Diagnostic accuracy of the Berlin questionnaire in detecting sleep-disordered breathing in patients with a recent myocardial infarction

Fatima H. Sert Kuniyoshi, Mark R. Zellmer, Andrew D. Calvin, Francisco Lopez-Jimenez, Felipe N. Albuquerque, Christelle Van Der Walt, Ivani C. Trombetta, Sean M. Caples, Abu S. Shamsuzzaman, Jan Bukartyk, Tomas Konecny, Apoor S. Gami, Tomas Kara, Virend Somers

Research output: Contribution to journalArticle

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Abstract

Background: The Berlin Questionnaire (BQ) has been used to identify patients at high risk for sleep-disordered breathing (SDB) in a variety of populations. However, there are no data regarding the validity of the BQ in detecting the presence of SDB in patients after myocardial infarction (MI). The aim of this study was to determine the performance of the BQ in patients after MI. Methods: We conducted a cross-sectional study of 99 patients who had an MI 1 to 3 months previously. The BQ was administered, scored using the published methods, and followed by completed overnight polysomnography as the "gold standard." SDB was defined as an apnea-hypopnea index of ≥ 5 events/h. The sensitivity, specificity, and positive and negative predictive values of the BQ were calculated. Results: Of the 99 patients, the BQ identified 64 (65%) as being at high-risk for having SDB. Overnight polysomnography showed that 73 (73%) had SDB. The BQ sensitivity and specificity was 0.68 and 0.34, respectively, with a positive predictive value of 0.68 and a negative predictive value of 0.50. Positive and negative likelihood ratios were 1.27 and 0.68, respectively, and the BQ overall diagnostic accuracy was 63%. Using different apnea-hypopnea index cutoff values did not meaningfully alter these results. Conclusion: The BQ performed with modest sensitivity, but the specificity was poor, suggesting that the BQ is not ideal in identifying SDB in patients with a recent MI.

Original languageEnglish (US)
Pages (from-to)1192-1197
Number of pages6
JournalChest
Volume140
Issue number5
DOIs
StatePublished - Nov 2011

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Sleep Apnea Syndromes
Berlin
Myocardial Infarction
Polysomnography
Apnea
Sensitivity and Specificity
Surveys and Questionnaires
Cross-Sectional Studies

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Diagnostic accuracy of the Berlin questionnaire in detecting sleep-disordered breathing in patients with a recent myocardial infarction. / Sert Kuniyoshi, Fatima H.; Zellmer, Mark R.; Calvin, Andrew D.; Lopez-Jimenez, Francisco; Albuquerque, Felipe N.; Van Der Walt, Christelle; Trombetta, Ivani C.; Caples, Sean M.; Shamsuzzaman, Abu S.; Bukartyk, Jan; Konecny, Tomas; Gami, Apoor S.; Kara, Tomas; Somers, Virend.

In: Chest, Vol. 140, No. 5, 11.2011, p. 1192-1197.

Research output: Contribution to journalArticle

Sert Kuniyoshi, FH, Zellmer, MR, Calvin, AD, Lopez-Jimenez, F, Albuquerque, FN, Van Der Walt, C, Trombetta, IC, Caples, SM, Shamsuzzaman, AS, Bukartyk, J, Konecny, T, Gami, AS, Kara, T & Somers, V 2011, 'Diagnostic accuracy of the Berlin questionnaire in detecting sleep-disordered breathing in patients with a recent myocardial infarction', Chest, vol. 140, no. 5, pp. 1192-1197. https://doi.org/10.1378/chest.10-2625
Sert Kuniyoshi, Fatima H. ; Zellmer, Mark R. ; Calvin, Andrew D. ; Lopez-Jimenez, Francisco ; Albuquerque, Felipe N. ; Van Der Walt, Christelle ; Trombetta, Ivani C. ; Caples, Sean M. ; Shamsuzzaman, Abu S. ; Bukartyk, Jan ; Konecny, Tomas ; Gami, Apoor S. ; Kara, Tomas ; Somers, Virend. / Diagnostic accuracy of the Berlin questionnaire in detecting sleep-disordered breathing in patients with a recent myocardial infarction. In: Chest. 2011 ; Vol. 140, No. 5. pp. 1192-1197.
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abstract = "Background: The Berlin Questionnaire (BQ) has been used to identify patients at high risk for sleep-disordered breathing (SDB) in a variety of populations. However, there are no data regarding the validity of the BQ in detecting the presence of SDB in patients after myocardial infarction (MI). The aim of this study was to determine the performance of the BQ in patients after MI. Methods: We conducted a cross-sectional study of 99 patients who had an MI 1 to 3 months previously. The BQ was administered, scored using the published methods, and followed by completed overnight polysomnography as the {"}gold standard.{"} SDB was defined as an apnea-hypopnea index of ≥ 5 events/h. The sensitivity, specificity, and positive and negative predictive values of the BQ were calculated. Results: Of the 99 patients, the BQ identified 64 (65{\%}) as being at high-risk for having SDB. Overnight polysomnography showed that 73 (73{\%}) had SDB. The BQ sensitivity and specificity was 0.68 and 0.34, respectively, with a positive predictive value of 0.68 and a negative predictive value of 0.50. Positive and negative likelihood ratios were 1.27 and 0.68, respectively, and the BQ overall diagnostic accuracy was 63{\%}. Using different apnea-hypopnea index cutoff values did not meaningfully alter these results. Conclusion: The BQ performed with modest sensitivity, but the specificity was poor, suggesting that the BQ is not ideal in identifying SDB in patients with a recent MI.",
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AU - Sert Kuniyoshi, Fatima H.

AU - Zellmer, Mark R.

AU - Calvin, Andrew D.

AU - Lopez-Jimenez, Francisco

AU - Albuquerque, Felipe N.

AU - Van Der Walt, Christelle

AU - Trombetta, Ivani C.

AU - Caples, Sean M.

AU - Shamsuzzaman, Abu S.

AU - Bukartyk, Jan

AU - Konecny, Tomas

AU - Gami, Apoor S.

AU - Kara, Tomas

AU - Somers, Virend

PY - 2011/11

Y1 - 2011/11

N2 - Background: The Berlin Questionnaire (BQ) has been used to identify patients at high risk for sleep-disordered breathing (SDB) in a variety of populations. However, there are no data regarding the validity of the BQ in detecting the presence of SDB in patients after myocardial infarction (MI). The aim of this study was to determine the performance of the BQ in patients after MI. Methods: We conducted a cross-sectional study of 99 patients who had an MI 1 to 3 months previously. The BQ was administered, scored using the published methods, and followed by completed overnight polysomnography as the "gold standard." SDB was defined as an apnea-hypopnea index of ≥ 5 events/h. The sensitivity, specificity, and positive and negative predictive values of the BQ were calculated. Results: Of the 99 patients, the BQ identified 64 (65%) as being at high-risk for having SDB. Overnight polysomnography showed that 73 (73%) had SDB. The BQ sensitivity and specificity was 0.68 and 0.34, respectively, with a positive predictive value of 0.68 and a negative predictive value of 0.50. Positive and negative likelihood ratios were 1.27 and 0.68, respectively, and the BQ overall diagnostic accuracy was 63%. Using different apnea-hypopnea index cutoff values did not meaningfully alter these results. Conclusion: The BQ performed with modest sensitivity, but the specificity was poor, suggesting that the BQ is not ideal in identifying SDB in patients with a recent MI.

AB - Background: The Berlin Questionnaire (BQ) has been used to identify patients at high risk for sleep-disordered breathing (SDB) in a variety of populations. However, there are no data regarding the validity of the BQ in detecting the presence of SDB in patients after myocardial infarction (MI). The aim of this study was to determine the performance of the BQ in patients after MI. Methods: We conducted a cross-sectional study of 99 patients who had an MI 1 to 3 months previously. The BQ was administered, scored using the published methods, and followed by completed overnight polysomnography as the "gold standard." SDB was defined as an apnea-hypopnea index of ≥ 5 events/h. The sensitivity, specificity, and positive and negative predictive values of the BQ were calculated. Results: Of the 99 patients, the BQ identified 64 (65%) as being at high-risk for having SDB. Overnight polysomnography showed that 73 (73%) had SDB. The BQ sensitivity and specificity was 0.68 and 0.34, respectively, with a positive predictive value of 0.68 and a negative predictive value of 0.50. Positive and negative likelihood ratios were 1.27 and 0.68, respectively, and the BQ overall diagnostic accuracy was 63%. Using different apnea-hypopnea index cutoff values did not meaningfully alter these results. Conclusion: The BQ performed with modest sensitivity, but the specificity was poor, suggesting that the BQ is not ideal in identifying SDB in patients with a recent MI.

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