One of the arguments against home testing is the lack of outcome data regarding testing done in that venue as opposed to tests performed with medical personnel in attendance. We postulated that the venue of testing doesn’t produce any significant differences in test results or outcomes.
We reviewed the clinical history and sleep test results of patients tested at home (H) using an Edentrace system versus attended (A) studies tested in a sleep lab or hospital setting using the same equipment. The venue of testing was determined by each patient’s insurance company guidelines. Patients were included based on the availability of outcome data gathered from a follow up questionnaire. The clinical outcomes were appraised by a standardized questionnaire we have been using since 1995. All of the follow up data was collected after patients had been using continuous positive airway pressure for a month or longer.
There were 332 patients in the (H) group and 541 patients in the (A) group. Table ITABLE IHOME (H)ATTENDED (A)TOTAL STUDIES332541Gender - Male75%72%Gender - Female25%28%Average age46.2 +/− 11 years46.0 +/− 9 yearsAverage BMI35.4 +/− 8kg/m236.5 +/− 12kg/m2Average AHI36.0 +/− 28 events/hour33.0 +/− 25 events/hourBaseline Clinical Severity (0=Best, 60=Most severe)34.7 +/−1034.0 +/− 10Clinical Severity on CPAP7.5 +/− 58.1 +/− 4summarizes our findings. There was no difference in age, gender mix, or BMI between the two groups. The apnea hypopnea index was similar in both groups (A=36.0 +/−28 vs H=33.0 +/− 25), as was the clinical severity score at baseline ((H) = 34.7/60 and (A) = 34.0/60). The follow up clinical score was markedly improved in both groups to approximately the same low level (H=7.5/60, A=8.1/60). Specific improvement noted in snoring level, observed apnea, morning sleepiness, daytime sleepiness, arousals, and cognitive function was similar in both groups.
The venue of testing does not produce any systematic variation in the AHI or clinical outcomes of patients with OSA.
Most patients would prefer to do tests in their home if the insurance company will pay for it. Some patients are hesitant to undergo testing due to insurance guidelines that mandate testing be done outside of their home. Our results suggest that such mandates may not be clinically justified.
R.J. Pisani, None.