The challenge of undiagnosed sleep apnea in low-risk populations: a decision analysis.
Objectives: Obstructive sleep apnea (OSA) may contribute to impaired performance among otherwise healthy active duty military personnel. We used decision analysis to evaluate three approaches to identifying and treating OSA in low-risk populations, which may differ from current standard practice for...
| Publicado en: | Military Medicine Vol. 179; no. 8; pp. 47 - 55 |
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| Autores principales: | , , , , |
| Formato: | research Journal Article |
| Publicado: |
Oxford University Press / USA
Aug2014 Supplement
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=109674923&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 109674923 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00264075 4DV jtl: Military Medicine issn: 00264075 maglogo: N pubinfo: dt: Aug2014 Supplement vid: 179 iid: 8 pid: 622 pub: Oxford University Press / USA artinfo: ui: 109674923 97443539 NLM25102549 2012676830 10.7205/MILMED-D-13-00483 NLM25102549 109674923 ppf: 47 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: The challenge of undiagnosed sleep apnea in low-risk populations: a decision analysis. aug: au: Bianchi, Matt T Hershman, Steven Bahadoran, Mahshid Ferguson, Matthew Westover, M Brandon sug: subj: Sleep Apnea, Obstructive Therapy Sleep Apnea, Obstructive Diagnosis Military Personnel Productivity Health Screening Economics Polysomnography Economics Human Continuous Positive Airway Pressure Economics Risk Factors Decision Support Techniques United States Sleep Apnea, Obstructive Economics Decision Trees Monitoring, Physiologic Economics Validation Studies Comparative Studies Evaluation Research Multicenter Studies ab: Objectives: Obstructive sleep apnea (OSA) may contribute to impaired performance among otherwise healthy active duty military personnel. We used decision analysis to evaluate three approaches to identifying and treating OSA in low-risk populations, which may differ from current standard practice for high-risk populations.Methods: We developed a decision tree to compare two simple strategies for diagnosis and management of sleep apnea in a low-risk population. In one strategy, a simple screening inventory was followed by conventional laboratory polysomnography (split-night), whereas the alternative strategy involved performing home testing in all individuals. This allowed us to weigh the costs associated with large-scale diagnostic approaches against the costs of untreated OSA in a small fraction of the population.Results: We found that the home testing approach was less expensive than the screen-then-test approach across a broad range of other important parameters, including the annual performance cost associated with untreated OSA, the prevalence of OSA, and the duration of active duty.Conclusions: Assuming even modest annual performance costs associated with untreated OSA, a population strategy involving large-scale home testing is less expensive than a screening inventory approach. These results may inform either targeted or large-scale investigation of undiagnosed OSA in low-risk populations such as active duty military. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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