{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:05:41Z","timestamp":1792785941442,"version":"4.5.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"University of Ottawa, the Department of Medicine","id":[{"id":"https:\/\/ror.org\/03c4mmv16","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Ontario Ministry of Health (MOH) and the Ministry of Long-Term Care","id":[{"id":"https:\/\/ror.org\/0320egb26","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Although polysomnography (PSG) is the diagnostic gold standard, PSG data on obstructive sleep apnea (OSA) presence and severity are rarely available at the population level. Health administrative databases offer broad coverage for OSA case ascertainment but require methods that address inherent misclassification. We utilized a previously validated probabilistic case ascertainment model of OSA to estimate population-level prevalence and correlates of OSA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a population-based retrospective cohort study in Ontario, Canada. First, using a clinical cohort with PSG-confirmed OSA severity (measurement cohort; n\u2009=\u200918\u00a0581), we quantified misclassification in probabilistic OSA case definitions. We then applied the externally validated probability models to all adults 18\u2009years and older in Ontario who underwent in-laboratory overnight PSG between 2010 and 2018 (provincial PSG cohort; n\u2009=\u2009834\u00a0361). OSA prevalence and correlates were estimated using multiple probability thresholds and a threshold-free bootstrap imputation approach (BIA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to the PSG-based gold standard, the BIA surrogate definition had the lowest average relative bias in OSA prevalence estimation (BIA: 5% versus &amp;gt;38% probability threshold: 11.4%). Using BIA, we estimate a 44.3% prevalence of moderate-severe OSA in the provincial PSG cohort, which in scenario-based projections yields a 3.4%\u201317.1% general population prevalence dependent on an assumed OSA underdiagnosis rate. OSA prevalence was higher in men, older ages, and previous comorbidity and was stable annually.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Probabilistic case ascertainment using health administrative data enables robust population-level estimation of OSA epidemiology despite the absence of clinical diagnostic data and provides a framework for studying OSA prevalence, correlates, and outcomes over time.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ije\/dyag176","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T11:10:16Z","timestamp":1786101016000},"source":"Crossref","is-referenced-by-count":0,"title":["A population-based study of obstructive sleep apnea: using probabilistic case ascertainment through health administrative databases"],"prefix":"10.1093","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5060-680X","authenticated-orcid":false,"given":"Robert","family":"Talarico","sequence":"first","affiliation":[{"name":"Ottawa Hospital Research Institute Clinical Epidemiology Program , Ottawa, ON,","place":["Canada"]},{"name":"Institute for Clinical Evaluative Sciences, ICES Ottawa , Ottawa, ON,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Povitz","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary Cumming School of Medicine , Calgary,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4693-0831","authenticated-orcid":false,"given":"Sachin R","family":"Pendharkar","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Calgary Cumming School of Medicine , Calgary,","place":["Canada"]},{"name":"Department of Community Health Sciences, University of Calgary Cumming School of Medicine , Calgary,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Reisman","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Western Ontario Schulich School of Medicine & Dentistry , London,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8543-1859","authenticated-orcid":false,"given":"Daniel I","family":"McIsaac","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute Clinical Epidemiology Program , Ottawa, ON,","place":["Canada"]},{"name":"Institute for Clinical Evaluative Sciences, ICES Ottawa , Ottawa, ON,","place":["Canada"]},{"name":"Department of Anesthesiology & Pain Medicine, University of Ottawa Faculty of Medicine , Ottawa,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5301-1796","authenticated-orcid":false,"given":"Tetyana","family":"Kendzerska","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute Clinical Epidemiology Program , Ottawa, ON,","place":["Canada"]},{"name":"Institute for Clinical Evaluative Sciences, ICES Ottawa , Ottawa, ON,","place":["Canada"]},{"name":"Department of Medicine, University of Ottawa Faculty of Medicine , Ottawa,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"2026092402430327700_dyag176-B1","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1016\/S2213-2600(19)30198-5","article-title":"Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis","volume":"7","author":"Benjafield","year":"2019","journal-title":"Lancet Respir Med"},{"key":"2026092402430327700_dyag176-B2","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1016\/S2213-2600(25)00243-7","article-title":"Projecting the 30-year burden of obstructive sleep apnoea in the USA: a prospective modelling study","volume":"13","author":"Boers","year":"2025","journal-title":"Lancet Respir Med"},{"key":"2026092402430327700_dyag176-B3","doi-asserted-by":"publisher","first-page":"101854","DOI":"10.1016\/j.smrv.2023.101854","article-title":"The economic cost of obstructive sleep apnea: a systematic review","volume":"72","author":"Alakorkko","year":"2023","journal-title":"Sleep Med Rev"},{"key":"2026092402430327700_dyag176-B4","volume-title":"Hidden Health Crisis Costing America Billions. 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