Validation of the sleep-EVAL system against clinical assessments of sleep disorders and polysomnographic data

Objectives: To validate the Sleep-EVAL expert system, a computerized tool designed for the assessment of sleep disorders, against polysomnographic data and clinical assessments by sleep specialists. Design: Patients were interviewed twice, once by a physician using Sleep-EVAL and again by a sleep specialist. Polysomnographic data were also recorded to ascertain diagnoses. Agreement between diagnoses generated by Sleep-EVAL and those formulated by Sleep specialists was determined via the kappa statistic. Settings: Sleep disorder centers at Stanford University (USA) and Regensburg University (Germany). Patients: 105 patients aged 18 years or over. Interventions: NA Results: Sleep-EVAL made an average of 1.32 diagnoses per patient, compared with 0.93 for the Sleep specialists. Overall agreement on any sleep-breathing disorder was 96.9% (Kappa .94). More than half of the patients were diagnosed with obstructive sleep apnea syndrome (OSAS); the agreement rate for this specific diagnosis was 96.7% (Kappa .93). Conclusions: The findings indicate that the Sleep-EVAL system is a valid instrument for the recognition of major sleep disorders, particularly insomnia and OSAS.