TY - JOUR
T1 - Cost-effectiveness analysis of automatic titration of continuous positive airway pressure at home in 1 night versus 2 nights
AU - Roldán, Nicolás
AU - Sampol, Gabriel
AU - Sagalés, Teresa
AU - Romero, Odile
AU - Jurado, María José
AU - Ríos, José
AU - Lloberesa, Patricia
PY - 2008/12
Y1 - 2008/12
N2 - OBJECTIVE: To assess the cost-effectiveness of automatic continuous positive airway pressure (CPAP) titration at home on 1 night or 2 consecutive nights in patients with the sleep apnea-hypopnea syndrome (SAHS). PATIENTS AND METHODS: A home titration study was performed using automatic CPAP for 2 consecutive nights on 100 patients with SAHS and an indication for CPAP. The number of successful studies and the costs of the first night and both nights were analyzed. The pressure requirements on each night and the agreement between the pressures selected visually by 2 different observers were compared. RESULTS: CPAP titration was successful in 85% and 80% of patients on the first night and second night, respectively, and in 88% of patients after both nights. No significant differences between the 2 nights were found for the following parameters: 95th percentile pressure (mean [SD], 10.2 [1.8] cm H2O and 10.2 [1.6] cm H2O on the first and second nights, respectively), mean pressure (7.8 [1.7] cm H2O and 7.7 [1.7] cm H2O), or the pressure selected visually (9.4 [1.5] cm H2O and 9.4 [1.4] cm H2O). Interobserver agreement on the pressure selected was good: the κ statistics were 0.956 for the first night and 0.91 for the second night. The 1-night study cost €232.63 and the 2-night study cost €227.93. CONCLUSIONS: Automatic CPAP titration at home for 1 night enables a substantially greater number of patients to be studied at a similar cost than is possible when titration is accomplished in 2 consecutive nights.
AB - OBJECTIVE: To assess the cost-effectiveness of automatic continuous positive airway pressure (CPAP) titration at home on 1 night or 2 consecutive nights in patients with the sleep apnea-hypopnea syndrome (SAHS). PATIENTS AND METHODS: A home titration study was performed using automatic CPAP for 2 consecutive nights on 100 patients with SAHS and an indication for CPAP. The number of successful studies and the costs of the first night and both nights were analyzed. The pressure requirements on each night and the agreement between the pressures selected visually by 2 different observers were compared. RESULTS: CPAP titration was successful in 85% and 80% of patients on the first night and second night, respectively, and in 88% of patients after both nights. No significant differences between the 2 nights were found for the following parameters: 95th percentile pressure (mean [SD], 10.2 [1.8] cm H2O and 10.2 [1.6] cm H2O on the first and second nights, respectively), mean pressure (7.8 [1.7] cm H2O and 7.7 [1.7] cm H2O), or the pressure selected visually (9.4 [1.5] cm H2O and 9.4 [1.4] cm H2O). Interobserver agreement on the pressure selected was good: the κ statistics were 0.956 for the first night and 0.91 for the second night. The 1-night study cost €232.63 and the 2-night study cost €227.93. CONCLUSIONS: Automatic CPAP titration at home for 1 night enables a substantially greater number of patients to be studied at a similar cost than is possible when titration is accomplished in 2 consecutive nights.
KW - Apnea-hypopnea syndrome
KW - Automatic CPAP titration
KW - Cost-effectiveness
KW - Home CPAP titration
UR - http://www.scopus.com/inward/record.url?scp=58049198517&partnerID=8YFLogxK
U2 - 10.1016/S1579-2129(09)60004-5
DO - 10.1016/S1579-2129(09)60004-5
M3 - Article
C2 - 19091235
SN - 0300-2896
VL - 44
SP - 664
EP - 670
JO - Archivos de Bronconeumologia
JF - Archivos de Bronconeumologia
IS - 12
ER -