Evidence map›Paper›PMID 25348126›Full record

ArticleSleep2015

Long-Term Cost-Effectiveness of Upper Airway Stimulation for the Treatment of Obstructive Sleep Apnea: A Model-Based Projection Based on the STAR Trial.

Jan B Pietzsch, Shan Liu, Abigail M Garner, Eric J Kezirian, Patrick J Strollo

Registry-linked trialOpen access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Sleep, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07074288 (Obstructive Sleep Apnea Non-PAP Outcomes and Viable Alternatives), which is not on this map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07074288 narecruitingnot on this mapstarted 2025, after this paper: background citation

Obstructive Sleep Apnea Non-PAP Outcomes and Viable Alternatives (OSANOVA): Comparison of Mandibular Advancement Device and Hypoglossal Nerve Stimulation Outcomes

TypeinterventionalSponsorWashington University School of MedicineRan2025 to 2027Enrolled60ConditionsObstructive Sleep ApneaArmsMAD, HGNS
3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Reply to "Clinical pathway implications of bilateral hypoglossal nerve stimulation for PAP-intolerant OSA".Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026
    Article
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  5. Review
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  11. International Consensus Statement on Obstructive Sleep Apnea.International forum of allergy & rhinology · 2023
    Review
  12. Article
  13. Article
  14. Review
  15. Article
  16. Review
  17. Article
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Jan B PietzschWing Tech Inc., Menlo Park, CA.
Shan LiuWing Tech Inc., Menlo Park, CA.
Abigail M GarnerWing Tech Inc., Menlo Park, CA.
Eric J KezirianKeck School of Medicine of the University of Southern California, Los Angeles, CA.
Patrick J StrolloUniversity of Pittsburgh, PA.
Menlo School · USUniversity of Pittsburgh · USUniversity of Southern California · USUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

STUDY

objectivesUpper airway stimulation (UAS) is a new approach to treat moderate-to-severe obstructive sleep apnea. Recently, 12-month data from the Stimulation Treatment for Apnea Reduction (STAR) trial were reported, evaluating the effectiveness of UAS in patients intolerant or non-adherent to continuous positive airway pressure therapy. Our objective was to assess the cost-effectiveness of UAS from a U.S. payer perspective.

designA 5-state Markov model was used to predict cardiovascular endpoints (myocardial infarction [MI], stroke, hypertension), motor vehicle collisions (MVC), mortality, quality-adjusted life years (QALYs), and costs. We computed 10-year relative event risks and the lifetime incremental cost-effectiveness ratio (ICER) in $/QALY, comparing UAS therapy to no treatment under the assumption that the STAR trial-observed reduction in mean apnea-hypopnea index from 32.0 to 15.3 events/h was maintained. Costs and effects were discounted at 3% per year.

settingU.S. healthcare system; third-party payer perspective.

participants83% male cohort with mean age of 54.5 years.

interventionsUAS vs. no treatment. MEASUREMENTS AND

resultsUAS substantially reduced event probabilities over 10 years (relative risks: MI 0.63; stroke 0.75; MVC 0.34), and was projected to add 1.09 QALYs over the patient's lifetime. Costs were estimated to increase by $42,953, resulting in a lifetime ICER of $39,471/QALY.

conclusionsRelative to the acknowledged willingness-to-pay threshold of $50,000-$100,000/QALY, our results indicate upper airway stimulation is a cost-effective therapy in the U.S. healthcare system.

Indexed as

Cost-Benefit AnalysisAdultAgedFemaleHumansMaleMarkov ChainsMiddle AgedMyocardial InfarctionQuality-Adjusted Life YearsRiskSleep Apnea, ObstructiveStrokecost effectivenesshypoglossal nerveimplantable neurostimulatorsobstructive sleep apneaupper airway stimulation

Identifiers

PMID25348126
PMCPMC4402668
OpenAlexW2006324282

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.