1. Validity and Cost-Effectiveness of Pediatric Home Respiratory Polygraphy for the Diagnosis of Obstructive Sleep Apnea in Children: Rationale, Study Design, and Methodology
- Author
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Maria Ángeles Villar, Maria Jose Jurado, Leila Kheirandish-Gozal, Maria Luz Alonso, David Gozal, Marian Martínez, Carmen Luna, Paula Rodríguez Rodríguez, Joaquín Durán-Cantolla, Olga Mediano, Milagros Merino, Genoveva Del Rio, Jaime Corral, Santiago Juarros, Esther Oceja, Institut Català de la Salut, [Oceja E] Domiciliary Hospitalization, Sleep Unit, OSI Araba University Hospital, Vitoria, Spain. [Rodríguez P] Research Service and Bioaraba Research Institute, OSI Araba University Hospital, UPV/EHU, Vitoria, Spain. [Jurado MJ] Unitat del Son, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Luz Alonso M] Sleep Unit, Complejo Hospitalario de Burgos, Burgos, Spain. [Del Río G] Sleep Unit, Fundación Jiménez Díaz, Madrid, Spain. [Villar MÁ] Sleep Unit, Hospital Universitario de Basurto, Bilbao, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
medicine.medical_specialty ,Diagnosis::Diagnostic Techniques and Procedures::Monitoring, Physiologic::Polysomnography [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,Cost effectiveness ,diagnosis ,Psychological intervention ,Disease ,Polysomnography ,Biochemistry, Genetics and Molecular Biology (miscellaneous) ,Article ,03 medical and health sciences ,0302 clinical medicine ,enfermedades del sistema nervioso::trastornos del sueño-vigilia::disomnias::trastornos intrínsecos del sueño::síndromes de apnea del sueño::apnea obstructiva del sueño [ENFERMEDADES] ,Quality of life ,children ,Structural Biology ,medicine ,economía y organizaciones para la atención de la salud::economía::costes y análisis de costes::análisis coste-beneficio [ATENCIÓN DE SALUD] ,respiratory polygraphy ,Intensive care medicine ,lcsh:QH301-705.5 ,medicine.diagnostic_test ,business.industry ,Gold standard ,cost-effectiveness analysis ,obstructive sleep apnea (OSA) ,Cost-effectiveness analysis ,diagnóstico::técnicas y procedimientos diagnósticos::monitorización fisiológica::polisomnografía [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,medicine.disease ,nervous system diseases ,respiratory tract diseases ,Obstructive sleep apnea ,030228 respiratory system ,lcsh:Biology (General) ,Health Care Economics and Organizations::Economics::Costs and Cost Analysis::Cost-Benefit Analysis [HEALTH CARE] ,Síndromes d'apnea del son - Diagnòstic ,Cost-eficàcia ,Nervous System Diseases::Sleep Wake Disorders::Dyssomnias::Sleep Disorders, Intrinsic::Sleep Apnea Syndromes [DISEASES] ,business ,030217 neurology & neurosurgery ,Biotechnology - Abstract
Obstructive sleep apnea (OSA) in children is a prevalent, albeit largely undiagnosed disease associated with a large spectrum of morbidities. Overnight in-lab polysomnography remains the gold standard diagnostic approach, but is time-consuming, inconvenient, and expensive, and not readily available in many places. Simplified Home Respiratory Polygraphy (HRP) approaches have been proposed to reduce costs and facilitate the diagnostic process. However, evidence supporting the validity of HRP is still scarce, hampering its implementation in routine clinical use. The objectives were: Primary, to establish the diagnostic and therapeutic decision validity of a simplified HRP approach compared to PSG among children at risk of OSA. Secondary: (a) Analyze the cost-effectiveness of the HRP versus in-lab PSG in evaluation and treatment of pediatric OSA, (b) Evaluate the impact of therapeutic interventions based on HRP versus PSG findings six months after treatment using sleep and health parameters and quality of life instruments, (c) Discovery and validity of the urine biomarkers to establish the diagnosis of OSA and changes after treatment.
- Published
- 2021