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Future Research Needs for Diagnosis of Obstructive Sleep Apnea
Future Research Needs Papers, No. 11
Ethan M Balk, MD, MPH, Co-Project Lead, Mei Chung, PhD, MPH, Co-Project Lead, Denish Moorthy, MBBS, MS, Research Associate, Jeffrey A Chan, BS, Research Associate, Kamal Patel, MPH, MBA, Research Associate, Thomas W Concannon, PhD, Investigator, Sara J Ratichek, MA, Project Coordinator, and Lina Kong Win Chang, BS, Research Assistant.
Author Information and AffiliationsStructured Abstract
Background:
Obstructive sleep apnea (OSA) is an important public health issue, with challenges for diagnosis and treatment. A recent Comparative Effectiveness Review (CER) found numerous areas with insufficient or low strength of evidence
Purpose:
With the assistance of a panel of representative stakeholders, to identify and prioritize future research needs topics for diagnosis of OSA.
Methods:
Twenty-one panel members represented six stakeholder categories: patients and the public, providers, purchasers of health care, payers, policymakers, and principal investigators. Building on future research needs topics derived from the CER, stakeholders nominated additional topics for discussion. Nominated topics were discussed by stakeholders (excluding product makers) on a secure Web site discussion board. At the close of the discussion period, stakeholders nominated their top five Future Research Needs topics based on the Agency for Healthcare Research and Quality Effective Health Care Program selection criteria. From these nominations, the highest priority Future Research Needs were determined and were elaborated upon to include possible study designs to address the topics.
Future Research Needs Topics:
The high priority future needs topics included:
- Age and gender specific criteria for abnormal breathing (or OSA)
- Routine (or selected) preoperative screening for sleep apnea
- Cost effectiveness of a management strategy (diagnosis [of symptomatic or high-risk patients] through treatment [of patients diagnosed with OSA]), specifically for patients with mild-to-moderate disease severity
- Cost effectiveness of use of diagnostic algorithms and portable monitors, including limited-channel, low-cost portable devices
- Value of having a sleep medicine specialist involved in the diagnosis of OSA
- What is the prognostic accuracy of clinical prediction rules to predict clinical outcomes?
Fourteen other future research needs topics were discussed.
Challenges:
Stakeholder participation in the online discussion board was low. Discussions were begun by only five stakeholders and only 33 percent of stakeholders participated in the online discussion. The median number of comments across topics was only two. Topic nomination was done by 16 stakeholders (76 percent). Lessons learned from this Future Research Needs panel discussion can be applied to future panels.
Contents
- Preface
- Acknowledgements
- Executive Summary
- Background
- Methods
- Stakeholder Panel
- Identification and Invitation of Individual Stakeholders
- Introduction of Process to the Stakeholder Panel
- Iterative Process To Identify Future Research Needs Topics
- Use of Microsoft® SharePoint
- Approach to Prioritization
- Approach to Research Question Development and Considerations for Potential Research Designs
- Results
- Discussion
- References
- Acronyms
- Appendixes
Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services1, Contract No. 290-2007-10055 I, Prepared by: Tufts Evidence-based Practice Center, Tufts Medical Center, Boston, MA
Suggested citation:
Balk EM, Chung M, Moorthy D, Chan JA, Patel K, Concannon TW, Ratichek SJ, Chang LKW. Future Research Needs for Diagnosis of Obstructive Sleep Apnea. Future Research Needs Paper No. 11. (Prepared by the Tufts Evidence-based Practice Center under Contract No. 290-2007-10055 I.) AHRQ Publication No. 12-EHC031-EF. Rockville, MD: Agency for Healthcare Research and Quality; February 2012. www.effectivehealthcare.gov/reports/final.cfm.
This report is based on research conducted by the Tufts Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10055 I). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.
The information in this report is intended to help health care researchers and funders of research make well-informed decisions in designing and funding research and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of scientific judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical research and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances.
None of the investigators has any affiliation or financial involvement that conflicts with the material presented in this report.
- 1
540 Gaither Road, Rockville, MD 20850; www
.ahrq.gov
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