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Meas."],"published-print":{"date-parts":[[2018,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objective<\/jats:italic>\n                    : This study is aimed at assessing symbolic dynamics as a reliable technique to characterise complex fluctuations of portable oximetry in the context of automated detection of childhood obstructive sleep apnoea-hypopnoea syndrome (OSAHS).\n                    <jats:italic>Approach<\/jats:italic>\n                    : Nocturnal oximetry signals from 142 children with suspected OSAHS were acquired using the Phone Oximeter: a portable device that integrates a pulse oximeter with a smartphone. An apnoea-hypopnoea index (AHI)\u2009\u2009\u2a7e\u2009\u20095 events h\n                    <jats:sup>\u22121<\/jats:sup>\n                    from simultaneous in-lab polysomnography was used to confirm moderate-to-severe childhood OSAHS. Symbolic dynamics was used to parameterise non-linear changes in the overnight oximetry profile. Conventional indices, anthropometric measures, and time-domain linear statistics were also considered. Forward stepwise logistic regression was used to obtain an optimum feature subset. Logistic regression (LR) was used to identify children with moderate-to-severe OSAHS.\n                    <jats:italic>Main results<\/jats:italic>\n                    : The histogram of 3-symbol words from symbolic dynamics showed significant differences (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009\u2009&lt;\u2009\u20090.01) between children with AHI\u2009\u2009&lt;\u2009\u20095 events h\n                    <jats:sup>\u22121<\/jats:sup>\n                    and moderate-to-severe patients (AHI\u2009\u2009\u2a7e\u2009\u20095 events h\n                    <jats:sup>\u22121<\/jats:sup>\n                    ). Words representing increasing oximetry values after apnoeic events (re-saturations) showed relevant diagnostic information. Regarding the performance of individual characterization approaches, the LR model composed of features from symbolic dynamics alone reached a maximum performance of 78.4% accuracy (65.2% sensitivity; 86.8% specificity) and 0.83 area under the ROC curve (AUC). The classification performance improved combining all features. The optimum model from feature selection achieved 83.3% accuracy (73.5% sensitivity; 89.5% specificity) and 0.89 AUC, significantly (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009\u2009&lt;0.01) outperforming the other models.\n                    <jats:italic>Significance<\/jats:italic>\n                    : Symbolic dynamics provides complementary information to conventional oximetry analysis enabling reliable detection of moderate-to-severe paediatric OSAHS from portable oximetry.\n                  <\/jats:p>","DOI":"10.1088\/1361-6579\/aae2a8","type":"journal-article","created":{"date-parts":[[2018,9,19]],"date-time":"2018-09-19T12:10:04Z","timestamp":1537359004000},"page":"104002","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":11,"title":["Symbolic dynamics to enhance diagnostic ability of portable oximetry from the Phone Oximeter in the detection of paediatric sleep apnoea"],"prefix":"10.1088","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1027-2395","authenticated-orcid":false,"given":"Daniel","family":"\u00c1lvarez","sequence":"first","affiliation":[{"name":"Hospital Universitario R\u00edo Hortega"},{"name":"University of Valladolid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Crespo","sequence":"additional","affiliation":[{"name":"Hospital Universitario R\u00edo Hortega"},{"name":"University of Valladolid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5898-2006","authenticated-orcid":false,"given":"Fernando","family":"Vaquerizo-Villar","sequence":"additional","affiliation":[{"name":"University of Valladolid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1237-3424","authenticated-orcid":false,"given":"Gonzalo C","family":"Guti\u00e9rrez-Tobal","sequence":"additional","affiliation":[{"name":"University of Valladolid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Cerezo-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Hospital Universitario R\u00edo Hortega"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5648-206X","authenticated-orcid":false,"given":"Ver\u00f3nica","family":"Barroso-Garc\u00eda","sequence":"additional","affiliation":[{"name":"University of Valladolid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8427-2035","authenticated-orcid":false,"given":", J Mark","family":"Ansermino","sequence":"additional","affiliation":[{"name":"The University of British Columbia and British Columbia Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2048-4391","authenticated-orcid":false,"given":"Guy A","family":"Dumont","sequence":"additional","affiliation":[{"name":"The University of British Columbia and British Columbia Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9915-2570","authenticated-orcid":false,"given":"Roberto","family":"Hornero","sequence":"additional","affiliation":[{"name":"University of Valladolid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4554-2167","authenticated-orcid":false,"given":"F\u00e9lix","family":"del Campo","sequence":"additional","affiliation":[{"name":"Hospital Universitario R\u00edo Hortega"},{"name":"University of Valladolid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9503-6908","authenticated-orcid":false,"given":"Ainara","family":"Garde","sequence":"additional","affiliation":[{"name":"University of Twente"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2018,10,11]]},"reference":[{"key":"pmeaaae2a8bib001","doi-asserted-by":"publisher","first-page":"2816","DOI":"10.1109\/TBME.2010.2056924","type":"journal-article","article-title":"Multivariate analysis of blood oxygen saturation recordings in obstructive sleep apnea diagnosis","volume":"57","author":"\u00c1lvarez","year":"2010","journal-title":"IEEE Trans. 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