Validity and reliability of the Thai version of the pediatric obstructive sleep apnea screening tool

Abstract

Objective: Obstructive sleep apnea (OSA) is highly prevalent in children and requires an expensive and relatively unavailable sleep study for diagnosis. This study was undertaken to translate the previously validated pediatric OSA screening tool (POSAST) to the Thai language and assess its accuracy and test–retest reliability in at-risk symptomatic children. Study Design: Prospective cross-sectional cohort study. Methods: Pediatric patients clinically referred for suspected OSA who underwent overnight polysomnography (PSG) were recruited, and caregivers completed the Thai version of the POSAST. The same questionnaire was completed again after 2–4 weeks. The reliability of the questionnaire was determined by internal consistency and test–retest reliability. The validity of the questionnaire was assessed by constructing receiver operating characteristic (ROC) curves to identify the equation-derived score and total additive score cutoff points that identify high risk for moderate and severe OSA (AHI of ≥ 5 events/h). Results: One hundred and ten subjects completed the study. The mean age was 8.4 ± 2.9 years. The mean apnea-hypopnea index (AHI) was 10.9 ± 11.9 events/h. Test–retest reliability (Pearson correlation coefficient = 0.96, p <.001) and internal consistency between each question (Cronbach's alpha coefficient = 0.82, p <.001) were excellent. An equation-derived score cut-off of 1.9 yielded 78.4% sensitivity, 50.0% specificity, 76.3% positive predictive value (PPV), and 52.9% negative predictive value (NPV), while a total additive score cut-off of 8 corresponded to 81.1% sensitivity, 52.8% specificity, 77.9% PPV, and 57.6% NPV for diagnosing moderate and severe OSA (AHI ≥ 5 events/h). Conclusion: The internal consistency and reproducibility of the Thai version of the POSAST are satisfactory, display acceptable validity, and the instrument can be used for screening symptomatic Thai children for OSA.