| Abstract | Cilj: Procijeniti osjetljivost i specifičnost Briselskog upitnika u procjeni rizika za OSA-u i prometne nezgode, te obilježja ROC krivulje Briselskog upitnika u pacijenata u Centru za medicinu spavanja Medicinskog fakulteta u Splitu i Kliničkog bolničkog centra Split.
Ispitanici i metode: U istraživanju je sudjelovalo ukupno 1293 pacijenata (813 muškaraca i 482 žena), prosječne životne dobi od 59,74 ± 14,49 godina. Podatci o ispitanicma koji su bili upućeni u Centar za medicinu spavanja Medicinskog fakulteta Sveučilišta u Splitu i Kliničkog bolničkog centra Split prikupljeni su i šifrirane baze podataka. U ovo istraživanje uključeni su antropometrijski podatci, podatci o anamnezi spavanja i komorbiditetima, nalaz cjelonoćne polisomnografije/poligrafije i upitnika probira koji su uključili Briselski upitnik kojim se procjenjuje rizik za prometne nesreće uslijed pospanosti za volanom i ESS upitnik kojim je procijenjena dnevna pospanost u osam uobičajenih dnevnih situacija.
Rezultati: Od ukupnog broja pacijenata, vozača je bilo 805 (62,26%), više muškaraca u odnosu na žene (610 (75,8%) vs. 195 (24,2%), P<0,001). Muškarci su imali značajno više prometnih nesreća u odnosu na žene (P<0,001), više zamijećenih zastoja disanja tijekom spavanja (P<0,001) kao i smetnji hrkanja tijekom spavanja (P=0,006). Prosječna vrijednost AHI bila je značajno veća u muškaraca u odnosu na žene (29,66 ± 26,04 vs. 17,31 ± 20,98, P<0,001). Rezultati našeg istraživanja pokazuju da od ukupnog broja ispitanika 882 (74,4%) nema rizik za prometne nezgode, dok 304 (25,6%) ima rizik za prometne nezgode prema rezultatima Briselskog upitnika. Nadalje, od 304 ispitanika koji su imali rizik za prometne nezgode 276 (90,8%) imalo je dijagnosticiranu OSA (AHI>5), dok je među 882 ispitanika koji nisu imali rizik za prometne nezgode prema rezultatima Briselskog upitnika 694 (78,7%) ispitanika imalo dijagnosticiranu OSA-u (AHI>5). Briselski upitnik je u prepoznavanju OSA-e imao visoku specifičnost koja je iznosila 87,04 dok mu je osjetljivost iznosila 28,45 (AUC 0,58, P<0,001).
Zaključak: Briselski upitnik je jednostavan alat za probir rizika za OSA-u u osoba koje prijavljuju vozački ispit i žele dobiti vozačku dozvolu, no s obzirom na svoju nisku osjetljivost i visoku specifičnost možemo zaključiti da ne pokazuje dobru dijagnostičku valjanost s obzirom da je vrijednost AUC iznosila manje od 0,58. Manjak objavljenih istraživanja o vrijednosti osjetljivosti i specifičnosti Briselskog upitnika u prepoznavanju rizičnih OSA pacijenata razlog je potrebe za daljnjim istraživanjima i to na većoj skupini pacijenata kako bi se utvrdila valjanost ovoga upitnika u probiru rizika za OSA-u. |
| Abstract (english) | Objective: To evaluate the sensitivity and specificity of the Brussels questionnaire in assessing the risk for OSA and traffic accidents, and the characteristics of the ROC curve of the Brussels questionnaire in patients at the Sleep Medicine Center of the University of Split School of Medicine and the Clinical Hospital Center Split.
Participants and Methods: The study included 1293 patients (813 men and 482 women) with an average age of 59.74 ± 14.49 years, referred to the Sleep Medicine Center of the University of Split School of Medicine and the Clinical Hospital Center Split. Data collected encompassed anthropometric measurements, sleep history, comorbidities, overnight polysomnography/poligraphy findings, and responses to screening questionnaires, including the Brussels questionnaire for traffic accident risk due to drowsiness and the ESS questionnaire for daytime sleepiness.
Results: Of the total number of patients, there were 805 drivers (62.26%), more men than women (610 (75.8%) vs. 195 (24.2%), P<0.001). Men had significantly more traffic accidents compared to women (P<0.001), more observed respiratory arrests during sleep (P<0.001), and more snoring disturbances during sleep (P=0.006). The average AHI value was significantly higher in men compared to women (29.66 ± 26.04 vs. 17.31 ± 20.98, P<0.001). Our study results show that out of the total number of participants, 882 (74.4%) had no risk for traffic accidents, while 304 (25.6%) had a risk for traffic accidents according to the Brussels questionnaire results. Furthermore, out of the 304 participants who had a risk for traffic accidents, 276 (90.8%) were diagnosed with OSA (AHI>5), while among the 882 participants who did not have a risk for traffic accidents according to the Brussels questionnaire results, 694 (78.7%) were diagnosed with OSA (AHI>5). The Brussels questionnaire had high specificity of 87.04 in identifying OSA, but its sensitivity was 28.45 (AUC 0.58, P<0.001).
Conclusion: The Brussels questionnaire is a simple screening tool for assessing the risk of OSA in individuals applying for a driving test and wanting to obtain a driver's license. However, given its low sensitivity and high specificity, we can conclude that it does not demonstrate good diagnostic validity, as the AUC value was less than 0.58. The lack of published research on the sensitivity and specificity values of the Brussels questionnaire in recognizing high-risk OSA patients indicates the need for further research on a larger group of patients to determine the validity of this questionnaire in screening for OSA risk. |
