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Title of Journal: Sleep Breath

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Abbravation: Sleep and Breathing

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Springer Berlin Heidelberg

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1522-1709

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Process and outcome for international reliability

Authors: Xiaozhe Zhang Xiaosong Dong Jan W Kantelhardt Jing Li Long Zhao Carmen Garcia Martin Glos Thomas Penzel Fang Han
Publish Date: 2014/05/07
Volume: 19, Issue: 1, Pages: 191-195
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Abstract

The subjects consist of polysomnography PSGs from 15 subjects in a German sleep laboratory with 7 mild to moderate sleep apnea hypopnea syndrome SAHS patients and 8 healthy controls and PSGs from 15 narcolepsy patients in a Chinese sleep laboratory Five experienced technologists including two Chinese and three Germans without common training scored the PSGs following the 2007 AASM manual except the EEG signals included only two EEG leads C3/A2 and C4/A1 Differences in interscorer agreement were analyzed based on epochbyepoch comparison by means of Cohen’s κ and quantitative sleep parameters by means of intraclass correlation coefficientsInterlaboratory epochbyepoch agreement comparison between scorers from the two countries yielded a moderate agreement with a mean κ value of 057 for controls 058 for SAHS and 054 for narcolepsy When compared with controls the interscoring agreement is higher for wake and N3 stage scoring in SAHS and N1 and N3 scoring in narcolepsy p  005 The only sleep stage with lower scoring agreement in both SAHS κ 069 vs 079 p = 0034 and narcolepsy 066 vs 079 p = 0022 was stage REM Interlaboratory comparisons showed that the most common combinations of deviating scorings were N1 and N2 N2 and N3 and N1 and wake A 65  deviating scoring rate of wake and REM and a 134  deviating scoring rate of N1 and REM indicated that interlaboratory scoring in narcolepsy was about twice as in SAHS and controls confused This was further confirmed by agreement analysis of quantitative parameters using intraclass correlation coefficients ICC21 indicating REM sleep scoring agreement was lower in narcolepsy than in controls p  005Low REM stage scoring agreement exists for narcoleptics and SAHS indicating the necessity to study sleep stage scoring agreement for a specific sleep disorder Intensive training is needed for the scoring of sleep in international multiple center studies to improve the scoring agreementThis work was supported by research grants of the International Science and Technology Cooperation Program of China 2014DFA31500 Beijing Municipal Science and Technology Commission Z131107000413113 and the SinoGerman Center for Research Promotion GZ538 which also supported a research visit of XZ to Germany JK acknowledges funding from the German Research Society DFG grant KA 1676/4


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