The concordance of manuel (visual) scoring and automatic analysis in sleep staging

Uyku evrelemesinde manuel (görsel) evreleme ile otomatik evrelemenin uyumu Uyku apne sendromlarının tanısında ve tedavisinin planlanmasında, tüm gece polisomnografik (PSG) kayıtlara ihtiyaç vardır. Otomatik evreleme için geliştirilen yazılım algoritmaları ile uyku uzmanı evrelemesi arasında %80’e varan uyumun olduğu belirtilmektedir. Laboratuvar deneyimlerimize bu yüksek oranların yansımadığı görülmüş ve kullanılan otomatik evreleme yazılımı ile manuel (görsel) evreleme arasındaki uyumu denetlemek amacıyla bu çalışma planlanmıştır. Çalışmaya alınan obstrüktif uyku apne sendromu tanısı almış 30 olgunun verisi rastlantısal olarak seçildi. En az 1000 PSG evreleme deneyimi olan birbirileri arasındaki uyumu %80-95 olan iki evreleyicinin uyku evrelemeleri ile otomatik analiz sonuçları karşılaştırıldı. Çalışmamızda; yaş ortalaması 48.83 ± 13.51 yıl olan 18 erkek hasta ile 44.58 ± 14.28 yıl olan 12 kadın hastaya ait 21.060 epok değerlendirildi. Otomatik analizde; toplam uyku süresi ve uyku etkinliği düşük (sırasıyla p= 0.003, p= 0.004), AHİ ve ODI değerleri yüksek bulundu (sırasıyla p= 0.802, p= 0.193). Sekiz bin sekiz yüz on dokuz (%41.88) epok farklı evrelenmiştir. Evre I (%88.43)’in en fazla farklı değerlendirildiği saptandı. Evre I; 572 epokta uyanık, evre II; 2276 epokta ve evre IV; 983 epokta evre III, REM ise 574 epokta evre II olarak evrelendirilmiştir. Otomatik analiz ile incelenen PSG tetkiklerinde kayıt süreleri ve uyku mimarisindeki yanlışlıklar, olgunun tanısını etkileyecek ve tedavi seçiminde yanlışa yol açacaktır.Full night polysomnography (PSG) remains the gold standard diagnostic test for the evaluation of sleep and the detection of sleep disorders. The computer-assisted scoring methods have been developed to accelerate the scoring. It is said that there was a concordance up to 80% between these scoring softwares and manual scoring. According to our experiences, it is not matched with this belief. In this study, we intend to examine whether the results of automatic analysis match with manual (visual) evaluation. The PSG records of 30 cases with a diagnosis of obstructive sleep apnea syndrome (OSAS) are chosen randomly. We compare the results of automatic analysis with the results of two scorers who have a concordance of 80-95% and at least 1000 PSG scoring experiences. We evaluated 21.060 epochs of 18 men with 48.83 ± 13.51 ages, and 12 women with 44.56 ± 14.28 ages. In automatic analysis; total sleep time (p= 0.003) and sleep efficiency (p= 0.004) were low. AHI (p= 0.802) and ODI (p= 0.193) values were high. The epochs scored differently were 8819 epochs (41.88%). The stage I (88.43%) scored mostly different, was allocated to be awake (572 epochs). Stage II and stage IV were scored as stage III in 2276 and 983 epochs respectively. REM epochs were allocated to stage II (574 epochs). The differences in recording times and sleep architecture of PSG tests which examed by automatic analysis will affect all other parameters. Thus, we believe that it will make mistakes in the diagnosis and treatment of sleep disorders

Uyku evrelemesinde manuel (görsel) evreleme ile otomatik evrelemenin uyumu]

Full night polysomnography (PSG) remains the gold standard diagnostic test for the evaluation of sleep and the detection of sleep disorders. The computer-assisted scoring methods have been developed to accelerate the scoring. It is said that there was a concordance up to 80% between these scoring softwares and manual scoring. According to our experiences, it is not matched with this belief. In this study, we intend to examine whether the results of automatic analysis match with manual (visual) evaluation. The PSG records of 30 cases with a diagnosis of obstructive sleep apnea syndrome (OSAS) are chosen randomly. We compare the results of automatic analysis with the results of two scorers who have a concordance of 8095% and at least 1000 PSG scoring experiences. We evaluated 21.060 epochs of 18 men with 48.83 +/- 13.51 ages, and 12 women with 44.56 +/- 14.28 ages. In automatic analysis; total sleep time (p= 0.003) and sleep efficiency (p= 0.004) were low. AHI (p= 0.802) and ODI (p= 0.193) values were high. The epochs scored differently were 8819 epochs (41.88%). The stage I (88.43%) scored mostly different, was allocated to be awake (572 epochs). Stage II and stage IV were scored as stage III in 2276 and 983 epochs respectively. REM epochs were allocated to stage II (574 epochs). The differences in recording times and sleep architecture of PSG tests which examed by automatic analysis will affect all other parameters. Thus, we believe that it will make mistakes in the diagnosis and treatment of sleep disorders