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

Table 9

Summary table on validation studies of commercial approaches (see text for details); = number of participants/recordings; AHI = Apnea-Hypopnea Index; L = lab; H = home; AUC = area under ROC curve; = Pearson’s correlation coefficient; = Kappa index; ICC = intraclass correlation coefficient. ¹Manual editing of the automatic results was allowed.

System

Device type

Database

/ratio male

Age (mean ± std.)

AHI (mean ± std.)

Reference test

Event definition

Lab/home

Cut-off AHI

Sensitivity (%)

Specificity (%)

Others

Study source

Morpheus I

I

Brigham and Women’s Hospital, USA

31/0.71

44.3 ± 11.3

20.6 ± 23 (scorer 1); 22.5 ± 24.5 (scorer 2)

Same-night Level 1 PSG

H: >30% reduction + 4% desaturation

L

15

—

—

AUC = 0.98

Pittman et al. [105]

Somnolyzer 24x7

I

SIESTA database [106]

51/0.86

51 ± 10

45 ± 31

Same-night Level 1 PSG

—

L

—

—

—

Woertz et al. [107]

-Somnostar 4100

I

Hospital Mutua de Terrassa, Spain

28/0.75

50 ± 8.8

—

Same-night Level 1 PSG

H: significant reduction + [3% desaturation or arousal]

L

10

55

100

ICC = 0.81

Barreiro et al. [108]

Morpheus Hx

III

Brigham and Women’s Hospital, USA

53/0.68

47.8 ± 11.3

15.4 ± 24

Same-night Level 1 PSG

AASM2007

L

15

100

92.7

Amir et al. [109]

ARES

III

Murrieta Sleep Medical Center and Pomona Valley Hospital, USA

284/0.62

48

—

Same-night Level 1 PSG

—

L

10

97.4

85.6

= 0.85

Westbrook et al. [110]

187/0.66

46

—

Different-night Level 1 PSG

—

H

30

79.4

100

= 0.77

Westbrook et al. [110]

NYU Sleep Disorders Center, USA

92/—

—

—

Same-night Level 1 PSG

H: >50% reduction or discernible reduction + 4% desaturation

L

15

95^1

94^1

—

Ayappa et al. [111]

86/—

—

—

Different-night Level 1 PSG

H: >50% reduction or discernible reduction + 4% desaturation

H

15

85^1

91^1

—

Ayappa et al. [111]

Prince of Wales Hospital, The Chinese University of Hong Kong, China

132/0.75

47.8 ± 9.8 (men); 52.3 ± 12.2 (women)

41.6 ± 26.9 (men); 32.3 ± 22.9 (women)

Same-night Level 1 PSG

AASM1999; H: >50% reduction or discernible reduction + [3% desaturation or arousal]

L

5

89

100

AUC = 0.97

To et al. [112]

Somnocheck

III

University of Erlangen-Nuremberg, Germany

51/0.86

53.4 ± 12.9

23.9 ± 26.2

Same-night Level 1 PSG

H: >50% reduction + 4% desaturation

L

10

83

95

= 0.83

Ficker et al. [113]

WristOx 3100

IV

Hospital Aleman, Argentina

154/0.77

50.8 ± 14.3

13.8

Same-night Level 1 PSG

H: discernible reduction + [3% desaturation or arousal]

L

5

89.2

94.2

AUC = 0.96

Nigro et al. [114]

WatchPAT 100

IV

Brigham and Women’s Hospital, USA

30/0.63

47 ± 14.8

23 ± 23.9

Same-night Level 1 PSG

AASM1999; H: >50% reduction or; discernible reduction + [3% desaturation or arousal]

L

20

90.9

84.2

= 0.87

Ayas et al. [115]

Technion Sleep Medicine Center, Israel

102/0.76

41.4 ± 15.2

—

Same-night Level 1 PSG

AASM1999; H: >50% reduction or; discernible reduction + [3% desaturation or arousal]

L

20

—

—

= 0.88; AUC = 0.87

Bar et al. [116]

Brigham and Women’s Hospital, USA

29/0.72

43.2 ± 10.8

31.6 ± 20.6

Same-night Level 1 PSG

AASM1999; H: >50% reduction or; discernible reduction + [3% desaturation or arousal]

L

10

96

100

= 0.89; ICC = 0.88; AUC = 0.96

Pittman et al. [117]

Different-night Level 1 PSG

AASM1999; H: >50% reduction or; discernible reduction + [3% desaturation or arousal]

H

15

96

100

r = 0.72; ICC = 0.72; AUC = 0.97

Pittman et al. [117]

Skaraborg Sleep Study [118], Sweden

98/0.56

60 ± 6.7

25.5 ± 22.9

Same-night Level 2 PSG

H: >50% reduction or; discernible reduction + [4% desaturation or arousal]

H

10

—

—

r = 0.90; AUC = 0.93

Zou et al. [119]

ApneaLink

IV

Prince of Wales Hospital, The Chinese University of Hong Kong, China

50/0.88

50 ± 11.8

—

Same-night Level 1 PSG

AASM1999; H: >50% reduction or; discernible reduction + [3% desaturation or arousal]

L

5

100^1

100^1

AUC^2 = 1.00

Ng et al. [120]

—

59/0.49

57.3 ± 12

—

Same-night Level 1 PSG

AASM1999

L

15

90.9

94.6

AUC = 0.97

Erman et al. [121]

Sleep Disorders Center, King Saud University, Saudi Arabia

95/0.61

46.3 ± 12.6

34.1 ± 32.4

Same-night Level 1 PSG

AASM2007; H: >50% reduction + [3% desaturation or arousal]

L

30

63

98

r = 0.88; AUC = 0.88

Bahammam et al. [122]

Hospital Aleman, Argentina

90/0.77

49.6 ± 15.1

—

Same-night Level 1 PSG

H: >50% reduction

L

30

88.5

95.3

ICC = 0.88; r = 0.89; AUC = 0.92

Nigro et al. [123]

The University of British Columbia Hospital, Canada

50/0.64

48.7 ± 12.6

30 ± 25.8

Same-night Level 1 PSG

AASM1999

L

10

95

90

AUC = 0.98; ICC = 0.96

Chen et al. [124]

—

102/0.76

54.7 ± 13.3

—

Same-night Level 1 PSG

AASM1999

L

15

92

88.5

r = 0.95

Ragette et al. [125]

131/0.72

59.1 ± 14.6

—

Different-night Level 1 PSG

AASM1999

H

5

91.8

76.5

r = 0.85

Ragette et al. [125]

Somnolter

III

—

90/0.67

55.4 ± 8.7

—

Same-night Level 1 PSG

H: >50% reduction or; >30% reduction + [3% desaturation or arousal]

L

—

83.6

81.8

r = 0.95

Cheliout-Heraut et al. [126]

Embletta

III

Sleep Center, Royal Infirmary NHS Trust, Scotland, UK

39/0.82

46 ± 9

35.4 ± 5.5

Same-night Level 1 PSG

H: >50% reduction (on nasal pressure)

L

—

—

—

= 0.28

Dingli et al. [127]

50/—

50 ± 11

29.2 ± 2.7

Different-night Level 1 PSG

H: >50% reduction (on thoracoabdominal movement)

H

—

—

—

= 0.1

Dingli et al. [127]

Embletta PDS

III

Prince of Wales Hospital, China

80/0.78

51.4 ± 11.9

21.6 ± 19.1

Same-night Level 1 PSG

H: >30% reduction + [4% desaturation or arousal]

L

15

88

95

= 0.98

Ng et al. [128]

Lifeshirt

III

—

48/0.72

44

19.3 ± 24.6

Same-night Level 1 PSG

H: >30% reduction + [3% desaturation or arousal]

L

25

100^1

97^1

AUC^2 = 0.99

Goodrich and Orr [129]

Dallas Veterans Affairs Medical Center, USA

10/0.8

48.8 ± 14.2

28.2 ± 21.1

Same-night Level 1 PSG

H: >25% reduction + 3% desaturation

L

5

100

50

= 0.82

Carter et al. [130]

Different-night Level 1 PSG

H: >25% reduction + 3% desaturation

H

5

100

100

= 0.96

Carter et al. [130]

BreasSC20

III

Hospital Virgen de la Arrixaca, Spain

48/—

—

28.2

Same-night Level 3 PG

H: >30% reduction + 4% desaturation

H

5

—

—

= 0.72

Ruiz-López et al. [131]

Hospital Txagorritxu de Victoria-Gasteiz, Spain

60/0.77

51.6 ± 13.2

31 ± 27.6

Same-night Level 1 PSG

H: >50% reduction + [3% desaturation or arousal]

L

20

93.5

96.6

= 0.90; AUC = 0.98

Núñez et al. [132]

RUSleeping RTS

IV

Greater Pittsburgh Clinical Sleep Laboratory, USA

25/0.36

42.4 ± 12.9

20.6 ± 26.8

Same-night Level 1 PSG

AASM1999

L

5

83

100

= 0.73; AUC = 0.94

Grover and Pittman [133]

Stardust II

III

—

62/0.67

45.6 ± 18.2

25.3 ± 21.4

Same-night Level 3 PG

AASM1999; H: >50% reduction or; discernible reduction + [3% desaturation or arousal]

H

50

100

92.5

= 0.33; = 0.95

Yin et al. [134]