We are doing a prevalence study on Obstructive sleep apnea (OSA). There is an established association with neck circumference. Neck circumference increases with height and there is a variable called PPNC to correct for this. PPNC also has an established association with OSA

PPNC = (1000 × NC) / [(0.55 × Height) +310]

The parameter is actually calculating the percentage of the neck circumference to the predicted NC for the height. The original paper by Davies & Stradling, 1990 seems to be unavailable online. The correction equation suggested therein is population-dependent.

Would the correction be valid for the population under our study, if the value of PPNC for the controls (assumed normal) does not include the 100% (i.e. the predicted normal circumference) mark within +/- 1 SD?

Does it point to the fact that the correction is not valid for our population, since the predicted normal circumference value is not found even among the un-diseased population?

Or is there any other parameter which could be used in such a situation?

http://www.ncbi.nlm.nih.gov/pubmed/2376247

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