Because Type 3 studies can be slightly less sensitive on average than lab PSG, a negative result in a symptomatic patient should be repeated in the lab.
Who Are the Best Candidates?
Peter D. O’Connor, MD, OD, of the Department of Otolaryngology-Head and Neck Surgery, Sleep Medicine and Surgery at Brooke Army Medical Center in San Antonio, TX, spent some time in his presentation advising participants on careful patient selection. As the AASM notes in its Clinical Guidelines decision tree, the most appropriate use of HSS is in patients who have a high pretest probability of moderate to severe OSA. If patients have signs or symptoms of co-morbid disorders, it’s best to order lab PSG.
Dr. O’Connor noted that as of September 2009, 87 different HSS devices-primarily Type 3 and 4-were listed on the FDA Web site. It’s important to understand what the test provides, to whom you can apply it, whether the device has been validated, whether it has limitations, and whether you can utilize it within the parameters set by CMS, he said.