Médecine du sommeil personnalisée et syndrome d’apnées hypopnées obstructives du sommeil : entre précision et stratification, une proposition de clarification

Gauld, Christophe; Dumas, Guillaume; Darrason, Marie; Salles, Nathalie; Desvergnes, Pierre; Philip, Pierre; Micoulaud‐Franchi, Jean‐Arthur

doi:10.1016/j.msom.2020.08.003

Cited by 5 publications

(3 citation statements)

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“…These methods are intimately complementary: stratification requires identifying biomarkers (i.e., relying on precision) to differentiate its subgroups, and precision requires the creation of subgroups (i.e., relying on stratification) in order to study biomarkers (Gauld et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical intuition in psychology through the prism of personalized psychiatry

2023

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Section: Discussionmentioning

confidence: 99%

Clinical intuition in psychology through the prism of personalized psychiatry

2023

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“…Proposed hierarchised framework of revision of ICSD to better integrate sleep symptom network for the future of sleep medicine be "Snoring", "Breath abnormalities complaints" and "Breath abnormalities observation". Peripheral symptoms could be those related to precision medicine for OSAD (Eckert, 2018;Gauld, Dumas, et al, 2020), e.g. those related to impaired pharyngeal dilator muscle control, those related to an increased propensity for awakening during airway narrowing (low respiratory arousal threshold) and those concerning respiratory control instability (high loop gain).…”

Section: Generalisationmentioning

confidence: 99%

“…This structure would: (i) enhance the capacity of clinicians to look rapidly for other symptoms by referring to hub symptoms, (ii) offer a solid stable clinical framework over time so that clinicians share the same understanding of sleep disorders with the core symptoms, and (iii) ensure that the framework is dynamic and modifiable over time so that data from evidence-based medicine may be linked with the peripheral symptom, in the quest for a more personalised medicine of sleep disorders (Gauld, Darrason, et al, 2020). Note that this structure is different from the classic distinction used for many syndromic diagnostic criteria in medicine (e.g.…”

Section: Generalisationmentioning

confidence: 99%

Symptom network analysis of the sleep disorders diagnostic criteria based on the clinical text of the ICSD‐3

Gauld

Lopez

Morin

et al. 2021

Journal of Sleep Research

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Summary The third edition of the International Classification of Sleep Disorders (ICSD‐3) is the authoritative clinical text for the diagnosis of sleep disorders. An important issue of sleep nosology is to better understand the relationship between symptoms found in conventional diagnostic manuals and to compare classifications. Nevertheless, to our knowledge, there is no specific exhaustive work on the general structure of the networks of symptoms of sleep disorders as described in diagnostic manuals. The general aim of the present study was to use symptom network analysis to explore the diagnostic criteria in the ICSD‐3 manual. The ICSD‐3 diagnostic criteria related to clinical manifestations were systematically identified, and the units of analysis (symptoms) were labelled from these clinical manifestation diagnostic criteria using three rules (“Conservation”, “Splitting”, “Lumping”). A total of 37 of the 43 main sleep disorders with 160 units of analysis from 114 clinical manifestations in the ICSD‐3 were analysed. A symptom network representing all individual ICSD‐3 criteria and connections between them was constructed graphically (network estimation), quantified with classical metrics (network inference with global and local measures) and tested for robustness. The global measure of the sleep symptoms network shows that it can be considered as a small world, suggesting a strong interconnection between symptoms in the ICSD‐3. Local measures show the central role of three kinds of bridge sleep symptoms: daytime sleepiness, insomnia, and behaviour during sleep symptoms. Such a symptom network analysis of the ICSD‐3 structure could provide a framework for better systematising and organising symptomatology in sleep medicine.

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