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Rebuttal From Dr PackRebuttal From Dr Pack

Allan I. Pack, MBChB, PhD
Author and Funding Information

From the Division of Sleep Medicine/Department of Medicine and Center for Sleep and Circadian Neurobiology, Perelman School of Medicine at the University of Pennsylvania.

CORRESPONDENCE TO: Allan I. Pack, MBChB, PhD, Perelman School of Medicine at the University of Pennsylvania, Ste 2100, 125 S 31st St, Philadelphia, PA 19104-3403; e-mail: pack@mail.med.upenn.edu


FINANCIAL/NONFINANCIAL DISCLOSURES: The author has reported to CHEST the following conflicts of interest: Dr Pack holds an endowed chair, the Miclot Chair, that was funded by a donation from the Respironics Foundation.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(2):310-311. doi:10.1378/chest.15-0478
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Extract

Dr Freedman1 has accurately and effectively described the basis of the switch to use of home testing in the United States. I agree that for subjects with high pretest probabilities of OSA without other major issues, home testing is appropriate provided that subsequent management of therapy is by trained providers.

A test, however, does not by itself lead to “better outcomes.” What matters is management of the problem once the diagnosis is made. Moreover, what are the outcomes we seek to influence? Is it improved quality of life?2 Is it reduced crash risk?3 Is it improvement in BP?4,5 Is it reduced long-term health-care costs?6 Studies have shown that effective treatment of OSA can influence all of these outcomes.2-6

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