Overnight oximetry as a screening tool for moderate to severe obstructive sleep apnoea in South African children
Why this work is in the frame
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Bibliographic record
Abstract
BACKGROUND: Obstructive sleep apnoea (OSA) is common in children yet often overlooked, as symptom-based screening is unreliable. Polysomnography is regarded as the gold standard for the diagnosis of OSA, but is not widely available in South Africa (SA). Overnight oximetry is a validated screening tool for OSA. OBJECTIVES: To describe the impact and utility of overnight oximetry at a tertiary children's hospital in SA. METHODS: A retrospective descriptive study was conducted of patients screened for OSA by overnight oximetry at a paediatric referral hospital from December 2012 to December 2014. Clinical data were retrieved from the oximetry database and medical records. Recordings of ≥6 hours were considered adequate and included in the study. OSA severity was determined using the McGill score. Details on management and outcome were documented. RESULTS: Oximetry studies in 137 of 153 patients were suitable for analysis (88 males (64.2%), median age 31.4 months (interquartile range (IQR) 15.8 - 65.8). Adenotonsillar hypertrophy was common (n=97, 70.8%), and 65 children (47.4%) had two or more underlying OSA risk factors. McGill's score classified patients as follows: no/mild OSA n=55 (40.1%), moderate OSA n=23 (16.8%), severe OSA n=23 (16.8%) and very severe OSA n=36 (26.3%). Male gender, adenotonsillar hypertrophy and a lower weight-for-age z-score (-1.3 v. -0.7; p=0.038) were associated with severe to very severe OSA. Seventy-eight children (56.9%) were referred for surgery, 33 (24.1%) receiving urgent surgery within a median of 6 days (IQR 4 - 12). In contrast, 59 children (43.1%) with suspected OSA did not require surgical intervention. CONCLUSIONS: Overnight oximetry is a simple low-cost tool to assess severity of OSA and prioritise appropriate OSA management in resource-constrained settings such as SA.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.006 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it