{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:41:11Z","timestamp":1777563671642,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T00:00:00Z","timestamp":1574985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["1U01DC014706\u201001A1"],"award-info":[{"award-number":["1U01DC014706\u201001A1"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["1R21DC017553\u201001"],"award-info":[{"award-number":["1R21DC017553\u201001"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The Clinical Assessment Score\u201015 (CAS\u201015) has been validated as an office\u2010based assessment for pediatric sleep\u2010disordered breathing in otherwise healthy children. Our objective was to determine the generalizability of the CAS\u201015 in a multi\u2010institutional fashion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Five hundred and thirty children from 13 sites with suspected sleep\u2010disordered breathing were recruited, and the investigators completed the CAS\u201015. Based on decisions made in the course of clinical care, investigators recommended overnight polysomnography, observation, medical therapy, and\/or surgery. Two hundred and forty\u2010seven subjects had a follow\u2010up CAS\u201015.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age was 5.1 (2.6) years; 54.2% were male; 39.1% were white; and 37.0% were African American. Initial mean (standard deviation [SD]) CAS\u201015 was 37.3 (12.7), n = 508. Spearman correlation between the initial CAS\u201015 and the initial apnea\u2010hypopnea index (AHI) was 0.41 (95% confidence interval [CI], 0.29, 0.51), n = 212, <jats:italic>P<\/jats:italic> &lt;\u2009.001. A receiver\u2010operating characteristic curve predicting positive polysomnography (AHI\u2009&gt;\u20092) had an area under the curve of 0.71 (95% CI, 0.63, 0.80). A score\u2009\u2265\u200932 had a sensitivity of 69.0% (95% CI, 61.7, 75.5), a specificity of 63.4% (95% CI, 47.9, 76.6), a positive predictive value of 88.7% (95% CI, 82.1, 93.1), and a negative predictive value of 32.9% (95% CI, 23.5, 44.0) in predicting positive polysomnography. Among children who underwent surgery, the mean change (SD) score was 30.5 (12.6), n = 201, <jats:italic>t<\/jats:italic> =\u200936.85, <jats:italic>P<\/jats:italic> &lt;\u2009.001, effect size = 3.1.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study establishes the generalizability of the CAS\u201015 as a useful office tool for the evaluation of pediatric sleep\u2010disordered breathing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2B <jats:italic>Laryngoscope<\/jats:italic>, 130:2256\u20132262, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28428","type":"journal-article","created":{"date-parts":[[2019,11,29]],"date-time":"2019-11-29T14:35:05Z","timestamp":1575038105000},"page":"2256-2262","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Generalizability of the Clinical Assessment Score\u201015 for Pediatric Sleep\u2010Disordered Breathing"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2741-0216","authenticated-orcid":false,"given":"Nira A.","family":"Goldstein","sequence":"first","affiliation":[{"name":"Division of Pediatric Otolaryngology State University of New York Downstate Medical Center  Brooklyn New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norman R.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Pediatric Otolaryngology Children's Hospital Colorado  Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather C.","family":"Nardone","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Nemours\/Alfred I. duPont Hospital for Children  Wilmington Delaware"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdullah","family":"Aljasser","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery King Saud University Medical City  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allison B.J.","family":"Tobey","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology University of Pittsburgh Medical Center Children's Hospital of Pittsburgh  Pittsburgh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra","family":"Don","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Children's Hospital Los Angeles  Los Angeles California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fuad M.","family":"Baroody","sequence":"additional","affiliation":[{"name":"Section of Otolaryngology\u2013Head and Neck Surgery The University of Chicago Medicine and Comer Children's Hospital  Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek J.","family":"Lam","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Doernbecher Children's Hospital, Oregon Health and Science University  Portland Oregon"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Goudy","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology Children's Healthcare of Atlanta, Emory University School of Medicine  Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0997-9692","authenticated-orcid":false,"given":"Stacey L.","family":"Ishman","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology\u2013Head and Neck Surgery and Pulmonary Medicine Cincinnati Children's Hospital Medical Center  Cincinnati Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill M.","family":"Arganbright","sequence":"additional","affiliation":[{"name":"Department of Pediatric Otolaryngology Children's Mercy Hospital  Kansas City 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