P103 Using Westgard rules with QSleep to improve PSG scoring proficiency

Abstract Introduction The purpose of this study is to evaluate the effectiveness of applying Westgard quality control rules in conjunction with the Qsleep Quality Assurance program to enhance the proficiency and accuracy of polysomnography (PSG) scoring in a clinical sleep laboratory. Methods All sleep scientists from the RBWH are required to complete QSleep cycles. Scoring proficiency was assessed by plotting individual scientists’ Z-scores generated from QSleep on a Levey-Jennings chart, then applying Westgard rules to said Z-scores. Measurements assessed included Respiratory agreement, Arousal agreement, Sleep % agreement and the individual sleep stages. Feedback was then given to scientists who were deemed to be in warning or out of control under Westgard rules. Results Implementation of Westgard rules with Qsleep has seen improved scoring consistency across all sleep scientists. Based on Z scores – there has been overall lab improvement in Respiratory agreement, Arousal agreement, Sleep % agreement. The improvement was more pronounced among less experienced scorers, indicating a greater benefit for training purposes. Discussion The integration of Westgard rules via Qsleep program represents a novel approach to quality control in PSG scoring, reducing inter-scorer variability and enhancing overall scoring accuracy. This method serves as an effective training tool, improving proficiency among scientists. Future work should explore long-term outcomes and applicability in diverse clinical settings.