Document Detail

Unbiased categorical classification of pediatric sleep disordered breathing.
MedLine Citation:
PMID:  21061856     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVES: To classify pediatric sleep disordered breathing (SDB) using unbiased approaches. In children, decisions regarding severity and treatment of SDB are conducted solely based on empirical observations. Although recognizable entities clearly exist under the SDB spectrum, neither the number of SDB categories nor their specific criteria have been critically defined.
DESIGN: Retrospective cohort analysis and random prospective cohort.
SETTING: Community and clinical sample.
PATIENTS OR PARTICIPANTS: Urban 5- to 9-year-old community children undergoing overnight sleep study (NPSG), and a comparable prospectively recruited clinical SDB sample.
MEASUREMENTS AND RESULTS: Principal component analysis was used to identify the uniqueness of the polysomnographically derived measures that are routinely used in clinical settings: apnea-hypopnea index, apnea index, obstructive apnea index, nadir SpO2, spontaneous arousal index and respiratory arousal index. These measures were then incorporated using unbiased data mining approaches to further characterize and discriminate across categorical phenotypes. Of 1,133 subjects, 52.8% were habitual snorers. Six categorical phenotypes clustered without any a priori hypothesis. Secondly, a non-hierarchical model that incorporated 6 NPSG-derived measures enabled unbiased identification of algorithms that predicted these 6 severity-based clusters. Thirdly, a hierarchical model was developed and performed well on all severity-based clusters. Classification and predictive models were subsequently cross-validated statistically as well as clinically, using 2 additional datasets that included 259 subjects. Modeling reached approximately 93% accuracy in cluster assignment.
CONCLUSIONS: Data-driven analysis of conventional NPSG-derived indices identified 6 distinct clusters ranging from a cluster with normal indices toward clusters with more abnormal indices. Categorical assignment of individual cases to any of such clusters can be accurately predicted using a simple algorithm. These clusters may further enable prospective unbiased characterization of clinical outcomes and of genotype-phenotype interactions across multiple datasets.
Karen Spruyt; Gino Verleye; David Gozal
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Sleep     Volume:  33     ISSN:  0161-8105     ISO Abbreviation:  Sleep     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-10     Completed Date:  2010-12-14     Revised Date:  2013-07-03    
Medline Journal Info:
Nlm Unique ID:  7809084     Medline TA:  Sleep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1341-7     Citation Subset:  IM    
Department of Pediatrics and Comer Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA.
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MeSH Terms
Child, Preschool
Cohort Studies
Discriminant Analysis
Polysomnography / methods,  statistics & numerical data*
Principal Component Analysis
Prospective Studies
Retrospective Studies
Severity of Illness Index
Sleep Apnea Syndromes / classification*,  diagnosis
Urban Population
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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