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

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dc.contributor.advisorVillar Centeno, Juan Carlos
dc.contributor.advisorVargas Ramírez, Leslie Katherine
dc.contributor.authorParra Gómez, Laura Alejandra
dc.contributor.cvlacVillar Centeno, Juan Carlos [0000068519]spa
dc.contributor.cvlacVargas Ramírez, Leslie Katherine [0000706027]spa
dc.contributor.googlescholarVillar Centeno, Juan Carlos [nTlsWe0AAAAJ]spa
dc.contributor.googlescholarVargas Ramírez, Leslie Katherine [c2GP4jIAAAAJ]spa
dc.contributor.orcidVillar Centeno, Juan Carlos [0000-0002-7047-7299]spa
dc.contributor.orcidVargas Ramírez, Leslie Katherine [0000-0001-6826-721X]spa
dc.contributor.researchgateVillar Centeno, Juan Carlos [Juan_Villar11]spa
dc.contributor.scopusVillar Centeno, Juan Carlos [57193835436]spa
dc.coverage.campusUNAB Campus Bucaramangaspa
dc.coverage.spatialLatinoaméricaspa
dc.date.accessioned2022-07-11T13:20:33Z
dc.date.available2022-07-11T13:20:33Z
dc.date.issued2022
dc.degree.nameMagíster en Métodos para la Producción y Aplicación de Conocimiento Científico en Saludspa
dc.description.abstractLa 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.spa
dc.description.abstractenglishObstructive 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.spa
dc.description.degreelevelMaestríaspa
dc.description.learningmodalityModalidad Presencialspa
dc.description.tableofcontents1. 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 .......................................................................................................... 128spa
dc.format.mimetypeapplication/pdfspa
dc.identifier.instnameinstname:Universidad Autónoma de Bucaramanga - UNABspa
dc.identifier.reponamereponame:Repositorio Institucional UNABspa
dc.identifier.repourlrepourl:https://repository.unab.edu.cospa
dc.identifier.urihttp://hdl.handle.net/20.500.12749/16865
dc.language.isospaspa
dc.publisher.facultyFacultad Ciencias de la Saludspa
dc.publisher.grantorUniversidad Autónoma de Bucaramanga UNABspa
dc.publisher.programMaestría en Métodos para la Producción y Aplicación de Conocimiento Científico en Saludspa
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dc.relation.references177. Streatfeild J, Smith J, Mansfield D, Pezzullo L, Hillman D. The social and economic cost of sleep disorders. Sleep. 2021 Nov 12;44(11).spa
dc.relation.references178. Duan X, Zheng M, Zhao W, Huang J, Lao L, Li H, et al. Associations of Depression, Anxiety, and Life Events With the Risk of Obstructive Sleep Apnea Evaluated by Berlin Questionnaire. Frontiers in Medicine. 2022 Apr 7;9.spa
dc.relation.references179. Shieu MM, Zaheed A, Shannon C, Chervin RD, Conceicao A, Paulson HL, et al. Positive Airway Pressure and Cognitive Disorders in Adults With Obstructive Sleep Apnea: A Systematic Review of the Literature. Neurology. 2022 May 6;10.1212/WNL.0000000000200383.spa
dc.relation.references180. Ye L, Li W, Willis DG. Facilitators and barriers to getting obstructive sleep apnea diagnosed: perspectives from patients and their partners. Journal of Clinical Sleep Medicine. 2022 Mar;18(3):835–41.spa
dc.rights.accessrightsinfo:eu-repo/semantics/openAccessspa
dc.rights.creativecommonsAtribución-NoComercial-SinDerivadas 2.5 Colombia*
dc.rights.localAbierto (Texto Completo)spa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/2.5/co/*
dc.subject.keywordsMedical sciencesspa
dc.subject.keywordsHealth sciencesspa
dc.subject.keywordsObstructive apneaspa
dc.subject.keywordsAsymptomaticspa
dc.subject.keywordsSymptomaticspa
dc.subject.keywordsBerlin Questionnairespa
dc.subject.keywordsStop-bang scalespa
dc.subject.keywordsMedical screeningspa
dc.subject.keywordsHealth risk assessmentspa
dc.subject.keywordsBreathing disordersspa
dc.subject.keywordsSleep disordersspa
dc.subject.lembCiencias médicasspa
dc.subject.lembTamizaje médicospa
dc.subject.lembEvaluación de riesgos contra la saludspa
dc.subject.lembTrastornos de la respiraciónspa
dc.subject.lembTrastornos del sueñospa
dc.subject.proposalCiencias de la saludspa
dc.subject.proposalApnea obstructivaspa
dc.subject.proposalAsintomáticospa
dc.subject.proposalSintomáticospa
dc.subject.proposalCuestionario de Berlínspa
dc.subject.proposalEscala de stop-bangspa
dc.titleRecomendaciones sobre las estrategias de tamización para la población adulta de Latinoamérica de la Apnea Obstructiva del sueñospa
dc.title.translatedRecommendations on screening strategies for the adult population of Latin America for obstructive sleep apneaspa
dc.typeThesiseng
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aaspa
dc.type.driverinfo:eu-repo/semantics/masterThesisspa
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersionspa
dc.type.localTesisspa
dc.type.redcolhttp://purl.org/redcol/resource_type/TMspa

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Maestría en Métodos para la Producción y Aplicación de Conocimiento Científico en Salud