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Tradução do Questionário de Berlim para língua Portuguesa e sua aplicação na identificação da SAOS numa consulta de patologia respiratória do sono
Translation of Berlin Questionnaire to Portuguese language and its application in OSA identification in a sleep disordered breathing clinic
A.P. Vaza,
, M. Drummondb, P. Caetano Motaa, M. Severoc, J. Almeidaa, J. Carlos Winckb
Corresponding author
a Serviço de Pneumologia, H.S. João, Porto, Portugal
b Serviço de Pneumologia, H.S. João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
c Departamento de Higiene e Epidemiologia da Faculdade de Medicina da Universidade do Porto, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
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"apellidos" => "Vaz" "email" => array:1 [ 0 => "vaz.anapaula@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Drummond" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "P." "apellidos" => "Caetano Mota" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Severo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "J." "apellidos" => "Almeida" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "J." "apellidos" => "Carlos Winck" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Serviço de Pneumologia, H.S. João, Porto, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Serviço de Pneumologia, H.S. João, Faculdade de Medicina da Universidade do Porto, Porto, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Higiene e Epidemiologia da Faculdade de Medicina da Universidade do Porto, Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Autor para correspondência." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Translation of Berlin Questionnaire to Portuguese language and its application in OSA identification in a sleep disordered breathing clinic" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-07-11" "fechaAceptado" => "2010-09-12" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec566804" "palabras" => array:4 [ 0 => "Questionário de Berlim" 1 => "Apneia Obstrutiva do Sono" 2 => "Rastreio" 3 => "Diagnóstico" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec566805" "palabras" => array:4 [ 0 => "Berlin Questionnaire" 1 => "Obstructive sleep apnea" 2 => "Screening" 3 => "Diagnosis" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span><span class="elsevierStyleSectionTitle">Introdução</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">O Questionário de Berlim (QB), originalmente desenvolvido em língua inglesa como um instrumento de rastreio da síndrome de apneia obstrutiva do sono (SAOS) em cuidados de saúde primários, tem sido aplicado no âmbito dos cuidados secundários, com resultados variáveis.</p></span> <span><span class="elsevierStyleSectionTitle">Objectivos</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Obtenção da versão em língua Portuguesa do QB e avaliação da sua utilidade numa consulta de Patologia Respiratória do Sono.</p></span> <span><span class="elsevierStyleSectionTitle">Material e métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">O QB foi traduzido utilizando a metodologia <span class="elsevierStyleItalic">back translation</span> e aplicado, previamente ao estudo cardiorespiratório do sono, a 95 indivíduos consecutivos referenciados à consulta de patologia respiratória do sono por suspeita de SAOS. A avaliação do risco para a SAOS baseou-se nas respostas a 10 itens, organizados em 3 categorias: roncopatia e apneias presenciadas (categoria 1), sonolência diurna (categoria 2), hipertensão arterial (HTA)/obesidade (categoria 3).</p></span> <span><span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Na amostra estudada, 67,4% era do sexo masculino, com uma média de idades de 51<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13 anos. As categorias 1, 2 e 3 foram positivas em 91,6, 24,2 e 66,3%, respectivamente. O QB identificou 68,4% dos doentes como apresentando alto risco para a SAOS e os restantes, 31,6%, baixo risco. A sensibilidade e a especificidade do QB, considerando um índice de apneia/hipopneia (IAH)<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>5, foi de 72,1 e 50,0% respectivamente, de 82,6 e 44,8% para um IAH<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>15 e de 88,4 e 39,1% para um IAH<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>30. Estar incluído no grupo de alto risco para a SAOS não influenciou significativamente a probabilidade de ter doença (likelihood ratio (LR) positivo entre 1,44–1,49). Apenas os itens referentes à intensidade sonora da roncopatia, apneias presenciadas e HTA/obesidade, apresentaram uma associação positiva estatisticamente significativa com o IAH, com o modelo constituído pela associação destes itens a apresentar uma maior capacidade de discriminação, especialmente para um IAH<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>5 (sensibilidade 65,2%, especificidade 80,0%, LR Positivo 3.26).</p></span> <span><span class="elsevierStyleSectionTitle">Conclusão</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">O QB não é um instrumento apropriado de rastreio da SAOS numa consulta de patologia respiratória do sono, embora a intensidade da roncopatia, as apneias presenciadas e a HTA/obesidade tenham demonstrado ser elementos do questionário com expressão significativa nesta população.</p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span><span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Berlin Questionnaire (BQ), an English language screening tool for obstructive sleep apnea (OSA) in primary care, has been applied in tertiary settings, with variable results.</p></span> <span><span class="elsevierStyleSectionTitle">Aims</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Development of BQ Portuguese version and evaluation of its utility in a sleep disordered breathing clinic (SDBC).</p></span> <span><span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">BQ was translated using back translation methodology and prospectively applied, previously to cardiorespiratory sleep study, to 95 consecutive subjects, referred to a SDBC, with OSA suspicion. OSA risk assessment was based on responses in 10 items, organized in 3 categories: snoring and witnessed apneas (category 1), daytime sleepiness (category 2), high blood pressure (HBP)/obesity (category 3).</p></span> <span><span class="elsevierStyleSectionTitle">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In the studied sample, 67.4% were males, with a mean age of 51<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13 years. Categories 1, 2 and 3 were positive in 91.6, 24.2 and 66.3%, respectively. BQ identified 68.4% of the patients as being in the high risk group for OSA and the remaining 31.6% in the low risk. BQ sensitivity and specificity were 72.1 and 50%, respectively, for an apnea-hipopnea index (AHI)<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>5, 82.6 and 44.8% for AHI<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>15, 88.4 and 39.1% for AHI<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>30. Being in the high risk group for OSA did not influence significantly the probability of having the disease (positive likelihood ratio [LR] between 1.44–1.49). Only the items related to snoring loudness, witnessed apneas and HBP/obesity presented a statistically positive association with AHI, with the model constituted by their association presenting a greater discrimination capability, especially for an AHI > 5 (sensitivity 65.2%, specificity 80%, positive LR 3.26).</p></span> <span><span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The BQ is not an appropriate screening tool for OSA in a SDBC, although snoring loudness, witnessed apneas, HBP/obesity have demonstrated being significant questionnaire elements in this population.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Referências" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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ISSN: 08732159Original language: Portuguese
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