, Volume 13, Issue 2, pp 127-136
Date: 02 Oct 2008

Validation of the WristOx 3100™ oximeter for the diagnosis of sleep apnea/hypopnea syndrome

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Abstract

Objective

To evaluate the diagnostic accuracy of the Nonin WristOx 3100™ and its software (nVision 5.0) in patients with suspicion of sleep apnea/hypopnea syndrome (SAHS).

Methods

All participants (168) had the oximetry and polysomnography simultaneously. The two recordings were interpreted blindly. The software calculated: adjusted O2 desaturation index [ADI]-mean number of O2 desaturation per hour of total recording analyzed time of ≥ 2%, 3%, 4%, 5%, and 6% (ADI2, 3, 4, 5, and 6) and AT90-accumulated time at SO2 < 90%. The ADI2, 3, 4, 5, and 6 and the AT90 cutoff points that better discriminated between subjects with or without SAHS arose from the receiver operating characteristic curve analysis. The sensitivity (S), specificity (E), and positive and negative likelihood ratio (LR+, LR−) for the different thresholds for ADI were calculated.

Results

One hundred and fifty-four patients were included (119 men, mean age 51, median apnea/hypopnea index [AHI] 14, median body mass index [BMI] 28.3 kg/m2). The best cutoff points of ADI were: SAHS = AHI ≥ 5: ADI2 > 19.3 (S 89%, E 94%, LR+ 15.5 LR− 0.11); SAHS =AHI ≥ 10: ADI3 > 10.5 (S 88%, E 94%, LR+ 15 LR− 0.12); SAHS = AHI ≥ 15: ADI3 > 13.4 (S 88%, E 90%, LR+ 8.9, LR− 0.14). AT90 had the lowest diagnosis accuracy. An ADI2 ≤ 12.2 excluded SAHS (AHI ≥ 5 and 10; S 100%, LR− 0) and ADI3 > 4.3 (AHI ≥ 5 and 10) or 32 (AHI ≥ 15) confirmed SAHS (E 100%).

Conclusions

A negative oximetry defined as ADI2 ≤ 12.2 excluded SAHS defined as AHI ≥ 5 or 10 with a sensitivity and negative likelihood ratio of 100% and 0%, respectively. Furthermore, a positive oximetry defined as an ADI3 > 32 (SAHS = AHI ≥ 15) had a specificity of 100% to confirm the pathology.