DOI: 10.5061/dryad.qnk98sfhg
title: Moderate-severe OSA screening based on support vector machine of the Chinese population facio-cervical measurements dataset: A cross-sectional study

description: Objectives Obstructive sleep apnea (OSA) has received much
 attention as a risk factor for perioperative complications and 68.5% of
 OSA patients remain undiagnosed before surgery. Facio-cervical
 characteristics may screen OSA for Asians due to smaller upper airways
 compared to Caucasians. Thus, our study aimed to explore a
 machine-learning model to screen moderate-severe OSA based on
 facio-cervical and anthropometric measurements. Design A
 cross-sectional study. Setting Data were collected from the
 Shanghai Jiao Tong University School of Medicine affiliated Ruijin
 Hospital between February 2019 and August 2020. Participants A total of
 481 Chinese participants were included in the study. Primary and secondary
 outcome (1) Identification of moderate-severe OSA with apnea-hypopnea
 index (AHI)15 events·h−1. (2) Verification of the machine learning model.
 Results The SABIHC2 model (Sex-Age-Body mass index-maximum Interincisal
 distance-ratio of Height to thyro-sternum distance-neck
 Circumference-waist Circumference) was set up. The SABIHC2 model could
 screen moderate-severe OSA with an area under the curve (AUC)=0.832, the
 sensitivity of 0.916, and specificity of 0.749, and performed better than
 the STOP-BANG questionnaire, which showed AUC=0.631, the sensitivity of
 0.487, and specificity of 0.772. Especially for asymptomatic patients (ESS
 &lt; 10), the SABIHC2 model
 demonstrated better predictive ability compared
 to the STOP-BANG questionnaire, with AUC (0.824 vs. 0.530),
 sensitivity (0.892 vs. 0.348), and specificity (0.755 vs. 0.809).
 Conclusion The SABIHC2 machine learning model provides a simple and
 accurate assessment of moderate-severe OSA in the Chinese population,
 especially for those without significant daytime sleepiness.
description: Participants with suspected<i> </i>OSA (snoring,
 witnessed apnea, or excessive daytime sleepiness, etc.) were enrolled in
 the study from Ruijin Hospital, Shanghai Jiao Tong University School of
 Medicine between February 2019 and August
 2020. All participants underwent anthropometric measurements and
 subsequent overnight polysomnography (PSG). Participants were grouped
 according to their AHI gain into the following: 1) no or mild OSA
 (subjects without moderate-to-severe OSA: AHI &lt;15
 events·h<sup>−1</sup>), 2) moderate-severe OSA (moderate to
 severe OSA: AHI ≥ 15 events·h<sup>−1</sup>). Exclusion
 criteria: (1) Patients showing complications with severe respiratory
 diseases, such as severe COPD, interstitial lung disease, or acute asthma;
 (2) Patients showing complications with serious cardiovascular diseases
 such as acute myocardial infarction, acute heart failure, or chronic
 congestive heart failure (Grade III and IV); (3) Patients with mental
 illnesses who could not cooperate with the examination; (4) Patients who
 receiving non-invasive positive pressure ventilation therapy; (5) Patients
 who might have other sleep disorders under clinical evaluation.
 Age, sex, height, weight, BMI, neck circumference (NC), waist
 circumference (WC), Epworth Sleepiness Scale (ESS), and STOP-BANG
 questionnaire were recorded. The STOP-BANG questionnaire is a scoring
 model consisting of eight questions and its scores are based on Yes/No
 answers (score: 1/0). The eight questions included snoring, tiredness,
 observed apnea, high blood pressure, BMI, age, neck circumference, and
 gender. Facio-cervical measurements including Mallampati score, MID, TMD,
 and TSD were measured. The Mallampati score was evaluated when
 participants were asked to sit upright and open their mouths as wide as
 possible. In grade I, the entire uvula, faucial pillar, and soft palate
 are visible. In grade II, part of the uvula and palate are visible. In
 grade III, the soft palate is visible, but the uvula is
 obscured.<sup>14</sup> MID was recorded by asking the
 participant to sit upright and open the mouth as wide as
 possible.<sup>15</sup> The TMD was measured as the straight
 distance between the thyroid notch and the lower border of the mental
 prominence, while the head was fully extended, and the mouth
 closed.<sup>16</sup> TSD was measured as the distance between
 the thyroid notch and the upper border of the sternum. The distance was
 rounded to the nearest 0.5 cm. The ratios of height to TMD (H/TMD) and
 height to TSD (H/TSD) were calculated.<sup>16</sup> 
description: There is no missing value.