Evidence map›Paper›PMID 39046658›Full record

ArticleSleep & breathing = Schlaf & Atmung2024

Is the Epworth Sleepiness scale a valid outcome measure to evaluate the effectiveness of positive airway pressure treatments on daytime sleepiness? Psychometric insights from measurement invariance and response shifts.

Po-Yi Chen, Min-Heng Wang, Chih-Ning Chang, Chien-Ming Yang, Tzi-Yang Chao

Abstract readValidation Study
PubMed Publisher
In one paragraph

Article in Sleep & breathing = Schlaf & Atmung, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Review
  2. Article
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

5 authors.

Po-Yi ChenDepartment of Educational Psychology and Counseling, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da-an District, Taipei, 106308, Taiwan. poyichen@ntnu.edu.tw.
Min-Heng WangGraduate Institute of Public Affairs, National Taiwan University, Taipei, 10617, Taiwan.
Chih-Ning ChangDepartment of Educational Psychology and Counseling, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da-an District, Taipei, 106308, Taiwan.
Chien-Ming YangDepartment of Psychology, National Chengchi University, Taipei, 11605, Taiwan.
Tzi-Yang ChaoDepartment of Educational Psychology and Counseling, National Taiwan Normal University, No. 162, Section 1, Heping East Road, Da-an District, Taipei, 106308, Taiwan.

Funding

Ministry of Education Ministry of EducationMinistry of Science and Technology, Taiwan MOST 113-2410-H-003-006-
6 · The paper itself

Abstract

purposeAlthough the validity of the Epworth Sleepiness Scale (ESS) as an effectiveness measure for sleep apnea treatments such as continuous positive airway pressure (CPAP) has been supported by multiple studies, some researchers continue to challenge it. They suggest that in addition to its impact on relieving patients' daytime sleepiness, CPAP also alters the internal standards patients use to evaluate their sleepiness (i.e., response shift; RS), confounding the meaning of the difference in the ESS scores. We believe an issue yet to be addressed in this debate is that all existing evidence of RS has been obtained through the then-test approach, a retrospective method sensitive to various cognitive mechanisms. Thus, in the current study, we re-examined this issue using the structural equation modeling (SEM) approach, a method that can be directly applied to randomized clinical trial (RCT) data without retrospective measures.

methodsWith the ESS data from two independent RCTs, we conducted cross-sectional and longitudinal measure invariance tests in SEM to examine whether CPAP would lead to RS.

resultsThe ESS demonstrated cross-sectional and longitudinal scalar invariance against CPAP treatments. Its factorial pattern, loadings, and thresholds were invariant between the treatment and control groups and pre- and post-treatment, supporting the comparability of the observed mean ESS scores across time and groups.

conclusionOur results support the validity of the average difference scores of the ESS for quantifying the effectiveness of CPAP on group-level daytime sleepiness in RCTs with relatively large sample sizes.

Indexed as

Continuous Positive Airway PressureDisorders of Excessive SomnolencePsychometricsSleep Apnea, ObstructiveAdultAgedCross-Sectional StudiesFemaleHumansLongitudinal StudiesMaleMiddle AgedOutcome Assessment, Health CareReproducibility of ResultsSurveys and QuestionnairesTreatment OutcomeContinuous positive airway pressureEpworth sleepiness scaleMeasurement invarianceResponse shiftSleep apnea

Identifiers

PMID39046658

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.