No Evidence for Diagnostic Value of Mallampati Score in Patients Suspected of Having Obstructive Sleep Apnea Syndrome

Abstract

Objective. To analyze whether the Mallampati score is reliable as a simple diagnostic test for predicting obstructive sleep apnea syndrome (OSAS). Data Sources. A literature search was performed using PubMed, Embase, Scopus, Cochrane, and CINAHL databases. Review Methods. Studies were ranked by their relevance and validity in a critical appraisal table. Positive and negative predictive values were obtained or recalculated from the selected articles. Results. Eight relevant articles met the inclusion criteria. Three studies reported predictive values for a Mallampati score of 3 to 4. The prevalence (or prior probability) of OSAS in these 3 studies was 58% (95% confidence interval [CI], 50-67), 76% (95% CI, 72-79), and 82% (95% CI, 80-84), respectively. With a Mallampati score of 1 to 2, the risk of OSAS decreases to 45% (95% CI, 33-58), 74% (95% CI, 70-78), and 81% (95% CI, 77-86), respectively. With a Mallampati score of 3 to 4, the risk of OSAS is 69% (95% CI, 59-80), 82% (95% CI, 74-89), and 82% (95% CI, 79-85), respectively. The differences between the prior and the posterior probabilities are rather small and do not reach statistical significance. Conclusion. There is no evidence to maintain that the Mallampati score is of added value for ruling in or ruling out a diagnosis of OSAS in patients suspected for OSAS.