Obstructive Sleep Apnea-5

Instrument Name: Obstructive Sleep Apnea-5

Abbreviation: OSA-5

Points for Consideration:

None

Description of Tool:

The Obstructive Sleep Apnea-5 (OSA-5) is a 5-item ObsRO developed to screen and triage children at risk of obstructive sleep apnea among large numbers of referrals for sleep-disordered breathing. Parents are asked to rate their child's symptoms over the past four weeks. Items are rated on a 4-level scale ranging from 1="None of the time", 2="Some of the time", 3="Most of the time", to 4="All of the time". A higher score represents more likelihood of having obstructive sleep apnea.

Other Related Tools (if applicable):

The OSA-20 consists of 20 items to determine the impact of OSA on children's health-related quality of life. This version includes two additional items: Item 12 (Social problems) and Item 16 (School problems).
The OSA-18 consists of 18 items to determine the impact of OSA on children's health-related quality of life. This revised version does not include Item 12 (Social problems) and Item 16 (School problems) included in the OSA-20.

Minimum Qualification Required by COA Administrator: No degree requirement

Comment:

The OSA-5 was developed as an abbreviated form of the OSA-18 originally developed by Franco et al., 2000. The items included in the OSA-5 were selected based on the strongest associations with OSA found in the authors' previous work (Walter et al., 2016) and clinical experience. The OSA-5 consists of the OSA-18 Item 1 (Loud snoring), Item 2 (Breath holding spells or pauses in breathing at night), Item 3 (Choking or gasping sounds while asleep), Item 5 (Mouth breathing because of nasal obstruction) and Item 16 (Breathing problems during sleep that made you worried that they were not getting enough air). Further, the modified response scale includes four options, reduced from the original 7 options included in the OSA-18: 1="None of the time", 2="Some of the time", 3="Most of the time", and 4="All of the time".

Year: 2018

Objective of Development:

To help screen and triage children at risk of obstructive sleep apnea among large numbers of referrals for sleep-disordered breathing.

Population of Development: Age range (therapeutic indication):

Age range: 2-17 years (Children who had either polysomnography or oximetry for suspected sleep apnea)

Pediatric Population(s) in which COA has been used:

None identified

COA type: ObsRO

Number of Items 5

Mode of Administration: Caregiver-rated

Data Collection Mode: Paper and pen administration

Time for Completion: No information

Response Scales: 4-point scale: ranging from 1="None of the time", 2="Some of the time", 3="Most of the time", and 4="All of the time"

Summary of Scoring:

Available scores: A total score is obtained by summing the scores of all 5 items. The total score can range from 0 to 15.

Weighting: No

Score interpretation: Higher scores=More likelihood of having OSA.

Evidence of Literature Review: None identified

Evidence of Instrument Review: None identified

Evidence of Clinical or Expert Input: Yes

Evidence of concept elicitation in target patient population: Yes

Evidence of a Saturation Grid: None identified

Evidence for Selection of Data Collection Method: None identified

Recall/Observation Period: Past 4 weeks

Evidence for Selection of Reponse Options: Yes

Evidence of cognitive interviewing of draft instrument in target patient population: None identified

Evidence of Preliminary Scoring of Items and Domains: None identified

Evidence related to respondent and administrator burden: None identified

Evidence of a Conceptual Framework: None identified

Evidence of an item-tracking matrix: None identified

Evidence related to item selection: Yes

Evidence of re-testing the final version: Yes

Internal consistency (Cronbach's alpha): Yes

Evidence of internal consistency: Soh HJ (2018) - Method: Cronbach's alpha - Results: 0.80 - Population/Disease: Children aged 2-18 years who had either polysomnography or oximetry; n=366

Test-retest Reliability (ICC):

None identified

Inter-rater/ inter-interviewer reliability (kappa):

None identified

Evidence of test-retest or inter-rater reliability: None identified

Concurrent validity (convergent, divergent):

None identified

Known-group validity:

None identified

Evidence of Translatability Assessment: None identified

Evidence related to missing data: None identified

Evidence for Selection of Recall Period: None identified

Evidence of Administration Instructions and Training Provided: None identified

Evidence of concurrent validity: None identified

Evidence of known-groups validity: None identified

Evidence of ability to detect change over time: None identified

Ability to detect change (Responsiveness):

None identified

Responder Thresholds:

None identified

Evidence of responder thresholds: None identified

Soh HJ, Rowe K, Davey MJ, Horne RSC, Nixon GM. The OSA-5: Development and validation of a brief questionnaire screening tool for obstructive sleep apnea in children. Int J Pediatr Otorhinolaryngol. 2018 Oct;113:62-66. doi: 10.1016/j.ijporl.2018.07.029. Epub 2018 Jul 19. PMID: 30174012. Full Text Article: https://pubmed.ncbi.nlm.nih.gov/30174012/

Franco RA Jr, Rosenfeld RM, Rao M. First place--resident clinical science award 1999. Quality of life for children with obstructive sleep apnea. Otolaryngol Head Neck Surg. 2000 Jul;123(1 Pt 1):9-16. doi: 10.1067/mhn.2000.105254. PMID: 10889473. Full Text Article: https://pubmed.ncbi.nlm.nih.gov/10889473/

Walter, L. M., Biggs, S. N., Cikor, N., Rowe, K., Davey, M. J., Horne, R. S., & Nixon, G. M. (2016). The efficacy of the OSA-18 as a waiting list triage tool for OSA in children. Sleep and Breathing, 20, 837-844. Full Text Article: https://pubmed.ncbi.nlm.nih.gov/26669876/

None identified

None identified

Yes

None identified

None identified

Authors: Soh HJ, Rowe K, Davey MJ, Horne RSC, Nixon GM

Contact:
Gillian M. Nixon
The Ritchie Centre, Department of Paediatrics
Monash University and Hudson Institute of Medical Research
Melbourne, Australia.
E-mail address: gillian.nixon@monashhealth.org

None identified

None identified

https://www.sciencedirect.com/science/article/abs/pii/S0165587618303446#:~:text=In%20conclusion%2C%20we%20have%20developed,symptoms%20of%20sleep%20disordered%20breathing