title: Clinical Utility of Berlin Questionnaire in Comparison to Polysomnography in Patients with Obstructive Sleep Apnea.
abstract: The aim of this study was to assess the utility of the Berlin questionnaire (BQ) in adult patients at high risk of obstructive sleep apnea (OSA). The study consisted of 64 patients recruited for the polysomnography diagnostics of sleep respiratory disturbances. The anthropometric assessment included body weight, height, and body mass index (BMI), all related to the risk of OSA. The BQ consisted of the following three categories: 1 - snoring, 2 - daytime somnolence, and 3 - hypertension. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were evaluated. Likelihood ratio was used to assess the diagnostic accuracy. We found that patients were, on average obese; the mean BMI amounted to 31.9 ± 6.0 kg/m2. Polysomnography identified OSA in 73.4% of patients (AHI >5), where the BQ categorized 87.5% of patients at high risk of OSA. Sensitivity of the BQ was 87.2%, specificity 11.8%, PPV 73.2%, and NPV 25.0%. Diagnostic accuracy assessed by the likelihood ratio had a value of 1.00. The BQ had a false discovery rate of 31.2% and misclassification rate of 32.8%. We conclude that the BQ is a sensitive tool that should be used in clinical settings in which the benefit of high sensitivity outweighs the disadvantage of low specificity.
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 114-116 Arthur-Scheunert-Allee, Nuthetal, 14558, Potsdam, Germany. stelmach@dife.de.|Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland. stelmach@dife.de.
authors.forename: Marta
authors.initials: M
authors.lastname: Stelmach-Mardas
authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, 114-116 Arthur-Scheunert-Allee, Nuthetal, 14558, Potsdam, Germany.
authors.forename: Khalid
authors.initials: K
authors.lastname: Iqbal
authors.affiliation: Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, Poznan, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Mardas
authors.affiliation: Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Kostrzewska
authors.affiliation: Department of Pulmonology, Allergology and Respiratory Oncology, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Piorunek
mesh_terms: D001604:Berlin; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: Apnea-hypopnea index; Diagnostic tool; Hypertension; Obesity; Obstructive sleep apnea; Polysomnography; Questionnaire; Sleep disordered breathing