The Resource Diagnosis and treatment of obstructive sleep apnea in adults, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Tufts Evidence-based Practice Center, Tufts Medical Center ; investigators, Ethan M. Balk [and others], (electronic resource)

Diagnosis and treatment of obstructive sleep apnea in adults, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Tufts Evidence-based Practice Center, Tufts Medical Center ; investigators, Ethan M. Balk [and others], (electronic resource)

Label
Diagnosis and treatment of obstructive sleep apnea in adults
Title
Diagnosis and treatment of obstructive sleep apnea in adults
Statement of responsibility
prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Tufts Evidence-based Practice Center, Tufts Medical Center ; investigators, Ethan M. Balk [and others]
Contributor
Subject
Genre
Language
eng
Summary
BACKGROUND: Methods for diagnosing and treating obstructive sleep apnea (OSA) are cumbersome, resource-intensive, and often inconvenient for the patient. PURPOSE: Systematically review the evidence on OSA diagnosis and treatment in adults. The Key Questions focus on OSA screening and diagnosis, treatments, associations between apnea-hypopnea index (AHI) and clinical outcomes, and predictors of treatment compliance. DATA SOURCES: MEDLINE(r), Cochrane Central Register of Controlled Trials, and existing systematic and narrative reviews. STUDY SELECTION: Primarily prospective comparative studies of different tests, randomized controlled trials of treatments, and multivariable association studies. Only published, peer-reviewed, English-language articles were selected and manually screened based on predetermined eligibility criteria. DATA EXTRACTION: A standardized protocol was used to extract details on design, diagnoses, interventions, outcomes, and quality. DATA SYNTHESIS: In total, 234 studies met eligibility criteria (46 on diagnostic tests, 17 predictor studies, 190 on treatments). We found moderate evidence that portable monitors are accurate in diagnosing OSA (as defined by polysomnography), but retain a variable bias in estimating AHI; low strength of evidence that the Berlin Questionnaire is able to prescreen patients with OSA with moderate accuracy; and insufficient evidence to evaluate other questionnaires or clinical prediction rules. No study adequately addressed phased testing for OSA. There was insufficient evidence on routine preoperative testing for OSA. High strength of evidence indicates an AHI >30 events/hr is an independent predictor of death; lesser evidence for other outcomes. We found moderate evidence that continuous positive airway pressure (CPAP) is an effective treatment for OSA; moderate evidence that autotitrating and fixed CPAP have similar effects; insufficient evidence regarding comparisons of other CPAP devices; moderate evidence that oral devices are effective treatment for OSA; moderate evidence that CPAP is superior to oral devices; and insufficient trial evidence regarding the relative value of most other OSA interventions, including surgery. We found high and moderate evidence, respectively, that AHI and Epworth Sleepiness Scale are independent predictors of CPAP compliance, and low evidence that some treatments improve CPAP compliance. LIMITATIONS: Very few trials evaluated objective clinical outcomes. Data were meager for many specific questions. Studies were generally of moderate to poor quality, and often had short followups, high dropout rates, and poor analyses and reporting. CONCLUSIONS: Portable monitors and questionnaires may be effective screening tools, but assessments with clinical outcomes are necessary to prove their value over polysomnography. CPAP is highly effective in minimizing AHI and improving sleepiness. Oral devices are also effective, although not as effective as CPAP. Other interventions, including those to improve compliance, have not been adequately tested
Member of
Cataloging source
NLM
Funding information
Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, 540 Gaither Road, Rockville, MD 20850; www.ahrq.gov Contract No. 290-2007-10055-1, Prepared by: Tufts Evidence-based Practice Center, Tufts Medical Center, Boston, MA.
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
  • statistics
NLM call number
WF 16
http://library.link/vocab/relatedWorkOrContributorName
  • Balk, Ethan
  • United States
  • Tufts Evidence-based Practice Center
  • Effective Health Care Program (U.S.)
  • Effective Health Care Program (U.S.)
Series statement
  • Comparative effectiveness review
  • AHRQ publication
Series volume
  • no. 32
  • no. 11-EHC052
http://library.link/vocab/subjectName
  • Sleep Apnea, Obstructive
  • Sleep Apnea, Obstructive
  • Comparative Effectiveness Research
  • Evidence-Based Medicine
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
http://bibfra.me/vocab/relation/supportingbody
RzTDSdffmEM
Label
Diagnosis and treatment of obstructive sleep apnea in adults, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Tufts Evidence-based Practice Center, Tufts Medical Center ; investigators, Ethan M. Balk [and others], (electronic resource)
Instantiates
Publication
Note
  • "Contract No. 290-2007-10055-1."
  • "July 2011."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
760890821
Extent
1 online resource
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations
Specific material designation
remote
System control number
(OCoLC)760890821
Label
Diagnosis and treatment of obstructive sleep apnea in adults, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Tufts Evidence-based Practice Center, Tufts Medical Center ; investigators, Ethan M. Balk [and others], (electronic resource)
Publication
Note
  • "Contract No. 290-2007-10055-1."
  • "July 2011."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
760890821
Extent
1 online resource
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations
Specific material designation
remote
System control number
(OCoLC)760890821

Library Locations

  • Ellis LibraryBorrow it
    1020 Lowry Street, Columbia, MO, 65201, US
    38.944491 -92.326012
  • Engineering Library & Technology CommonsBorrow it
    W2001 Lafferre Hall, Columbia, MO, 65211, US
    38.946102 -92.330125
  • Fisher Delta Research CenterBorrow it
    2-64 Agricultural Bldg, Columbia, MO, 65201, US
    38.958397 -92.303491
  • Geological Sciences LibraryBorrow it
    201 Geological Sciences, Columbia, MO, 65211, US
    38.947375 -92.329062
  • J. Otto Lottes Health Sciences LibraryBorrow it
    1 Hospital Dr, Columbia, MO, 65201, US
    38.939544 -92.328377
  • Journalism LibraryBorrow it
    102 Reynolds Jrnlism Institute, Columbia, MO, 65211, US
    38.947290 -92.328025
  • Mathematical Sciences LibraryBorrow it
    104 Ellis Library, Columbia, MO, 65201, US
    38.944377 -92.326537
  • University ArchivesBorrow it
    Columbia, MO, 65201, US
  • University Archives McAlester AnnexBorrow it
    703 Lewis Hall, Columbia, MO, 65211, US
    38.934630 -92.342290
  • University of Missouri Libraries DepositoryBorrow it
    2908 Lemone Blvd, Columbia, MO, 65211, US
    38.919360 -92.291620
  • Zalk Veterinary Medical LibraryBorrow it
    Veterinary Medicine West, Columbia, MO, 65211, US
    38.941099 -92.317911
Processing Feedback ...