TY - JOUR
T1 - Sex-Specific Prediction Models for Sleep Apnea from the Hispanic Community Health Study/Study of Latinos This article has been presented in abstract form (Shah NA, Hanna DB, Teng Y, et al. Epidemiol Genet Sleep Disordered Breathing. 2014: A5334).
AU - Shah, Neomi
AU - Hanna, David B.
AU - Teng, Yanping
AU - Sotres-Alvarez, Daniela
AU - Hall, Martica
AU - Loredo, Jose S.
AU - Zee, Phyllis
AU - Kim, Mimi
AU - Yaggi, H. Klar
AU - Redline, Susan
AU - Kaplan, Robert C.
N1 - Publisher Copyright:
© 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
PY - 2016/6/1
Y1 - 2016/6/1
N2 - Objective We developed and validated the first-ever sleep apnea (SA) risk calculator in a large population-based cohort of Hispanic/Latino subjects. Methods Cross-sectional data on adults from the Hispanic Community Health Study/Study of Latinos (2008-2011) were analyzed. Subjective and objective sleep measurements were obtained. Clinically significant SA was defined as an apnea-hypopnea index ≥ 15 events per hour. Using logistic regression, four prediction models were created: three sex-specific models (female-only, male-only, and a sex × covariate interaction model to allow differential predictor effects), and one overall model with sex included as a main effect only. Models underwent 10-fold cross-validation and were assessed by using the C statistic. SA and its predictive variables; a total of 17 variables were considered. Results A total of 12,158 participants had complete sleep data available; 7,363 (61%) were women. The population-weighted prevalence of SA (apnea-hypopnea index ≥ 15 events per hour) was 6.1% in female subjects and 13.5% in male subjects. Male-only (C statistic, 0.808) and female-only (C statistic, 0.836) prediction models had the same predictor variables (ie, age, BMI, self-reported snoring). The sex-interaction model (C statistic, 0.836) contained sex, age, age × sex, BMI, BMI × sex, and self-reported snoring. The final overall model (C statistic, 0.832) contained age, BMI, snoring, and sex. We developed two websites for our SA risk calculator: one in English (https://www.montefiore.org/sleepapneariskcalc.HTML) and another in Spanish (http://www.montefiore.org/sleepapneariskcalc-es.HTML). Conclusions We created an internally validated, highly discriminating, well-calibrated, and parsimonious prediction model for SA. Contrary to the study hypothesis, the variables did not have different predictive magnitudes in male and female subjects.
AB - Objective We developed and validated the first-ever sleep apnea (SA) risk calculator in a large population-based cohort of Hispanic/Latino subjects. Methods Cross-sectional data on adults from the Hispanic Community Health Study/Study of Latinos (2008-2011) were analyzed. Subjective and objective sleep measurements were obtained. Clinically significant SA was defined as an apnea-hypopnea index ≥ 15 events per hour. Using logistic regression, four prediction models were created: three sex-specific models (female-only, male-only, and a sex × covariate interaction model to allow differential predictor effects), and one overall model with sex included as a main effect only. Models underwent 10-fold cross-validation and were assessed by using the C statistic. SA and its predictive variables; a total of 17 variables were considered. Results A total of 12,158 participants had complete sleep data available; 7,363 (61%) were women. The population-weighted prevalence of SA (apnea-hypopnea index ≥ 15 events per hour) was 6.1% in female subjects and 13.5% in male subjects. Male-only (C statistic, 0.808) and female-only (C statistic, 0.836) prediction models had the same predictor variables (ie, age, BMI, self-reported snoring). The sex-interaction model (C statistic, 0.836) contained sex, age, age × sex, BMI, BMI × sex, and self-reported snoring. The final overall model (C statistic, 0.832) contained age, BMI, snoring, and sex. We developed two websites for our SA risk calculator: one in English (https://www.montefiore.org/sleepapneariskcalc.HTML) and another in Spanish (http://www.montefiore.org/sleepapneariskcalc-es.HTML). Conclusions We created an internally validated, highly discriminating, well-calibrated, and parsimonious prediction model for SA. Contrary to the study hypothesis, the variables did not have different predictive magnitudes in male and female subjects.
KW - clinical decision-making
KW - community health
KW - epidemiology (pulmonary)
KW - sex-specific prediction
KW - sleep apnea
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U2 - 10.1016/j.chest.2016.01.013
DO - 10.1016/j.chest.2016.01.013
M3 - Article
C2 - 26836933
AN - SCOPUS:84973562828
SN - 0012-3692
VL - 149
SP - 1409
EP - 1418
JO - Chest
JF - Chest
IS - 6
ER -