Evidence map›Paper›PMID 34717928›Full record

ArticleChest2022

Diagnostic Performance of Machine Learning-Derived OSA Prediction Tools in Large Clinical and Community-Based Samples.

Steven J Holfinger, M Melanie Lyons, Brendan T Keenan, Diego R Mazzotti, Jesse Mindel, Greg Maislin, Peter A Cistulli, Kate Sutherland, Nigel McArdle, Bhajan Singh and 8 more

Open access · greenAbstract read
In one paragraph

Article in Chest, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 pooled it
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.

  1. Pooled it
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  11. A novel machine learning model for screening the risk of obstructive sleep apnea using craniofacial photography with questionnaires.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 11 institutions in 6 countries.

Steven J HolfingerDivision of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH. Electronic address: Steven.Holfinger@osumc.edu.
M Melanie LyonsDivision of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
Brendan T KeenanDivision of Sleep Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Diego R MazzottiDivision of Medical Informatics, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS.
Jesse MindelDivision of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
Greg MaislinDivision of Sleep Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Peter A CistulliCharles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Respiratory and Sleep Medicine, Royal North Shore Hospital Sydney, Sydney, NSW, Australia.
Kate SutherlandCharles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Respiratory and Sleep Medicine, Royal North Shore Hospital Sydney, Sydney, NSW, Australia.
Nigel McArdleWest Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; School of Human Sciences, University of Western Australia, Crawley, WA, Australia.
Bhajan SinghWest Australian Sleep Disorders Research Institute, Sir Charles Gairdner Hospital, Nedlands, WA, Australia; School of Human Sciences, University of Western Australia, Crawley, WA, Australia.
Ning-Hung ChenDivision of Pulmonary, Critical Care Medicine and Sleep Medicine, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.
Thorarinn GislasonDepartment of Sleep Medicine, Landspitali University Hospital, Reykjavik, Iceland; Medical Faculty, University of Iceland, Reykjavik, Iceland.
Thomas PenzelInterdisciplinary Center of Sleep Medicine, Charité University Hospital, Berlin, Germany.
Fang HanDepartment of Respiratory Medicine, Peking University, Beijing, China.
Qing Yun LiDepartment of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Richard SchwabDivision of Sleep Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Allan I PackDivision of Sleep Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Ulysses J MagalangDivision of Pulmonary, Critical Care, and Sleep Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
The Ohio State University Wexner Medical Center · USUniversity of Pennsylvania · USRoyal North Shore Hospital · AUChang Gung Memorial Hospital · TWCharité - Universitätsmedizin Berlin · DEPeking University · CNRuijin Hospital · CNUniversity of Iceland · ISUniversity of Kansas Medical Center · USUniversity of Western Australia · AUWest Australian Sleep Disorders Research Institute · AU

Funding

Understanding the relationship between obesity and tongue fat in humans and ratsP01HL094307 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI PACK, ALLAN I · 2009 to 2020
$23.7M
The Ohio State University Center for clinical and Translational ScienceUL1TR001070 · NCATS · OHIO STATE UNIVERSITY · PI JACKSON, REBECCA D · 2013 to 2017
$22.6M
National Sleep Research Resource (NSRR)R24HL114473 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI REDLINE, SUSAN S., ZHANG, GUO-QIANG · 2013 to 2017
$7.5M
DATA COORDINATING CENTER FOR SLEEP HEART STUDYU01HL064360 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI DIENER-WEST, MARIE · 1999 to 2007
$4.4M
The Sleep Heart Health Study (SHHS)U01HL053938 · NHLBI · UNIVERSITY OF ARIZONA · PI QUAN, STUART F. · 1994 to 2007
$2.0M
SLEEP HEART HEALTH STUDYU01HL053931 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI RAPOPORT, DAVID M. · 1994 to 2003
$1.9M
THE SLEEP HEART HEALTH STUDYU01HL053937 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI PUNJABI, NARESH · 1994 to 2007
$1.6M
SLEEP HEART HEALTH STUDYU01HL053916 · NHLBI · UNIVERSITY OF CALIFORNIA DAVIS · PI ROBBINS, JOHN A · 1994 to 2007
$1.5M
THE SLEEP HEART HEALTH STUDYU01HL053934 · NHLBI · UNIVERSITY OF MINNESOTA TWIN CITIES · PI SHAHAR, EYAL · 1994 to 2007
$1.4M
SLEEP HEART HEALTH STUDYU01HL053941 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI O'CONNOR, GEORGE T · 1994 to 2007
$1.4M
NCATS NIH HHS UL1 TR001070NHLBI NIH HHS P01 HL094307NHLBI NIH HHS R24 HL114473NHLBI NIH HHS U01 HL053916NHLBI NIH HHS U01 HL053931NHLBI NIH HHS U01 HL053934NHLBI NIH HHS U01 HL053937NHLBI NIH HHS U01 HL053938NHLBI NIH HHS U01 HL053941NHLBI NIH HHS U01 HL064360
6 · The paper itself

Abstract

backgroundPrediction tools without patient-reported symptoms could facilitate widespread identification of OSA. RESEARCH QUESTION: What is the diagnostic performance of OSA prediction tools derived from machine learning using readily available data without patient responses to questionnaires? Also, how do they compare with STOP-BANG, an OSA prediction tool, in clinical and community-based samples? STUDY DESIGN AND

methodsLogistic regression and machine learning techniques, including artificial neural network (ANN), random forests (RF), and kernel support vector machine, were used to determine the ability of age, sex, BMI, and race to predict OSA status. A retrospective cohort of 17,448 subjects from sleep clinics within the international Sleep Apnea Global Interdisciplinary Consortium (SAGIC) were randomly split into training (n = 10,469) and validation (n = 6,979) sets. Model comparisons were performed by using the area under the receiver-operating curve (AUC). Trained models were compared with the STOP-BANG questionnaire in two prospective testing datasets: an independent clinic-based sample from SAGIC (n = 1,613) and a community-based sample from the Sleep Heart Health Study (n = 5,599).

resultsThe AUCs (95% CI) of the machine learning models were significantly higher than logistic regression (0.61 [0.60-0.62]) in both the training and validation datasets (ANN, 0.68 [0.66-0.69]; RF, 0.68 [0.67-0.70]; and kernel support vector machine, 0.66 [0.65-0.67]). In the SAGIC testing sample, the ANN (0.70 [0.68-0.72]) and RF (0.70 [0.68-0.73]) models had AUCs similar to those of the STOP-BANG (0.71 [0.68-0.72]). In the Sleep Heart Health Study testing sample, the ANN (0.72 [0.71-0.74]) had AUCs similar to those of STOP-BANG (0.72 [0.70-0.73]).

interpretationOSA prediction tools using machine learning without patient-reported symptoms provide better diagnostic performance than logistic regression. In clinical and community-based samples, the symptomless ANN tool has diagnostic performance similar to that of a widely used prediction tool that includes patient symptoms. Machine learning-derived algorithms may have utility for widespread identification of OSA.

Indexed as

Sleep Apnea, ObstructiveHumansMachine LearningPolysomnographyProspective StudiesRetrospective StudiesSurveys and Questionnairesartificial neural networkelectronic medical recordkernel support vector machinemachine learningOSAprediction modelrandom forest

Identifiers

PMID34717928
PMCPMC8941600
OpenAlexW3210619311

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.