TY - JOUR T1 - Cloud Algorithm-Driven Oximetry-Based Diagnosis of Obstructive Sleep Apnea in Symptomatic Habitually-Snoring Children JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01788-2018 SP - 1801788 AU - Zhifei Xu AU - Gonzalo C. Gutiérrez-Tobal AU - Yunxiao Wu AU - Leila Kheirandish-Gozal AU - Xin Ni AU - Roberto Hornero AU - David Gozal Y1 - 2018/01/01 UR - http://erj.ersjournals.com/content/early/2018/11/15/13993003.01788-2018.abstract N2 - The ability of a cloud-driven Bluetooth oximetry-based algorithm to diagnose obstructive sleep apnea (OSA) was examined in habitually snoring children concurrently undergoing overnight polysomnography. Children clinically referred for overnight in-laboratory polysomnographic evaluation for suspected OSAS were simultaneously hooked with a Bluetooth oximeter linked to a smartphone. PSG findings were scored and the apnea hypopnea index (AHIPSG) was tabulated while oximetry data yielded an estimated AHIOXI using a validated algorithm. The accuracy of the oximeter in identifying correctly patients with OSAS in general, or with mild (AHI1–5 events·h−1), moderate (5–10 events·h−1) or severe OSAS (>10 events·h−1) was examined in 432 subjects (6.5±3.2 years) with 343 having AHIPSG>1 event·h−1. The accuracies of AHIOXI were consistently >79% for all levels of OSAS severity, and specificity was particularly favorable for AHI≥10 events·h−1 (92.7%). Using the criterion of AHIPSG >1 event·h−1, only 4.7% of false negative cases emerged, from which only 0.6% of cases showed moderate or severe OSAS. Overnight oximetry processed via Bluetooth technology by a cloud-based machine learning-derived algorithm can reliably diagnose OSAS in children with clinical symptoms suggestive of the disease. This approach provides virtually limitless scalability and should alleviate the substantial difficulties in accessing pediatric sleep laboratories while markedly reducing the costs of OSAS diagnosis.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Xu has nothing to disclose.Conflict of interest: Dr. Gutiérrez-Tobal has nothing to disclose.Conflict of interest: Dr. Wu has nothing to disclose.Conflict of interest: Dr. Kheirandish-Gozal reports other from Serenium Inc, during the conduct of the study.Conflict of interest: Dr. Ni has nothing to disclose.Conflict of interest: Dr. Hornero has nothing to disclose.Conflict of interest: Dr. Gozal has nothing to disclose. ER -