The DOI matches its Crossref record; 67 of the 68 references it cites were found in a registry or an index, and 1 are not checked yet.
An Integrated Health-Economic Analysis of Diagnostic and Therapeutic Strategies in the Treatment of Moderate-to-Severe Obstructive Sleep Apnea
Open accessAbstract
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is a common disorder associated with substantially increased cardiovascular risks, reduced quality of life, and increased risk of motor vehicle collisions due to daytime sleepiness. This study evaluates the cost-effectiveness of three commonly used diagnostic strategies (full-night polysomnography, split-night polysomnography, unattended portable home-monitoring) in conjunction with continuous positive airway pressure (CPAP) therapy in patients with moderate-to-severe OSA. DESIGN: A Markov model was created to compare costs and effectiveness of different diagnostic and therapeutic strategies over a 10-year interval and the expected lifetime of the patient. The primary measure of cost-effectiveness was incremental cost per quality-adjusted life year (QALY) gained. PATIENTS OR PARTICIPANTS: Baseline computations were performed for a hypothetical average cohort of 50-year-old males with a 50% pretest probability of having moderate-to-severe OSA (apnea-hypopnea index [AHI] ≥ 15 events per hour). MEASUREMENTS AND RESULTS: For a patient with moderate-to-severe OSA, CPAP therapy has an incremental cost-effectiveness ratio (ICER) of $15,915 per QALY gained for the lifetime horizon. Over the lifetime horizon in a population with 50% prevalence of OSA, full-night polysomnography in conjunction with CPAP therapy is the most economically efficient strategy at any willingness-to-pay greater than $17,131 per-QALY gained because it dominates all other strategies in comparative analysis. CONCLUSIONS: Full-night polysomnography (PSG) is cost-effective and is the preferred diagnostic strategy for adults suspected to have moderate-to-severe OSA when all diagnostic options are available. Split-night PSG and unattended home monitoring can be considered cost-effective alternatives when full-night PSG is not available.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The first study 167 demonstrated an incremental cost-effectiveness ratio (ICER) of CDN$15,915 per quality-adjusted life year (QALY) with CPAP therapy”
From Treatment of Adult Obstructive Sleep Apnea With Positive Airway Pressure: An American Academy of Sleep Medicine Systematic Review, Meta-Analysis, and GRADE Assessment (2019) · cites this paper as [167]
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Marin, J. M., Carrizo, S. J., Vicente, E., & Agusti, A. G. (2005) · The Lancet · doi:10.1016/s0140-6736(05)71141-7 · Cited by 4,678
Obstructive Sleep Apnea as a Risk Factor for Stroke and Death
Yaggi, H. K., Concato, J., Kernan, W. N., Lichtman, J. H., Brass, L. M., & Mohsenin, V. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043104 · Cited by 3,004
Lee, J. A. H. (1986) · JAMA · doi:10.1001/jama.1986.03370120114036 · Cited by 2,252
Becker, H. F., Jerrentrup, A., Ploch, T., Grote, L., Penzel, T., Sullivan, C. E., & Peter, J. H. (2003) · Circulation · doi:10.1161/01.cir.0000042706.47107.7a · Cited by 931
Cutler, J. A., Sorlie, P. D., Wolz, M., Thom, T., Fields, L. E., & Roccella, E. J. (2008) · Hypertension · doi:10.1161/hypertensionaha.108.113357 · Cited by 918
Sleep Apnea as an Independent Risk Factor for All-Cause Mortality: The Busselton Health Study
(2008) · Sleep · doi:10.5665/sleep/31.8.1079 · Cited by 889
Long-term Use of CPAP Therapy for Sleep Apnea/Hypopnea Syndrome
McARDLE, N., DEVEREUX, G., HEIDARNEJAD, H., ENGLEMAN, H. M., MACKAY, T. W., & DOUGLAS, N. J. (1999) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.159.4.9807111 · Cited by 820
Lifetime Cost of Stroke in the United States
Taylor, T. N., Davis, P. H., Torner, J. C., Holmes, J. S., Meyer, J. W., & Jacobson, M. F. (1996) · Stroke · doi:10.1161/01.str.27.9.1459 · Cited by 806
Preference-Based EQ-5D Index Scores for Chronic Conditions in the United States
Sullivan, P. W., & Ghushchyan, V. H. (2006) · Medical Decision Making · doi:10.1177/0272989x06290495 · Cited by 707
Access to Diagnosis and Treatment of Patients with Suspected Sleep Apnea
Flemons, W. W., Douglas, N. J., Kuna, S. T., Rodenstein, D. O., & Wheatley, J. R. (2004) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200308-1124pp · Cited by 678
Research works printed but not linked: 2
- [11]Gold MR, Siegel JE, Russell LB, Weinstein MC. Cost-effectiveness in Health and Medicine. New York: Oxford University Press; 1996. [Google Scholar]
- [16]British Heart Foundation Statistics Website. HeartStats. British Heart Foundation; 2009. [Google Scholar]
Cited by
Sorted by citations
Kapur, V. K., Auckley, D. H., Chowdhuri, S., Kuhlmann, D. C., Mehra, R., Ramar, K., & Harrod, C. G. (2017) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.6506 · Cited by 3,253
Patil, S. P., Ayappa, I. A., Caples, S. M., Kimoff, R. J., Patel, S. R., & Harrod, C. G. (2019) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.7638 · Cited by 721
Tietjens, J. R., Claman, D., Kezirian, E. J., De Marco, T., Mirzayan, A., Sadroonri, B., Goldberg, A. N., Long, C., Gerstenfeld, E. P., & Yeghiazarians, Y. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.118.010440 · Cited by 397
Rosen, C. L., Auckley, D., Benca, R., Foldvary-Schaefer, N., Iber, C., Kapur, V., Rueschman, M., Zee, P., & Redline, S. (2012) · Sleep · doi:10.5665/sleep.1870 · Cited by 367
International Consensus Statement on Obstructive Sleep Apnea
Chang, J. L., Goldberg, A. N., Alt, J. A., Mohammed, A., Ashbrook, L., Auckley, D., Ayappa, I., Bakhtiar, H., Barrera, J. E., Bartley, B. L., et al. (2023) · International Forum of Allergy & Rhinology · doi:10.1002/alr.23079 · Cited by 350
Metadata
- Authors
- Pietzsch, J. B., Garner, A. M., Cipriano, L. E., & Linehan, J. H.
- Affiliations
- Stanford University (US)
- Northwestern University (US)
- Corresponding author
- John H. Linehan
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-06-01
- Volume
- 34
- Issue
- 6
- Pages
- 695-709
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC3098944
- OpenAlex
- W2085685282
- Cited by
- 149
- References
- 67
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 7 · 2023: 8 · 2022: 9 · 2021: 7 · 2020: 3 · 2019: 7 · 2018: 7 · 2017: 17 · 2016: 14 · 2015: 23 · 2014: 13 · 2013: 16 · 2012: 12
- FWCI
- 9.16
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- SLEEP (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Northwestern University
- Topics
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- obstructive sleep apnea, cost-effectiveness, split-night polysomnography, home sleep apnea testing, continuous positive airway pressure, OSA diagnosis, quality-adjusted life years, Markov model
- MeSH terms
- Adult, Cost-Benefit Analysis, Female, Humans, Male, Markov Chains, Health Care Costs, Outcome Assessment, Health Care, Polysomnography, Quality-Adjusted Life Years, Sleep Apnea, Obstructive, Continuous Positive Airway Pressure
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
