Beyond the Apnoea–Hypopnoea Index – Prognostic Value of Other Elements of Polysomnography to Describe Sleep-disordered Breathing in Heart Failure

2009 ◽  
Vol 5 (2) ◽  
pp. 53
Author(s):  
Philip B Adamson ◽  

There is increasing appreciation of the prevalence of sleep-disordered breathing (SDP) in heart failure. As we examine this patient population, the difficulties of determining success in the treatment of SDB are becoming evident. The apnoea–hypopnoea index (AHI) is the standard method of measuring both the severity of the disease and treatment success, but in itself is a composite of multiple components. This article examines both current and developing measurements in the treatment of SDB.

2019 ◽  
Vol 161 (2) ◽  
pp. 343-347 ◽  
Author(s):  
Grace Baik ◽  
Scott E. Brietzke

Objectives Use decision analysis techniques to assess the potential utility gains/losses and costs of adding bilateral inferior turbinoplasty to tonsillectomy/adenoidectomy (T/A) for the treatment of obstructive sleep-disordered breathing (oSDB) in children. Use sensitivity analysis to explore the key variables in the scenario. Study Design Cost-utility decision analysis model. Setting Hypothetical cohort. Subjects and Methods Computer software (TreeAge Software, Williamstown, Massachusetts) was used to construct a decision analysis model. The model included the possibility of postoperative complications and persistent oSDB after surgery. Baseline clinical and quality-adjusted life year (QALY) parameters were estimated using published data. Cost data were estimated from Centers for Medicare and Medicaid 2018 databases ( www.cms.gov ). Sensitivity analyses were completed to assess for key model parameters. Results The utility analysis of the baseline model favored the addition of turbinoplasty (0.8890 vs 0.8875 overall utility) assuming turbinate hypertrophy was present. Sensitivity analysis indicated the treatment success increase (%) provided by concurrent turbinoplasty was the key parameter in the model. A treatment success increase of 3% of turbinoplasty was the threshold where concurrent turbinoplasty was favored over T/A alone. The incremental cost-effectiveness ratio (ICER) of $27,333/QALY for the baseline model was favorable to the willingness-to-pay threshold of $50,000 to $100,000/QALY for industrialized nations. Conclusions The addition of turbinoplasty for children with turbinate hypertrophy to T/A for the treatment of pediatric oSDB is beneficial from both a utility and cost-benefit analysis standpoint even if the benefits of turbinoplasty are relatively modest.


2012 ◽  
Vol 28 (6) ◽  
pp. 728-734 ◽  
Author(s):  
Akiomi Yoshihisa ◽  
Satoshi Suzuki ◽  
Takashi Owada ◽  
Shoji Iwaya ◽  
Hiroyuki Yamauchi ◽  
...  

2016 ◽  
Vol 17 ◽  
pp. 32-37 ◽  
Author(s):  
Mirjam Ljunggren ◽  
Liisa Byberg ◽  
Jenny Theorell-Haglöw ◽  
Bertil Lindahl ◽  
Karl Michaëlsson ◽  
...  

SLEEP ◽  
2010 ◽  
Vol 33 (4) ◽  
pp. 551-560 ◽  
Author(s):  
Nancy S. Redeker ◽  
Ulrike Muench ◽  
Mark J. Zucker ◽  
Joyce Walsleben ◽  
Michelle Gilbert ◽  
...  

Heart & Lung ◽  
2011 ◽  
Vol 40 (4) ◽  
pp. 385-386
Author(s):  
R. Germany ◽  
J. Kalgreen ◽  
A. Ketelsen ◽  
L. Austin

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