Simplification of the severity hierarchy score for pediatric sleep apnea screening

Pediatric Obstructive Sleep Apnea is a common condition. However, it remains under diagnosed exposing to associated morbidities. Polysomnography is the standard diagnostic test, but its availability is sometimes limited, especially in poor countries. The questionnaire proposed by Spruyt and Gazal has been validated as a screening tool by many studies. A score above 2.75 have an 82% sensitivity, a 81% specificity and a negative predictive value of 92% for detecting moderate OSA. However, the way of calculating the score seems to us rather complicated and may limit its use in daily practice. Therefore, we propose, for calculating the score, a table that may be printed in sheets of paper. We propose a simple modification that could, in our opinion; greatly facilitate the use of this screening tool by reducing the use of calculators and the risks of errors. In this way, we hope to make its use much easier in everyday practice.