Future Research Needs for Diagnosis of Obstructive Sleep Apnea: Identification of Future Research Needs From Comparative Effectiveness Review No. 32 [Internet]

Background: Obstructive sleep apnea (OSA) is an important public health issue, with challenges for diagnosis and treatment. A recent Comparative Effectiveness Review (CER) found numerous areas with insufficient or low strength of evidence

Purpose: With the assistance of a panel of representative stakeholders, to identify and prioritize future research needs topics for diagnosis of OSA.

Methods: Twenty-one panel members represented six stakeholder categories: patients and the public, providers, purchasers of health care, payers, policymakers, and principal investigators. Building on future research needs topics derived from the CER, stakeholders nominated additional topics for discussion. Nominated topics were discussed by stakeholders (excluding product makers) on a secure Web site discussion board. At the close of the discussion period, stakeholders nominated their top five Future Research Needs topics based on the Agency for Healthcare Research and Quality Effective Health Care Program selection criteria. From these nominations, the highest priority Future Research Needs were determined and were elaborated upon to include possible study designs to address the topics.

Future Research Needs Topics: The high priority future needs topics included:

1. Age and gender specific criteria for abnormal breathing (or OSA)

2. Routine (or selected) preoperative screening for sleep apnea

3. Cost effectiveness of a management strategy (diagnosis [of symptomatic or high-risk patients] through treatment [of patients diagnosed with OSA]), specifically for patients with mild-to-moderate disease severity

   1. Cost effectiveness of use of diagnostic algorithms and portable monitors, including limited-channel, low-cost portable devices

4. Value of having a sleep medicine specialist involved in the diagnosis of OSA

5. What is the prognostic accuracy of clinical prediction rules to predict clinical outcomes?

Fourteen other future research needs topics were discussed.

Challenges: Stakeholder participation in the online discussion board was low. Discussions were begun by only five stakeholders and only 33 percent of stakeholders participated in the online discussion. The median number of comments across topics was only two. Topic nomination was done by 16 stakeholders (76 percent). Lessons learned from this Future Research Needs panel discussion can be applied to future panels.