美国睡眠vwin088医学学院（AASM）组织并协调了一项涉及20个组织的多社会计划，以开发和提交全面comment letterin response to theCPAP技术评估草案and附录posted recently by the Agency for Healthcare Research and Quality (AHRQ).

AHRQ posted the draft CPAP assessment on April 1, indicating that the Centers for Medicare & Medicaid Services (CMS) had requested it. The 155-page document, based on a systematic review of the scientific literature, analyzed measures of sleep-disordered breathing, identified research gaps, and made a statement in the conclusion that, “The published evidence mostly does not support that CPAP prescription affects long-term, clinically important outcomes.”

OSA讨论中的长期结果研究

During this panel discussion, held June 13, 2021, during the Virtual SLEEP 2021 annual meeting, content experts reviewed the findings of the draft CPAP technology assessment that was posted recently by the AHRQ. The moderators also summarized the multi-society response coordinated by the AASM, and they discussed approaches the sleep research community can take to address knowledge deficiencies raised by the report.
Updated June 17, 2021

20页的多社会评论信强调，AHRQ的结论是，CPAP处理没有重大好处并不能反映出可用证据的总数。因此，目前编写的对报告草案的误解将对数百万美国人的照顾产生有害的影响，而OSA现在和将来都会从CPAP治疗中受益。该信提供了具体的建议来解决这些问题，并要求AHRQ考虑在最终出版之前修改报告草案，以避免误解或出现偏见。

评论信提到了以下问题：

  • 过度的嗜睡不是被认为是临床上重要的，以患者为中心的长期结局。
  • 不考虑有关汽车撞车的重要数据。
  • 血压的改善不被认为是临床上相关的结果。
  • 呼吸暂停指数（AHI）作为中间结果的分析具有潜在的局限性。
  • The future research section did not adequately consider the barriers to conducting randomized controlled trials (RCTs).
  • The summary statements were unclear.

AHRQ stated that the report is intended to help health care decision makers make well-informed decisions that improve the quality of health care services. However, AHRQ also noted that the report is not intended to be a substitute for the application of clinical judgment.

AASM非常感谢联合写作小组成员，他们在过去的两周中投入了不可思议的时间和精力来制图和修改信件：MD，PhD，PhD（AASM代表）；彼得·盖伊（Peter Gay），医学博士（胸部代表）；医学博士Karin Johnson（美国神经病学会代表）；R. John Kimoff，医学博士（美国胸腔社会代表）；和Allan Pack，MBCHB，博士学位（睡眠研究协会代表）。

AASM还感谢以下组织支持这项倡议并签署评论信：

  • 睡眠呼吸暂停合作伙伴联盟
  • 美国牙科睡眠医学
  • 美国神经病学学会
  • American Association for Respiratory Care
  • 美国睡眠协会技术人员
  • American College of Chest Physicians
  • 美国睡眠呼吸暂停协会
  • 美国胸腔学会
  • 亚洲睡眠医学学会
  • Australasian Sleep Association
  • Board of Registered Polysomnographic Technologists
  • 加利福尼亚睡眠协会
  • Canadian Sleep Society
  • European Respiratory Society
  • European Sleep Research Society
  • 马里兰州睡眠协会
  • Sleep Research Society
  • 南部睡眠协会
  • 世界睡眠社会

The comment period closed at 5 p.m. on April 23. AHRQ has not indicated when a final draft will be posted. Public comments and the report authors’ responses to the comments (the “disposition of comments”) will be publicly posted on theTechnology Assessment Programwebsite within three months after the associated final report is posted.

Questions or comments about the letter can be submitted tocoding@www.docksidequiltgallery.com。

2021年4月26日更新