Diagnostic Accuracy of the Multivariable Apnea Prediction (MAP) Index as a Screening Tool for Obstructive Sleep Apnea
AbstractBackground and Objective: Obstructive sleep apnea (OSA) is the most common type of sleep-disordered breathing. Multivariable apnea prediction (MAP) index consists of three questions about the frequency of OSA symptoms plus body mass index (BMI), age and sex that categorizes the patients to low and high risk for OSA using a formula. Objective MAP index was calculated by discounting the questions from formula. In this study, we evaluated the utility of the MAP index and objective MAP index in screening of the OSA.Materials and Methods: In a cross-sectional study, we enrolled 609 patients of three sleep clinics suspected of having OSA who underwent polysomnography (PSG) as a gold standard test for OSA diagnosis. The apnea-hypopnea index (AHI) of the PSG was used to classify the severity of OSA.Results: A significant strong correlation was observed between MAP index and objective MAP index using Spearman’s coefficient (r=0.801, P<0.001). Spearman’s correlation coefficient showed a stronger correlation between AHI and MAP index (r=0.586, P<0.001) than between AHI and objective MAP index (r=0.467, P<0.001). The area under the curve of the MAP index and objective MAP index were found to be 0.810 and 0.766, respectively, at AHI≥5; 0.792 and 0.728, respectively, at AHI≥15, and 0.767 and 0.684, respectively, at AHI≥30. The predictive parameters of the MAP index and objective MAP index for identifying OSA were satis- factory.Conclusions: This study showed that MAP index and especially objective MAP index might have a consid- erable utility in the screening of OSA.
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