Evidence map›Paper›PMID 28114683›Full record

Trial reportAnnals of internal medicine2017

Physician Decision Making and Clinical Outcomes With Laboratory Polysomnography or Limited-Channel Sleep Studies for Obstructive Sleep Apnea: A Randomized Trial.

Ching Li Chai-Coetzer, Nick A Antic, Garun S Hamilton, Nigel McArdle, Keith Wong, Brendon J Yee, Aeneas Yeo, Rajeev Ratnavadivel, Matthew T Naughton, Teanau Roebuck and 2 more

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Annals of internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Trial
  5. Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Feasibility of unattended home sleep apnea testing in a cognitively impaired clinic population.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2021
    Article
  11. Article
  12. Article
  13. Primary care and sleep unit agreement in management decisions for sleep apnea: a prospective study in Spain.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020
    Article
  14. Review
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Sleep Apnea Evolution and Left Ventricular Recovery After Percutaneous Coronary Intervention for Myocardial Infarction.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2018
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Ching Li Chai-CoetzerFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.
Nick A AnticFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.
Garun S HamiltonFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.
Nigel McArdleFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.
Keith WongFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.
Brendon J YeeFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.
Aeneas YeoFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.
Rajeev RatnavadivelFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.
Matthew T NaughtonFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.
Teanau RoebuckFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.
Richard WoodmanFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.
R Doug McEvoyFrom Flinders University, Repatriation General Hospital, and Royal Adelaide Hospital, Adelaide, South Australia; Monash Health, Monash University, and The Alfred Hospital, Melbourne, Victoria; Sir Charles Gairdner Hospital, Perth, Western Australia; Royal Prince Alfred Hospital & Woolcock Institute of Medical Research, Sydney, New South Wales; and Gosford Hospital, Gosford, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe clinical utility of limited-channel sleep studies (which are increasingly conducted at home) versus laboratory polysomnography (PSG) for diagnosing obstructive sleep apnea (OSA) is unclear.

objectiveTo compare patient outcomes after PSG versus limited-channel studies.

designMulticenter, randomized, noninferiority study. (Australian New Zealand Clinical Trials Registry: ACTRN12611000926932).

setting7 academic sleep centers.

participantsPatients (n = 406) aged 25 to 80 years with suspected OSA.

interventionSleep study information disclosed to sleep physicians comprised level 1 (L1) PSG data (n = 135); level 3 (L3), which included airflow, thoracoabdominal bands, body position, electrocardiography, and oxygen saturation (n = 136); or level 4 (L4), which included oxygen saturation and heart rate (n = 135). MEASUREMENTS: The primary outcome was change in Functional Outcomes of Sleep Questionnaire (FOSQ) score at 4 months. Secondary outcomes included the Epworth Sleepiness Scale (ESS), the Sleep Apnea Symptoms Questionnaire (SASQ), continuous positive airway pressure (CPAP) compliance, and physician decision making.

resultsChange in FOSQ score was not inferior for L3 (mean difference [MD], 0.01 [95% CI, -0.47 to 0.49; P = 0.96]) or L4 (MD, -0.46 [CI, -0.94 to 0.02; P = 0.058]) versus L1 (noninferiority margin [NIM], -1.0). Compared with L1, change in ESS score was not inferior for L3 (MD, 0.08 [CI, -0.98 to 1.13; P = 0.89]) but was inconclusive for L4 (MD, 1.30 [CI, 0.26 to 2.35; P = 0.015]) (NIM, 2.0). For L4 versus L1, there was less improvement in SASQ score (-17.8 vs. -24.7; P = 0.018), less CPAP use (4.5 vs. 5.3 hours per night; P = 0.04), and lower physician diagnostic confidence (P = 0.003). LIMITATION: Limited-channel studies were simulated by extracting laboratory PSG data and were not done in the home.

conclusionThe results support manually scored L3 testing in routine practice. Poorer outcomes with L4 testing may relate, in part, to reduced physician confidence. PRIMARY FUNDING SOURCE: National Health and Medical Research Council and Repat Foundation.

Indexed as

Clinical Decision-MakingAdultAgedAged, 80 and overContinuous Positive Airway PressureFemaleHumansMaleMiddle AgedMonitoring, AmbulatoryPatient SatisfactionPolysomnographyQuality of LifeSleep Apnea, ObstructiveSurveys and Questionnaires

Identifiers

PMID28114683

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.