Recomendaciones sobre las estrategias de tamización para la población adulta de Latinoamérica de la Apnea Obstructiva del sueño

La apnea obstructiva del sueño (AOS) es un trastorno prevalente en el mundo. Se caracteriza por tener una amplia gama de síntomas clínicos, desde asintomático, hasta el sintomático clásico con ronquido, apneas presenciadas y somnolencia diurna. Determinar su probabilidad pretest es clave para orient...

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Autores:
Parra Gómez, Laura Alejandra
Tipo de recurso:
Fecha de publicación:
2022
Institución:
Universidad Autónoma de Bucaramanga - UNAB
Repositorio:
Repositorio UNAB
Idioma:
spa
OAI Identifier:
oai:repository.unab.edu.co:20.500.12749/16865
Acceso en línea:
http://hdl.handle.net/20.500.12749/16865
Palabra clave:
Medical sciences
Health sciences
Obstructive apnea
Asymptomatic
Symptomatic
Berlin Questionnaire
Stop-bang scale
Medical screening
Health risk assessment
Breathing disorders
Sleep disorders
Ciencias médicas
Tamizaje médico
Evaluación de riesgos contra la salud
Trastornos de la respiración
Trastornos del sueño
Ciencias de la salud
Apnea obstructiva
Asintomático
Sintomático
Cuestionario de Berlín
Escala de stop-bang
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License
http://creativecommons.org/licenses/by-nc-nd/2.5/co/
id UNAB2_cb553ab08e354024dd63e3849e1f16ba
oai_identifier_str oai:repository.unab.edu.co:20.500.12749/16865
network_acronym_str UNAB2
network_name_str Repositorio UNAB
repository_id_str
dc.title.spa.fl_str_mv Recomendaciones sobre las estrategias de tamización para la población adulta de Latinoamérica de la Apnea Obstructiva del sueño
dc.title.translated.spa.fl_str_mv Recommendations on screening strategies for the adult population of Latin America for obstructive sleep apnea
title Recomendaciones sobre las estrategias de tamización para la población adulta de Latinoamérica de la Apnea Obstructiva del sueño
spellingShingle Recomendaciones sobre las estrategias de tamización para la población adulta de Latinoamérica de la Apnea Obstructiva del sueño
Medical sciences
Health sciences
Obstructive apnea
Asymptomatic
Symptomatic
Berlin Questionnaire
Stop-bang scale
Medical screening
Health risk assessment
Breathing disorders
Sleep disorders
Ciencias médicas
Tamizaje médico
Evaluación de riesgos contra la salud
Trastornos de la respiración
Trastornos del sueño
Ciencias de la salud
Apnea obstructiva
Asintomático
Sintomático
Cuestionario de Berlín
Escala de stop-bang
title_short Recomendaciones sobre las estrategias de tamización para la población adulta de Latinoamérica de la Apnea Obstructiva del sueño
title_full Recomendaciones sobre las estrategias de tamización para la población adulta de Latinoamérica de la Apnea Obstructiva del sueño
title_fullStr Recomendaciones sobre las estrategias de tamización para la población adulta de Latinoamérica de la Apnea Obstructiva del sueño
title_full_unstemmed Recomendaciones sobre las estrategias de tamización para la población adulta de Latinoamérica de la Apnea Obstructiva del sueño
title_sort Recomendaciones sobre las estrategias de tamización para la población adulta de Latinoamérica de la Apnea Obstructiva del sueño
dc.creator.fl_str_mv Parra Gómez, Laura Alejandra
dc.contributor.advisor.none.fl_str_mv Villar Centeno, Juan Carlos
Vargas Ramírez, Leslie Katherine
dc.contributor.author.none.fl_str_mv Parra Gómez, Laura Alejandra
dc.contributor.cvlac.spa.fl_str_mv Villar Centeno, Juan Carlos [0000068519]
Vargas Ramírez, Leslie Katherine [0000706027]
dc.contributor.googlescholar.spa.fl_str_mv Villar Centeno, Juan Carlos [nTlsWe0AAAAJ]
Vargas Ramírez, Leslie Katherine [c2GP4jIAAAAJ]
dc.contributor.orcid.spa.fl_str_mv Villar Centeno, Juan Carlos [0000-0002-7047-7299]
Vargas Ramírez, Leslie Katherine [0000-0001-6826-721X]
dc.contributor.scopus.spa.fl_str_mv Villar Centeno, Juan Carlos [57193835436]
dc.contributor.researchgate.spa.fl_str_mv Villar Centeno, Juan Carlos [Juan_Villar11]
dc.subject.keywords.spa.fl_str_mv Medical sciences
Health sciences
Obstructive apnea
Asymptomatic
Symptomatic
Berlin Questionnaire
Stop-bang scale
Medical screening
Health risk assessment
Breathing disorders
Sleep disorders
topic Medical sciences
Health sciences
Obstructive apnea
Asymptomatic
Symptomatic
Berlin Questionnaire
Stop-bang scale
Medical screening
Health risk assessment
Breathing disorders
Sleep disorders
Ciencias médicas
Tamizaje médico
Evaluación de riesgos contra la salud
Trastornos de la respiración
Trastornos del sueño
Ciencias de la salud
Apnea obstructiva
Asintomático
Sintomático
Cuestionario de Berlín
Escala de stop-bang
dc.subject.lemb.spa.fl_str_mv Ciencias médicas
Tamizaje médico
Evaluación de riesgos contra la salud
Trastornos de la respiración
Trastornos del sueño
dc.subject.proposal.spa.fl_str_mv Ciencias de la salud
Apnea obstructiva
Asintomático
Sintomático
Cuestionario de Berlín
Escala de stop-bang
description La apnea obstructiva del sueño (AOS) es un trastorno prevalente en el mundo. Se caracteriza por tener una amplia gama de síntomas clínicos, desde asintomático, hasta el sintomático clásico con ronquido, apneas presenciadas y somnolencia diurna. Determinar su probabilidad pretest es clave para orientar a los pacientes al estándar para el diagnóstico, la polisomnografía nocturna, por lo que se han creado diferentes escalas para determinar el riesgo de AOS en adultos, como el cuestionario de Berlín y la escala de STOP-Bang. Objetivo: Desarrollar un proceso de síntesis de la evidencia basado en el abordaje GRADE, para generar una serie de recomendaciones sobre el uso de las escalas para la tamización del AOS (cuestionario de Berlín y escala de STOPBang), en adultos de Latinoamérica. Metodología: Se realizó una revisión sistemática y metaanálisis de la literatura de acuerdo a la metodología PRISMA para revisiones sistemáticas, en torno a la pregunta de investigación en las bases de datos PubMed, Scopus y Biblioteca Virtual de Salud. Se realizó la selección inicial de los artículos mediante el aplicativo web para revisiones sistemáticas RAYYAN QCRI, la extracción de datos se realizó de en Google Sheets y el análisis estadístico llevó a cabo utilizando el programa Meta-DiSc para metaanálisis de estudios de diagnóstico. Posteriormente se realizó el abordaje de la certeza de la evidencia mediante la metodología GRADE, y se generaron las recomendaciones en torno a la pregunta de investigación en torno a las preguntas sobre la tamización para diagnóstico de AOS en la población adulta de Latinoamérica.
publishDate 2022
dc.date.accessioned.none.fl_str_mv 2022-07-11T13:20:33Z
dc.date.available.none.fl_str_mv 2022-07-11T13:20:33Z
dc.date.issued.none.fl_str_mv 2022
dc.type.eng.fl_str_mv Thesis
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/masterThesis
dc.type.local.spa.fl_str_mv Tesis
dc.type.hasversion.spa.fl_str_mv info:eu-repo/semantics/acceptedVersion
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/TM
status_str acceptedVersion
dc.identifier.uri.none.fl_str_mv http://hdl.handle.net/20.500.12749/16865
dc.identifier.instname.spa.fl_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
dc.identifier.reponame.spa.fl_str_mv reponame:Repositorio Institucional UNAB
dc.identifier.repourl.spa.fl_str_mv repourl:https://repository.unab.edu.co
url http://hdl.handle.net/20.500.12749/16865
identifier_str_mv instname:Universidad Autónoma de Bucaramanga - UNAB
reponame:Repositorio Institucional UNAB
repourl:https://repository.unab.edu.co
dc.language.iso.spa.fl_str_mv spa
language spa
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spelling Villar Centeno, Juan Carlos399926b0-729c-4af9-845c-0ad596601e9dVargas Ramírez, Leslie Katherine763c7a27-9213-4df9-8240-2150af0d61caParra Gómez, Laura Alejandraa44c2023-4421-4196-8025-a6b7d06cae6cVillar Centeno, Juan Carlos [0000068519]Vargas Ramírez, Leslie Katherine [0000706027]Villar Centeno, Juan Carlos [nTlsWe0AAAAJ]Vargas Ramírez, Leslie Katherine [c2GP4jIAAAAJ]Villar Centeno, Juan Carlos [0000-0002-7047-7299]Vargas Ramírez, Leslie Katherine [0000-0001-6826-721X]Villar Centeno, Juan Carlos [57193835436]Villar Centeno, Juan Carlos [Juan_Villar11]Latinoamérica2022-07-11T13:20:33Z2022-07-11T13:20:33Z2022http://hdl.handle.net/20.500.12749/16865instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coLa apnea obstructiva del sueño (AOS) es un trastorno prevalente en el mundo. Se caracteriza por tener una amplia gama de síntomas clínicos, desde asintomático, hasta el sintomático clásico con ronquido, apneas presenciadas y somnolencia diurna. Determinar su probabilidad pretest es clave para orientar a los pacientes al estándar para el diagnóstico, la polisomnografía nocturna, por lo que se han creado diferentes escalas para determinar el riesgo de AOS en adultos, como el cuestionario de Berlín y la escala de STOP-Bang. Objetivo: Desarrollar un proceso de síntesis de la evidencia basado en el abordaje GRADE, para generar una serie de recomendaciones sobre el uso de las escalas para la tamización del AOS (cuestionario de Berlín y escala de STOPBang), en adultos de Latinoamérica. Metodología: Se realizó una revisión sistemática y metaanálisis de la literatura de acuerdo a la metodología PRISMA para revisiones sistemáticas, en torno a la pregunta de investigación en las bases de datos PubMed, Scopus y Biblioteca Virtual de Salud. Se realizó la selección inicial de los artículos mediante el aplicativo web para revisiones sistemáticas RAYYAN QCRI, la extracción de datos se realizó de en Google Sheets y el análisis estadístico llevó a cabo utilizando el programa Meta-DiSc para metaanálisis de estudios de diagnóstico. Posteriormente se realizó el abordaje de la certeza de la evidencia mediante la metodología GRADE, y se generaron las recomendaciones en torno a la pregunta de investigación en torno a las preguntas sobre la tamización para diagnóstico de AOS en la población adulta de Latinoamérica.1. Título del proyecto ........................................................................................... 5 2. Resumen del proyecto..................................................................................... 5 3. Project title ....................................................................................................... 6 4. Abstract ............................................................................................................ 7 5. Resumen de recomendaciones ...................................................................... 8 6. Descripción del proyecto ................................................................................ 9 6.1. Planteamiento del problema de investigación y su justificación en términos de necesidades y pertinencia ...................................................................... 9 6.2. Marco teórico ............................................................................................. 11 6.3. Estado del arte .......................................................................................... 17 6.4. Objetivos.................................................................................................... 19 6.4.1. Objetivo general ............................................................................... 19 6.4.2. Objetivos específicos ....................................................................... 19 6.5. Metodología ............................................................................................... 20 6.5.1. Diseño .............................................................................................. 20 6.5.2. Pregunta genérica ............................................................................ 20 6.5.3. Preguntas secundarias .................................................................... 22 6.5.4. Fuentes de información ................................................................... 23 6.5.5. Criterios de elegibilidad .................................................................... 24 6.5.5.1. Inclusión ................................................................................ 24 6.5.5.2. Exclusión ............................................................................... 24 6.5.6. Estrategia de búsqueda ................................................................... 24 6.5.7. Proceso de selección de estudios ................................................... 24 6.5.8. Recolección de datos ....................................................................... 25 6.5.9. Evaluación de riesgo de sesgos ....................................................... 25 6.5.10. Análisis de datos .................................................................... 26 6.5.11. Generación de recomendaciones .......................................... 26 7. Resultados ...................................................................................................... 27 7.1. Proceso de selección del cuerpo de la evidencia ...................................... 27 7.2. Características principales de los estudios primarios ................................... 30 7.3. Evaluación de riesgo de sesgos ................................................................ 41 7.4. Escala de STOP-Bang .............................................................................. 50 7.5. Cuestionario de Berlín ............................................................................... 54 7.6. Pregunta 1: En la población general adulta de Latinoamérica ¿Es recomendable utilizar las escalas de tamizaje para AOS en atención primaria de manera rutinaria? ................................................................... 58 7.6.1. Escala de STOP-Bang ..................................................................... 58 7.6.2. Cuestionario de Berlín ...................................................................... 64 7.6.3. Discusión de la evidencia para la tamización de AOS en adultos de atención primaria / población general ................................................. 71 7.6.4. Recomendaciones para la pregunta 1 .............................................. 73 7.7. Pregunta 2: En adultos con obesidad ¿Es recomendable utilizar las escalas de tamización para AOS? ........................................................................................... 73 7.7.1. Escala de STOP-Bang ..................................................................... 73 7.7.2. Cuestionario de Berlín ...................................................................... 78 7.7.3. Discusión de la evidencia para la tamización de AOS en adultos con obesidad ................................................................................................................... 79 7.7.4. Recomendaciones para la pregunta 2 .............................................. 80 7.8. Pregunta 3: ¿Es recomendable utilizar las escalas de tamización para AOS en adultos jóvenes? .................................................................................................... 80 7.8.1. Escala de STOP-Bang ..................................................................... 81 7.8.2. Cuestionario de Berlín ...................................................................... 84 7.8.3. Discusión de la evidencia para la tamización de AOS en adultos jóvenes...................................................................................................................... 87 7.8.4. Recomendaciones para la pregunta 3 .............................................. 88 7.9. Pregunta 4: En población con comorbilidades específicas con mayor riesgo de AOS ¿Se recomienda utilizar las escalas de tamización para AOS de manera rutinaria? .......................................................................................................... 88 7.9.1. Escala de STOP-Bang ..................................................................... 88 7.9.2. Cuestionario de Berlín ...................................................................... 93 7.9.3. Discusión de la evidencia para la tamización de AOS en pacientes con comorbilidades específicas con mayor riesgo de AOS ..................... 98 7.9.4. Recomendaciones para la pregunta 4 ............................................ 100 7.10. Pregunta 5: En la población adulta de Latinoamérica referida a clínicas de sueño por sospecha de AOS ¿Es recomendable utilizar las escalas de tamización para AOS, frente a la polisomnografía nocturna? 100 7.10.1. Escala de STOP-Bang ......................................................... 100 7.10.2. Cuestionario de Berlín ......................................................... 104 7.10.3. Discusión de la evidencia para la tamización de AOS en pacientes referidos a clínicas de sueño por sospecha de AOS ........... 108 7.10.4. Recomendaciones para la pregunta 5 ................................. 109 8. Modificaciones al protocolo ........................................................................ 109 9. Fortalezas y debilidades .............................................................................. 109 10. Agradecimientos .......................................................................................... 110 11. Referencias bibliográficas .......................................................................... 110 12. Anexos .......................................................................................................... 128MaestríaObstructive sleep apnea (OSA) is prevalent around the world. With a wide range of clinical symptoms, from asymptomatic to classic symptoms like snoring, apneas, and daytime sleepiness. It is essential to determine the pretest probability of having OSA direct patients o the standard for diagnosis, nocturnal polysomnography, which is why different scales have been created to assess OSA risk in adults such as the Berlin questionnaire and the STOP-Bang scale. Objective: Develop an evidence-based synthesis process based on the GRADE approach to generate recommendations for using OSAs screening scales (Berlin Questionnaire and STOP-Bang scale) in Latin American adults. Methods: A systematic review and metanalysis of literature were made according to the PRISMA methodology for systematic reviews. A systematic search was done on PubMed, Scopus, and the Virtual Health Library databases. The initial selection was made on RAYYAN QCRI, and data extraction was performed using Google Sheets. Statistical analyses were performed using Meta-DiSc for diagnostic accuracy metanalysis. The certainty of the evidence was carried out using the GRADE methodology, and recommendations were generated according to the research question.application/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)Atribución-NoComercial-SinDerivadas 2.5 Colombiahttp://purl.org/coar/access_right/c_abf2Recomendaciones sobre las estrategias de tamización para la población adulta de Latinoamérica de la Apnea Obstructiva del sueñoRecommendations on screening strategies for the adult population of Latin America for obstructive sleep apneaThesisinfo:eu-repo/semantics/masterThesisTesisinfo:eu-repo/semantics/acceptedVersionhttp://purl.org/redcol/resource_type/TMMagíster en Métodos para la Producción y Aplicación de Conocimiento Científico en SaludUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludMaestría en Métodos para la Producción y Aplicación de Conocimiento Científico en SaludMedical sciencesHealth sciencesObstructive apneaAsymptomaticSymptomaticBerlin QuestionnaireStop-bang scaleMedical screeningHealth risk assessmentBreathing disordersSleep disordersCiencias médicasTamizaje médicoEvaluación de riesgos contra la saludTrastornos de la respiraciónTrastornos del sueñoCiencias de la saludApnea obstructivaAsintomáticoSintomáticoCuestionario de BerlínEscala de stop-bang1. 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Journal of Clinical Sleep Medicine. 2022 Mar;18(3):835–41.ORIGINAL2022_Tesis_Laura_Parra.pdf2022_Tesis_Laura_Parra.pdfTesisapplication/pdf4023067https://repository.unab.edu.co/bitstream/20.500.12749/16865/1/2022_Tesis_Laura_Parra.pdf4c85da516fa6849122cc3450230e2c07MD51open access2022_Licencia_Laura_Parra.pdf2022_Licencia_Laura_Parra.pdfLicenciaapplication/pdf111620https://repository.unab.edu.co/bitstream/20.500.12749/16865/2/2022_Licencia_Laura_Parra.pdf45fa12dbac4e0126ec734a1b853f5c30MD52metadata only accessLICENSElicense.txtlicense.txttext/plain; charset=utf-8829https://repository.unab.edu.co/bitstream/20.500.12749/16865/3/license.txt3755c0cfdb77e29f2b9125d7a45dd316MD53open accessTHUMBNAIL2022_Tesis_Laura_Parra.pdf.jpg2022_Tesis_Laura_Parra.pdf.jpgIM Thumbnailimage/jpeg4943https://repository.unab.edu.co/bitstream/20.500.12749/16865/4/2022_Tesis_Laura_Parra.pdf.jpge2287a0d4455979051088a9fdac74269MD54open access2022_Licencia_Laura_Parra.pdf.jpg2022_Licencia_Laura_Parra.pdf.jpgIM Thumbnailimage/jpeg9105https://repository.unab.edu.co/bitstream/20.500.12749/16865/5/2022_Licencia_Laura_Parra.pdf.jpgcd3140e40a308dc368e54163aa696198MD55open access20.500.12749/16865oai:repository.unab.edu.co:20.500.12749/168652022-07-11 22:00:43.228open accessRepositorio Institucional | Universidad Autónoma de Bucaramanga - UNABrepositorio@unab.edu.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