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150303 r ||| eng |
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|a Trikalinos, Thomas A.
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|a Obstructive sleep apnea-hypopnea syndrome
|h Elektronische Ressource
|b modeling different diagnostic strategies
|c Thomas A Trikalinos, Joseph Lau
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|a Rockville, Maryland
|b Agency for Healthcare Research and Quality
|c 2007, December 4, 2007
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| 300 |
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|a 1 PDF file (various pagings)
|b illustrations
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|a Includes bibliographical references
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|a Polysomnography / methods
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|a Continuous Positive Airway Pressure
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|a Sleep Apnea, Obstructive / diagnosis
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|a Lau, Joseph
|e [author]
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|a Tufts-New England Medical Center
|b Evidence-based Practice Center
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|a United States
|b Agency for Healthcare Research and Quality
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|a Technology Assessment Program (Agency for Healthcare Research and Quality)
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|a eng
|2 ISO 639-2
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|b NCBI
|a National Center for Biotechnology Information
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|a Technology assessment
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|a Title from PDF title page
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|u https://www.ncbi.nlm.nih.gov/books/NBK254128
|3 Volltext
|n NLM Bookshelf Books
|3 Volltext
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|a 610
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|a The current project is a follow-on to the Technology Assessment "Home diagnosis of obstructive sleep apnea-hypopnea syndrome" that was prepared by the Tufts-NEMC EPC. There are no direct comparison studies evaluating the plausible strategies for OSAHS diagnosis and initiation of CPAP treatment. In consultation with AHRQ and CMS staff we undertook an analysis of various strategies to manage patients with high clinical suspicion for OSAHS, using a Markov process-based decision tree. Markov modeling is an established decision analytic method. It is typically used to simulate comparisons when direct data are non-existent. Herein we focus on a description of the profile of different strategies in terms of accuracy of diagnosis, proportion of people started on CPAP, time to diagnosis, and time to successful CPAP titration among people who need it.
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|a The Center for Medicare and Medicaid Services (CMS) has requested a technology assessment through the Agency for Healthcare Research and Quality (AHRQ) on the role of home monitoring for the diagnosis of obstructive sleep apnea-hypopnea syndrome (OSAHS). On September 28, 2004, the evidence on home monitoring devices in the diagnosis of sleep apnea was discussed at a Medicare Coverage Advisory Committee meeting. The RTI EPC presented a technology assessment on this topic, which was an update of a prior technology assessment done for the American Academy of Sleep Medicine, the American Thoracic Society, and the American College of Chest Physicians. CMS has requested an update of the evidence presented in the RTI EPC technology assessment on home sleep monitoring with an expanded scope, including the assessment of the ability of polysomnography (PSG) indices to predict a response to continuous positive airway pressure (CPAP) treatment.
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|a We did not perform a full decision analysis (i.e., calculation of expected utilities over lifelong projections), because there are considerable uncertainties clinical outcomes such as deaths, cardiovascular events, strokes, etc. that pose great difficulties for a meaningful analysis
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