STUDY OBJECTIVES: We examined how telemedicine evaluation compares to face-to-face evaluation in identifying risk for sleep-disordered breathing. METHODS: This was a randomized interrater reliability study of 90 participants referred to a university sleep center. Participants were evaluated by a clinician investigator seeing the patient in-person, then randomized to a second clinician investigator who performed a patient evaluation online via audio-video conferencing. The primary comparator was pretest probability for obstructive sleep apnea. RESULTS: The primary outcome comparing pretest probability for obstructive sleep apnea showed a weighted kappa value of 0.414 (standard error 0.090, P = .002), suggesting moderate agreement between the 2 raters. Kappa values of our secondary outcomes varied widely, but the kappa values were lower for physical exam findings compared to historical elements. CONCLUSIONS: Evaluation for pretest probability for obstructive sleep apnea via telemedicine has a moderate interrater correlation with in-person assessment. A low degree of interrater reliability for physical exam elements suggests telemedicine assessment for obstructive sleep apnea could be hampered by a suboptimal physical exam. Employing standardized scales for obstructive sleep apnea when performing telemedicine evaluations may help with risk-stratification and ultimately lead to more tailored clinical management.
STUDY OBJECTIVES: We examined how telemedicine evaluation compares to face-to-face evaluation in identifying risk for sleep-disordered breathing. METHODS: This was a randomized interrater reliability study of 90 participants referred to a university sleep center. Participants were evaluated by a clinician investigator seeing the patient in-person, then randomized to a second clinician investigator who performed a patient evaluation online via audio-video conferencing. The primary comparator was pretest probability for obstructive sleep apnea. RESULTS: The primary outcome comparing pretest probability for obstructive sleep apnea showed a weighted kappa value of 0.414 (standard error 0.090, P = .002), suggesting moderate agreement between the 2 raters. Kappa values of our secondary outcomes varied widely, but the kappa values were lower for physical exam findings compared to historical elements. CONCLUSIONS: Evaluation for pretest probability for obstructive sleep apnea via telemedicine has a moderate interrater correlation with in-person assessment. A low degree of interrater reliability for physical exam elements suggests telemedicine assessment for obstructive sleep apnea could be hampered by a suboptimal physical exam. Employing standardized scales for obstructive sleep apnea when performing telemedicine evaluations may help with risk-stratification and ultimately lead to more tailored clinical management.
Authors: K R Merikangas; J Zhang; H Emsellem; S A Swanson; A Vgontzas; F Belouad; M M Blank; W Chen; M Einen; J P He; L Heaton; E Nakamura; S Rooholamini; E Mignot Journal: Sleep Med Date: 2014-02-15 Impact factor: 3.492
Authors: E Ray Dorsey; Vinayak Venkataraman; Matthew J Grana; Michael T Bull; Benjamin P George; Cynthia M Boyd; Christopher A Beck; Balaraman Rajan; Abraham Seidmann; Kevin M Biglan Journal: JAMA Neurol Date: 2013-05 Impact factor: 18.302
Authors: Daniel J Taylor; Allison K Wilkerson; Kristi E Pruiksma; Jacob M Williams; Camilo J Ruggero; Willie Hale; Jim Mintz; Katherine Marczyk Organek; Karin L Nicholson; Brett T Litz; Stacey Young-McCaughan; Katherine A Dondanville; Elisa V Borah; Antoinette Brundige; Alan L Peterson Journal: J Clin Sleep Med Date: 2018-03-15 Impact factor: 4.062
Authors: Mark E Fenton; Karen Heathcote; Rhonda Bryce; Robert Skomro; John K Reid; John Gjevre; David Cotton Journal: Chest Date: 2014-03-01 Impact factor: 9.410
Authors: María Jesús Coma-Del-Corral; María Luz Alonso-Álvarez; Marta Allende; José Cordero; Estrella Ordax; Fernando Masa; Joaquín Terán-Santos Journal: Telemed J E Health Date: 2012-11-27 Impact factor: 3.536