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Comment
. 2013 Jan 15;9(1):89-91.
doi: 10.5664/jcsm.2352.

Inter-scorer reliability between sleep centers can teach us what to improve in the scoring rules

Thomas Penzel  1 , Xiaozhe Zhang, Ingo Fietze
Affiliations
Comment

Inter-scorer reliability between sleep centers can teach us what to improve in the scoring rules

Thomas Penzel et al. J Clin Sleep Med. .
No abstract available

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Figures

Figure 1
Figure 1. A comparison of sleep scorings of nine scorers from different sleep centers across Germany based on the same recording
The recording was performed in a subject without sleep disorders being part of a control study. The comparison shows well some uncertainties between sleep stages and a major agreement in general. It shows also a remarkable error by scorer #3 with REM sleep in the beginning of the night.
Figure 2
Figure 2. A comparison of sleep scorings of nine scorers from different sleep centers across Germany based on the same recording
The recording was performed in a subject with obstructive sleep apnea. All the difficulties applying Rechtschaffen and Kales to sleep apnea EEG are obvious. Some scorers preferred to score arousal events as WAKE, others as MOVE, others as stage 1, and others as stage 2 sleep. REM sleep remained most consistent. Even the error by scorer #3 remained to be the same.
See this image and copyright information in PMC

Comment on

References

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    1. Rechtschaffen A, Kales A. A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Washington, DC: US Department of health, Education and Welfare Public Health Service - NIH/NIND; 1968.
    1. Rosenberg RS, Van Hout S. The American Academy of Sleep Medicine Inter-scorer reliability program: sleep stage scoring. J Clin Sleep Med . 2013;9:81–7. - PMC - PubMed
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    1. Penzel T, Behler PG, von Buttlar M, et al. Reliability of visual evaluation of sleep stages according to Rechtschaffen and Kales from eight polysomnographs by nine sleep centers. Somnologie. 2003;7:49–58.

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