Unattended sleep studies in a VA population

Initial evaluation by chart review versus clinic visit by a midlevel provider

Abdelhamid M. Alsharif, Michelle Potts, Regina Laws, Amado Freire, Ibrahim Sultan-Ali

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives Obstructive sleep apnea (OSA) is a prevalent disorder that is associated with multiple medical consequences. Although in-laboratory polysomnography is the gold standard for the diagnosis of OSA, portable monitors have been developed and studied to help increase efficiency and ease of diagnosis. We aimed to assess the adequacy of a midlevel provider specializing in sleep medicine to risk-stratify patients for OSA based on a chart review versus a comprehensive clinic evaluation before scheduling an unattended sleep study. Methods This study was an observational, nonrandomized, retrospective data collection by chart review of patients accrued prospectively who underwent an unattended sleep study at the Sleep Health Center at the Memphis Veterans Affairs Medical Center during the first 13 months of the program (May 1, 2011-May 31, 2012). A total of 205 patients were included in the data analysis. Results Analysis showed no statistically significant differences between chart review and clinic visit groups (P = 0.54) in terms of OSA diagnosis. Although not statistically significant, the analysis shows a trend toward higher mean age (50.3 vs 47.4 years; P = 0.10) and lower mean body mass index (34.4 vs 36.0; P = 0.08) in individuals who were evaluated during a comprehensive clinic visit. A statistically significant difference is seen in terms of the pretest clinical probability of OSA being moderate or high in 62.2% of patients in the clinic visit group and 95.7% in the chart review group, with a χ 2 P ≤ 0.0001. Conclusions In the Veterans Health Administration's system, the assessment of pretest probability may be determined by a midlevel provider using chart review with equal efficacy to a comprehensive face-to-face evaluation in terms of OSA diagnosis via unattended sleep studies.

Original languageEnglish (US)
Pages (from-to)677-681
Number of pages5
JournalSouthern Medical Journal
Volume109
Issue number10
DOIs
StatePublished - Oct 1 2016

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Obstructive Sleep Apnea
Ambulatory Care
Sleep
Population
Veterans Health
United States Department of Veterans Affairs
Polysomnography
Veterans
Observational Studies
Body Mass Index
Medicine
Health

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Unattended sleep studies in a VA population : Initial evaluation by chart review versus clinic visit by a midlevel provider. / Alsharif, Abdelhamid M.; Potts, Michelle; Laws, Regina; Freire, Amado; Sultan-Ali, Ibrahim.

In: Southern Medical Journal, Vol. 109, No. 10, 01.10.2016, p. 677-681.

Research output: Contribution to journalArticle

Alsharif, Abdelhamid M. ; Potts, Michelle ; Laws, Regina ; Freire, Amado ; Sultan-Ali, Ibrahim. / Unattended sleep studies in a VA population : Initial evaluation by chart review versus clinic visit by a midlevel provider. In: Southern Medical Journal. 2016 ; Vol. 109, No. 10. pp. 677-681.
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