Efficient Screening in Obstructive Sleep Apnea Using Sequential Machine Learning Models, Questionnaires, and Pulse Oximetry Signals: Mixed Methods Study
Bibliographic record
Abstract
Background Obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by frequent pauses or shallow breathing during sleep. Polysomnography, the gold standard for OSA assessment, is time consuming and labor intensive, thus limiting diagnostic efficiency. Objective This study aims to develop 2 sequential machine learning models to efficiently screen and differentiate OSA. Methods We used 2 datasets comprising 8444 cases from the Sleep Heart Health Study (SHHS) and 1229 cases from Taipei Veterans General Hospital (TVGH). The Questionnaire Model (Model-Questionnaire) was designed to distinguish OSA from primary insomnia using demographic information and Pittsburgh Sleep Quality Index questionnaires, while the Saturation Model (Model-Saturation) categorized OSA severity based on multiple blood oxygen saturation parameters. The performance of the sequential machine learning models in screening and assessing the severity of OSA was evaluated using an independent test set derived from TVGH. Results The Model-Questionnaire achieved an F1-score of 0.86, incorporating demographic data and the Pittsburgh Sleep Quality Index. Model-Saturation training by the SHHS dataset displayed an F1-score of 0.82 when using the power spectrum of blood oxygen saturation signals and reached the highest F1-score of 0.85 when considering all saturation-related parameters. Model-saturation training by the TVGH dataset displayed an F1-score of 0.82. The independent test set showed stable results for Model-Questionnaire and Model-Saturation training by the TVGH dataset, but with a slightly decreased F1-score (0.78) in Model-Saturation training by the SHHS dataset. Despite reduced model accuracy across different datasets, precision remained at 0.89 for screening moderate to severe OSA. Conclusions Although a composite model using multiple saturation parameters exhibits higher accuracy, optimizing this model by identifying key factors is essential. Both models demonstrated adequate at-home screening capabilities for sleep disorders, particularly for patients unsuitable for in-laboratory sleep studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.017 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".