title: Performance characteristics of the French version of the severity hierarchy score for paediatric sleep apnoea screening in clinical settings.
abstract: Paediatric obstructive sleep apnoea syndrome (OSAS) is a highly prevalent condition carrying increased risk for impaired cognitive and cardiovascular function. The standard diagnosis consists of full-night polysomnography (PSG), but limited access to PSG leads to substantial under-diagnosis. The use of a validated and simple diagnostic screening tool to predict OSAS could prioritise night sleep recordings in children at risk of OSAS, and help in clinical decision-making.
  
  
  
  This study aimed to prospectively assess the performance of the French version of the severity hierarchy score (SHS) in paediatric OSAS. This score consists of a discriminative subset of six respiratory items, and has already been validated in English for screening OSAS in the general paediatric population.
  
  
  
  A total of 96 children (mean age 7.1 ± 2.4 years; BMI z-score: -0.03 ± 1.50) were recruited; they had been were referred to two academic sleep centres in France for the putative diagnosis of sleep-disordered breathing. The parents completed the SHS questionnaire prior to PSG. Sensitivity and specificity of the SHS for detecting moderate OSAS, defined by an apnoea-hypopnoea index (AHI) of ≥5/hours of total sleep time (TST), were assessed, and ROC analysis was performed.
  
  
  
  An SHS score of >2.75 exhibited an 82% sensitivity, 81% specificity, and 92% negative predictive value for detecting an AHI of ≥5/hour TST in the cohort.
  
  
  
  The French version of the SHS emerged as favourably suited for the screening for OSAS in children.
authors.affiliation: Unité Sommeil et Fonction Respiratoire, Hôpital Saint-Antoine, Paris, France. Electronic address: nguyenxl@wanadoo.fr.
authors.forename: Xuân-Lan
authors.initials: XL
authors.lastname: Nguyên
authors.affiliation: UPMC & Inserm UMR S 1136 (EPAR team), Département de Santé Publique, Hôpital Tenon, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lévy
authors.affiliation: Unité Fonctionnelle d'Exploration Fonctionnelle Respiratoire et du Sommeil, Hôpital Armand-Trousseau, Groupe Hospitalier Universitaire de l'Est Parisien, (APHP), Paris, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Beydon
authors.affiliation: Sections of Pediatric Sleep Medicine and Pediatric Pulmonology, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, Chicago, IL, USA.
authors.forename: David
authors.initials: D
authors.lastname: Gozal
authors.affiliation: Unité Sommeil et Fonction Respiratoire, Hôpital Saint-Antoine, Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Fleury
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D010372:Pediatrics / Q000379:methods*; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: Diagnosis; Paediatric obstructive sleep apnoea syndrome; Polysomnography; Screening; Severity hierarchy score