL
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, National Taiwan University Hospital, Taipei. hsuwc@ntu.edu.tw.|Sleep Center, National Taiwan University Hospital, Taipei. hsuwc@ntu.edu.tw.
authors.forename: Wei-Chung
authors.initials: WC
authors.lastname: Hsu
mesh_terms: D000234:Adenoids / Q000473:pathology; D000293:Adolescent; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009929:Organ Size; D014066:Palatine Tonsil / Q000473:pathology; D017286:Polysomnography / Q000379:methods*; D012016:Reference Values; D018570:Risk Assessment / Q000379:methods*; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D063189:Symptom Assessment / Q000379:methods*
keywords: Child; physical examination; polysomnography; questionnaires; sleep apnea syndromes; symptom assessment