RT Journal Article
SR Electronic
T1 Effectiveness of home respiratory polygraphy for the diagnosis of sleep apnoea and hypopnoea syndrome
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 567
OP 573
DO 10.1136/thx.2010.152272
VO 66
IS 7
A1 Juan F Masa
A1 Jaime Corral
A1 Ricardo Pereira
A1 Joaquin Duran-Cantolla
A1 Marta Cabello
A1 Luis Hernández-Blasco
A1 Carmen Monasterio
A1 Alberto Alonso
A1 Eusebi Chiner
A1 Manuela Rubio
A1 Estefania Garcia-Ledesma
A1 Laura Cacelo
A1 Rosario Carpizo
A1 Lirios Sacristan
A1 Neus Salord
A1 Miguel Carrera
A1 José N Sancho-Chust
A1 Cristina Embid
A1 Francisco-José Vázquez-Polo
A1 Miguel A Negrín
A1 Jose M Montserrat
YR 2011
UL http://thorax.bmj.com/content/66/7/567.abstract
AB Introduction Home respiratory polygraphy (HRP) may be a cost-effective alternative to polysomnography for the diagnosis of sleep apnoea-hypopnoea syndrome (SAHS), but stronger evidence is needed. Normally, patients transport HRP equipment from the hospital to home and back, which may create difficulties for some patients.Objectives To determine both the diagnostic efficacy and cost of HRP (with and without a transportation service moving the device and telematic transmission of data) in a large sample compared with in-hospital polysomnography.Methods Patients suspected of having SAHS were included in a multicentre study (eight hospitals). They were assigned to home and hospital protocols in random order. Receiver operating characteristic curves were constructed for manual respiratory polygraphy scoring protocol and different polysomnographic cut-off points. Diagnostic efficacies for several polysomnographic cut-off points were explored and costs for two equally effective alternatives were calculated.Results Of 366 randomised patients, 348 completed the protocol. The best receiver operating characteristic curve was obtained with a polysomnographic cut-off of the apnoea-hypopnoea index (AHI)≥5. The sensitive HRP AHI cut-off point (<5) had a sensitivity of 96%, a specificity of 57% and a negative likelihood ratio (LR) of 0.07; the specific cut-off (>10) had a sensitivity of 87%, a specificity of 86% and a positive LR of 6.25. The cost of HRP was half that of polysomnography. Telematic transmission costs were similar if the patients' costs were taken in to account.Conclusion HRP is an alternative to polysomnography in patients with suspected SAHS. Telematic procedures may help patients with limited mobility and those who live a long way from the sleep centre.