Table 2. Combined Test Characteristics of a STOP-Bang Score of 3 or Greater.
| Test characteristic | All OSA, ie, AHI ≥5, % (95% CI) | Moderate to severe OSA, ie, AHI ≥15, % (95% CI) | Severe OSA, ie, AHI ≥30, % (95% CI) |
|---|---|---|---|
| All regions | |||
| Studies, No. (participants, No.) | 45 (24 192) | 38 (23 811) | 29 (17 984) |
| Prevalence | 80 (80 to 81) | 58 (58 to 59) | 39 (38 to 39) |
| Sensitivity | 92 (89 to 94) | 95 (93 to 96) | 97 (95 to 98) |
| Specificity | 33 (26 to 41) | 28 (22 to 34) | 24 (19 to 30) |
| PPV | 86 (85 to 86) | 66 (65 to 66) | 46 (45 to 47) |
| NPV | 47 (45 to 49) | 77 (75 to 78) | 91 (90 to 92) |
| Log scale DOR (95% CI) | 1.74 (0.88 to 2.59) | 1.91 (1.62 to 2.21) | 2.08 (1.72 to 2.43) |
| AUC (95% CI) | 0.76 (0.72 to 0.80) | 0.76 (0.72 to 0.80) | 0.72 (0.68 to 0.76) |
| North America | |||
| Studies, No. (participants, No.) | 9 (3507) | 9 (3507) | 8 (3460) |
| Prevalence | 81 (80 to 82) | 54 (53 to 56) | 32 (31 to 34) |
| Sensitivity | 90 (84 to 93) | 94 (93 to 96) | 96 (94 to 97) |
| Specificity | 34 (24 to 45) | 24 (18 to 33) | 20 (14 to 27) |
| PPV | 86 (84 to 87) | 60 (58 to 62) | 36 (34 to 38) |
| NPV | 45 (41 to 49) | 78 (74 to 81) | 91 (88 to 93) |
| Log scale DOR (95% CI) | 1.21 (–0.81 to 3.24) | 1.93 (1.40 to 2.47) | 1.59 (1.12 to 2.07) |
| AUC (95% CI) | 0.72 (0.68 to 0.76) | 0.89 (0.85 to 0.91) | 0.89 (0.86 to 0.91) |
| South America | |||
| Studies, No. (participants, No.) | 5 (9245) | 4 (9624) | 3 (8160) |
| Prevalence | 80 (79 to 81) | 58 (57 to 59) | 37 (36 to 38) |
| Sensitivity | 93 (87 to 96) | 96(91 to 98) | 96 (96 to 97) |
| Specificity | 33 (21 to 48) | 25(15 to 38) | 30 (28 to 31) |
| PPV | 87 (86 to 88) | 66 (65 to 67) | 44 (43 to 46) |
| NPV | 52 (49 to 54) | 78 (76 to 80) | 93 (92 to 94) |
| Log scale DOR, 95% CI | 4.09 (1.18 to 7.00) | 1.62 (1.27 to 1.97) | 2.36 (2.16 to 2.55) |
| AUC, 95% CIa | 0.76 (0.72 to 0.79) | 0.74 | 0.66 |
| Europe | |||
| Studies, No. (participants, No.) | 9 (4979) | 10 (5679) | 6 (3278) |
| Prevalence | 79 (78 to 80) | 60 (58 to 61) | 46 (45 to 48) |
| Sensitivity | 95 (90 to 97) | 97 (93 to 99) | 99 (97 to 99) |
| Specificity | 24 (13 to 39) | 25 (14 to 40) | 22 (12 to 36) |
| PPV | 81 (80 to 82) | 67 (66 to 69) | 56 (54 to 58) |
| NPV | 41 (36 to 46) | 78 (75 to 81) | 96 (94 to 98) |
| Log scale DOR, 95% CI | 2.81 (1.03 to 4.59) | 1.93 (1.60 to 2.26) | 3.00 (1.99 to 4.01) |
| AUC, 95% CI | 0.78 (0.74 to 0.81) | 0.81 (0.78 to 0.84) | 0.96 (0.93 to 0.97) |
| Middle East | |||
| Studies, No. (participants, No.) | 11 (3468) | 7 (2545) | 6 (1542) |
| Prevalence | 87 (86 to 88) | 67 (65 to 68) | 48 (46 to 51) |
| Sensitivity | 93 (87 to 96) | 95 (89 to 98) | 94 (85 to 98) |
| Specificity | 24 (12 to 44) | 28 (13 to 50) | 33 (17 to 54) |
| PPV | 90 (88 to 91) | 71 (69 to 73) | 55 (52 to 57) |
| NPV | 30 (26 to 35) | 66 (61 to 72) | 78 (73 to 83) |
| Log scale DOR, 95% CI | 0.75 (–1.27 to 2.78) | 2.24 (1.11 to 3.37) | 1.96 (1.48 to 2.45) |
| AUC, 95% CI | 0.77 (0.73 to 0.80) | 0.83 (0.79 to 0.86) | 0.78 (0.74 to 0.81) |
| East Asia | |||
| Studies, No. (participants, No.) | 4 (1665) | 4 (1665) | 3 (887) |
| Prevalence | 75 (73 to 77) | 56 (54 to 59) | 40 (37 to 43) |
| Sensitivity | 90 (81 to 96) | 93(84 to 97) | 90 (87 to 93) |
| Specificity | 44 (37 to 50) | 33 (27 to 41) | 30 (26 to 34) |
| PPV | 83 (81 to 85) | 64 (62 to 67) | 46 (43 to 50) |
| NPV | 56 (51 to 62) | 76 (71 to 81) | 82 (76 to 87) |
| Log scale DOR, 95% CI | 1.38 (–0.19 to 2.97) | 2.01 (1.24 to 2.77) | 1.89 (0.74 to 3.03) |
| AUC. 95% CIa | 0.56 (0.52 to 0.60) | 0.52 (0.48 to 0.56) | 0.41 |
| South or Southeast Asia | |||
| Studies, No. (participants, No.) | 7 (1519) | 4 (791) | 3 (657) |
| Prevalence | 75 (73 to 78) | 56 (52 to 59) | 34 (30 to 38) |
| Sensitivity | 81 (68 to 89) | 89 (73 to 96) | 96(93 to 98) |
| Specificity | 60 (46 to 73) | 45 (30 to 61) | 33 (28 to 37) |
| PPV | 86 (84 to 89) | 65 (61 to 69) | 42 (38 to 47) |
| NPV | 46 (41 to 51) | 70 (63 to 76) | 95 (89 to 98) |
| Log scale DOR, 95% CI | 1.36 (0.21 to 2.52) | 2.04 (1.12 to 2.96) | 2.54 (1.91 to 3.17) |
| AUC, 95% CIa | 0.76 (0.72 to 0.80) | 0.70 (0.66 to 0.74) | 0.89 |
Abbreviations: AHI, apnea-hypopnea index; AUC, area under the summary receiver operating characteristic curve; DOR, diagnostic odds ratio; NPV, negative predictive value; OSA, obstructive sleep apnea; PPV, positive predictive value.
a
For groups with fewer than 5 studies, 95% CIs for AUC values are not reported due to software output.