Natsky Andrea N, Chai-Coetzer Ching L, Vakulin Andrew, McEvoy R D, Adams Robert J, Kaambwa Billingsley
Health Economics, Flinders University College of Medicine and Public Health, Bedford Park, SA, Australia; National Centre for Sleep Health Services Research: A NHMRC Centre of Research Excellence, Flinders University, Bedford Park, SA, Australia.
Adelaide Institute for Sleep Health, A Flinders Centre of Research Excellence, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia; Respiratory and Sleep Service, Southern Adelaide Local Health Network, Bedford Park, SA, Australia; National Centre for Sleep Health Services Research: A NHMRC Centre of Research Excellence, Flinders University, Bedford Park, SA, Australia.
Sleep Med Rev. 2022 Apr;62:101608. doi: 10.1016/j.smrv.2022.101608. Epub 2022 Feb 10.
Evidence regarding the cost-effectiveness of limited channel tests compared to laboratory and home polysomnography (PSG) in diagnosing obstructive sleep apnoea (OSA) is unclear. Eligible studies were systematically sought across the following databases: MEDLINE, PsychINFO, SCOPUS, CINAHL, Cochrane, Emcare, Web of Science and ProQuest. Title and abstracts were screened before full-text review. Only full and partial economic evaluations reporting at least one economic outcome were included. A standardised template was used for critical appraisal and data extraction. Relevant findings were summarised using a qualitative approach adhering to economic reporting standards. Literature searches identified 999 non-duplicate abstracts, where 85 studies were retrieved for full-text review. The number of studies that met eligibility criteria and were included in the final analyses was 35, of which 31 investigated Level 3 and four assessed Level 4 tests. Based on the dominance ranking framework, both Level 3 and Level 4 tests were cost-effective compared to PSG. Although study designs and methodologies differ broadly, the findings indicated that using limited channel diagnostic sleep tests for OSA is associated with lower costs and non-inferior health outcomes relative to PSG. Limited channel tests also resulted in shorter waiting times and improved access to diagnostic services for patients with OSA. PROSPERO REGISTRATION NUMBER: CRD42020150130.
与实验室多导睡眠图（PSG）和家庭多导睡眠图相比，有限通道测试在诊断阻塞性睡眠呼吸暂停（OSA）方面的成本效益证据尚不清楚。我们在以下数据库中系统地检索了符合条件的研究：MEDLINE、PsychINFO、SCOPUS、CINAHL、Cochrane、Emcare、科学网和ProQuest。在进行全文审查之前，先对标题和摘要进行筛选。仅纳入报告了至少一项经济结果的完整和部分经济评估。使用标准化模板进行批判性评价和数据提取。采用符合经济报告标准的定性方法总结相关研究结果。文献检索共识别出999篇不重复的摘要，从中检索出85项研究进行全文审查。符合纳入标准并最终纳入分析的研究有35项，其中31项研究了3级测试，4项评估了4级测试。基于优势排序框架，与PSG相比，3级和4级测试均具有成本效益。尽管研究设计和方法差异很大，但研究结果表明，相对于PSG，使用有限通道诊断性睡眠测试诊断OSA的成本更低，健康结果不逊色。有限通道测试还缩短了等待时间，改善了OSA患者获得诊断服务的机会。PROSPERO注册号：CRD42020150130。
