@article {Thorntonp4967, author = {Andrew Thornton and Parmjit Singh and Warren Ruehland and Peter Rochford}, title = {Interpretation of central and obstructive apnea event type varies widely between scorers: An observational study}, volume = {38}, number = {Suppl 55}, elocation-id = {p4967}, year = {2011}, publisher = {European Respiratory Society}, abstract = {Background: Accurate classification of respiratory events in sleep as central or obstructive is critical to determining underlying pathophysiology and treatment.Aim: To measure agreement in event classification in a group of scorers.Methods: From June 2009 to Sept 2010, as part of a proficiency testing program within Australian and New Zealand laboratories, 10 studies were distributed. Four studies with AHI\>40/hr and \>10\% of events scored as central or mixed apnea were chosen for analysis. Studies were scored by up to 103 scorers (mean 80) in up to 24 laboratories. Scored studies were compared and events defined as concordant if they overlapped in time. The majority of scorers indicated they used {\textquotedblleft}Chicago{\textquotedblright} rules.Results: There was major disagreement between scorers in classification of respiratory events. The figure shows a scatter plot of the percentage of all apnea classified as central or mixed for each scorer and each study. A superimposed box plot shows median, 25th and 10th percentiles.Discussion: There is an expectation that scorers can accurately distinguish obstructive from central events. This observational study shows that interpretation varies widely. This has important consequences for treatment of individuals and for conduct of research studies. AASM rules may provide more clarity and improve concordance but ongoing training and interlaboratory comparisons are essential.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/38/Suppl_55/p4967}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }