Computer-Assisted Diagnosis of the Sleep Apnea-Hypopnea Syndrome: A Review

Table 6

Validation of respiratory event classification approaches (see text for details). = number of participants/recordings; AHI = Apnea-Hypopnea Index; TR = training set; TS = testing set; A = apnea; H = hypopnea; N = normal breathing; CA = central apnea; OA = obstructive apnea; MA = mixed apnea; PPV = positive predictive value; NPV = negative predictive value; AUC = areas under ROC curve; ACC = accuracy; ICC = intraclass correlation coefficient; = weighted Kappa coefficient; = Pearson’s linear correlation coefficient; S = single validation set; CV = cross-validation. ¹Minimum and maximum values.

Study source	Database	/ratio male	Age (mean ± std.)	AHI (mean ± std.)	Reference test	Event definition	Number of events	Sensitivity (%)	Specificity (%)	Others	Validation
Reisch et al. [46]	Ambrock Hospital, Germany	51/0.90	51.2	9.1	Same-night Level 1 PSG	See [46]	50 (H1) 50 (H2) 50 (OA) 50 (MA) 50 (CA)	56–85 (H1); 74–85 (H2); 25–94 (OA); 82–88 (MA); 60–88 (CA)	90–98 (H1); 90–98 (H2); 96–100 (OA); 87–100 (MA); 96–100 (CA)	—	TR/TS
Al-Ashmouny et al. [54]	Cairo University, Egypt	—/—	—	—	—	—	3626	—	—	—	S
Taha et al. [55]	Wisconsin sleep cohort study [71]	10/—	51.8 ± 7.17	18.2 ± 16.2	Same-night Level 1 PSG	See [55]	142 (OA) 41 (CA); 7 (MA)	68.3 (OA); 75.6 (CA); 100 (MA)	96.0 (OA); 100 (CA); 77.5 (MA)	ACC = 0.71	S
Sommermeyer; et al. [57]	Sahlgrenska University Hospital, Sweden, and sleep centers in Ulm, Berlin and Nuremberg, Germany	66/0.63	54 ± 14	19.3 ± 18.5	Same-night Level 3 PG	See [57]	3673 (OA); 1042 (CA)	—	—	= 0.87 (OA); = 0.95 (CA)	S
Steltner et al. [58]	Freiburg University Hospital, Germany	19/1.00	59.9 ± 10.6	16.5 ± 13.29	Same-night Level 1 PSG	See [58]	3957 (scorer 1); 2966 (scorer 2)	Scorer 1 =; 60 (H); 63 (OA); 20 (MA); 37 (CA); Scorer 2 =; 72 (H); 52 (OA); 0 (MA); 39 (CA)	—	= 0.45 ± 0.15; (scorer 1); 0.40 ± 0.19 (scorer 2)	CV (Leave-one-out P)
Várady et al. [59]	—	6/—	—	—	PSG (unknown level or timing)	—	189 (5 min each)	—	—	ACC = 0.91	S
Houdt et al. [60]	Sleep Medicine Center, Kempenhaeghe, The Netherlands	11/0.91	49.1 ± 11.4	16.5 ± 13.3	Same-night Level 1 PSG	AASM2007	—	—	—	ACC = 0.68	S
Al-Ani et al. [79]	Raymond Poincare Hospital, France	—/—	—	—	—	—	—	—	—	ACC = 0.90–1.00	—
Fontenla-Romero et al. [80]	Complejo Hospitalario Universitario de A Coruña, Spain	6/—	—	—	Same-night Level 1 PSG	—	40 (OA); 40 (MA); 40 (CA)	—	—	ACC =; 0.81 (OA); 0.80 (MA); 0.90 (CA)	CV (100 × 10 K-fold)
Tagluk et al. [81]	Medicine Faculty of Dicle University, Turkey	21/0.71	21–67^1	—	Same-night Level 1 PSG	—	120 (OA); 120 (CA); 120 (MA)	—	—	ACC =; 0.73 (OA); 0.94 (CA); 0.66 (MA)	TR/TS (240)
Tagluk and Sezgin [82]	Medicine Faculty of Dicle University, Turkey	21/0.71	21–67^1	—	Same-night Level 1 PSG	—	120 (OA); 120 (CA); 120 (MA)	—	—	ACC =; 0.85 (OA); 0.94 (CA); 0.78 (MA)	TR/TS (240)
Sezgin and; Emin Tagluk [78]	Medicine Faculty of Dicle University, Turkey	21/0.67	21–57^1	—	Same-night Level 1 PSG	—	120 (OA); 120 (CA); 120 (MA)	—	—	ACC = 0.86 (OA); 0.95 (CA); 0.80 (MA)	TR/TS (240)
Guijarro-Berdiñas et al. [83]	Complejo Hospitalario Universitario de A Coruña, Spain	6/—	—	—	Same-night Level 1 PSG	—	40 (OA); 40 (MA); 40 (CA)	89.6 (OA); 92.2 (MA); 89.0 (CA)	97.1 (OA); 89.6 (MA); 98.6 (CA)	ACC =; 0.95 (OA); 0.90 (MA); 0.95 (CA)	CV (100 × 10 K-fold)
Maali et al.; [77]	Concord Hospital, Australia	—/—	—	—	—	—	—	—	—	ACC = 0.84	—
Morgenstern; et al. [84]	Sleep Lab, Bethanien Hospital, Germany	28/—	52.6 ± 15.6	18.9 ± 18.5	Same-night Level 1 PSG	AASM1999	769 (H)	90	90	ACC = 0.90	CV (100 K-fold)