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
T2 - 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 - Funding Information:
HCHS/SOL is a community-based cohort study sponsored by the National Institutes of Health consisting of 16,415 self-identified Hispanic/Latino participants aged 18 to 74 years residing in four US sites (Bronx, New York; Chicago, Illinois; Miami, Florida; and San Diego, California). The details of the study design, sampling strategy, and recruitment have been described elsewhere. 12,13 All participants underwent a baseline interview and an extensive clinic examination (2008-2011) that included but was not limited to anthropometry, ECG, blood pressures in both arms, phlebotomy, glucose tolerance testing, audiometry, lung function, and oral examination. Questionnaires included sociodemographic characteristics, health and medical history, smoking, alcohol, medication use, occupational history, diet, and physical activity.
Funding Information:
Author contributions: N. S., D. B. H., and D. S.-A. had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors contributed substantially to the study design, data analysis and interpretation, and the writing of the manuscript. Financial/nonfinancial disclosures: The authors have reported to CHEST the following: P. Z. participated in clinical trials funded by Jazz and VANDA; served as a consultant for Philips Respironics, Merck & Co., Jazz, VANDA, Pernix, Aptalis, UCB, Purdue, Takeda, and Ferring; was involved in industry-sponsored continuing medical education, including case-based lectures on hypersomnia funded by an educational grant from Jazz to the Atlanta School of Sleep Medicine and Technology; and is a stockholder of Teva Pharmaceuticals. None declared (N. S., D. B. H., Y. T., D. S.-A., M. H., J. S. L., M. K., K. Y., S. R., R. C. K.). Role of the Sponsors: The funding sponsors supported the following aspects of this manuscript: design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, and approval of the manuscript. Other contributions: The authors thank the staff and participants of HCHS/SOL for their important contributions. The investigators’ website is http://www.cscc.unc.edu/hchs/ .
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
VL - 149
SP - 1409
EP - 1418
JO - Chest
JF - Chest
SN - 0012-3692
IS - 6
ER -