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National Knowledge-...
National Knowledge-Driven Management of Obstructive Sleep Apnea-The Swedish Approach
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- Grote, Ludger, 1964 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine,Gothenburg Univ, Inst Med, Sahlgrenska Acad, Ctr Sleep & Wake Disorders, S-40530 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Pulm Med, S-41345 Gothenburg, Sweden.,Center for Sleep and Wake Disorders, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, 405 30 Gothenburg, Sweden; Pulmonary Medicine, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
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- Anderberg, C. P. (författare)
- Kvarterskliniken, S-41136 Gothenburg, Sweden.
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- Friberg, Danielle (författare)
- Uppsala universitet,Öron-, näs- och halssjukdomar
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- Grundstrom, G. (författare)
- Sleep Apnea Patient Org Apne Sverige, S-13332 Saltsjoebaden, Sweden.,Sleep Apnea Patient Organisation (Apne Sverige), 13332 Saltsjoebaden, Sweden
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- Hinz, K. (författare)
- Reg Vastra Gotaland, Dept Hlth Care Dev, S-40544 Gothenburg, Sweden.,Department for Health Care Development, Region of Västra Götaland, 40544 Gothenburg, Sweden
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- Isaksson, G. (författare)
- Aleris Sleep Apnea Care, S-11361 Stockholm, Sweden.
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- Murto, T. (författare)
- Umeå Univ Hosp, Sleep Apnea Unit, Resp Med, S-90185 Umeå, Sweden.,Sleep Apnea Unit, Respiratory Medicine, Umeå University Hospital, 90185 Umeå, Sweden
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- Nilsson, Z. (författare)
- Ystad Hosp, ENT Dept, Sleep Apnea Unit, S-27182 Ystad, Sweden.,Sleep Apnea Unit, ENT Department, Ystad Hospital, 271 82 Ystad, Sweden
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- Spaak, J. (författare)
- Karolinska Institutet
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- Stillberg, G. (författare)
- Sleep Apnea Unit, S-70212 Örebro, Sweden.,Sleep Apnea Unit, Capio, 70212 Örebro, Sweden
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- Soderberg, K. (författare)
- Sleep Apnea Patient Org Apne Sverige, S-13332 Saltsjoebaden, Sweden.,Sleep Apnea Patient Organisation (Apne Sverige), 13332 Saltsjoebaden, Sweden
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- Tegelberg, A. (författare)
- Sleep Apnea Patient Assoc Apnefoereningen Syd, S-14630 Tullinge, Sweden.,Sleep Apnea Patient Association (Apnefoereningen Syd), 14630 Tullinge, Sweden
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- Theorell-Haglöw, Jenny (författare)
- Uppsala universitet,Malmö universitet,Odontologiska fakulteten (OD),Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden,Lungmedicin och allergologi
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- Ulander, Martin, 1980- (författare)
- Linköpings universitet,Medicinska fakulteten,Avdelningen för neurobiologi,Region Östergötland, Neurofysiologiska kliniken US,Dept Clin Neurophysiol, S-58185 Linköping, Sweden.
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- Hedner, Jan A, 1953 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institute of Medicine,Gothenburg Univ, Inst Med, Sahlgrenska Acad, Ctr Sleep & Wake Disorders, S-40530 Gothenburg, Sweden.;Sahlgrens Univ Hosp, Pulm Med, S-41345 Gothenburg, Sweden.,Center for Sleep and Wake Disorders, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, 405 30 Gothenburg, Sweden; Pulmonary Medicine, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
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(creator_code:org_t)
- 2023-03-20
- 2023
- Engelska.
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Ingår i: Diagnostics. - : MDPI AG. - 2075-4418. ; 13:6
- Relaterad länk:
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https://doi.org/10.3...
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https://mau.diva-por... (primary) (Raw object)
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https://liu.diva-por... (primary) (Raw object)
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https://uu.diva-port... (primary) (Raw object)
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https://gup.ub.gu.se...
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https://doi.org/10.3...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Introduction: This paper describes the development of "Swedish Guidelines for OSA treatment" and the underlying managed care process. The Apnea Hypopnea Index (AHI) is traditionally used as a single parameter for obstructive sleep apnea (OSA) severity classification, although poorly associated with symptomatology and outcome. We instead implement a novel matrix for shared treatment decisions based on available evidence. Methods: A national expert group including medical and dental specialists, nurses, and patient representatives developed the knowledge-driven management model. A Delphi round was performed amongst experts from all Swedish regions (N = 24). Evidence reflecting treatment effects was extracted from systematic reviews, meta-analyses, and randomized clinical trials. Results: The treatment decision in the process includes a matrix with five categories from a "very weak"" to "very strong" indication to treat, and it includes factors with potential influence on outcome, including (A) OSA-related symptoms, (B) cardiometabolic comorbidities, (C) frequency of respiratory events, and (D) age. OSA-related symptoms indicate a strong incitement to treat, whereas the absence of symptoms, age above 65 years, and no or well-controlled comorbidities indicate a weak treatment indication, irrespective of AHI. Conclusions: The novel treatment matrix is based on the effects of treatments rather than the actual frequency of respiratory events during sleep. A nationwide implementation of this matrix is ongoing, and the outcome is monitored in a prospective evaluation by means of the Swedish Sleep Apnea Registry (SESAR).
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Odontologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Dentistry (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Radiologi och bildbehandling (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Radiology, Nuclear Medicine and Medical Imaging (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Oto-rhino-laryngologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Otorhinolaryngology (hsv//eng)
Nyckelord
- standardized care
- treatment indication
- diagnosis
- CPAP
- oral device
- upper airway surgery
- weight reduction
- positional therapy
- positive airway pressure
- risk
- General & Internal Medicine
- standardized care
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
Hitta via bibliotek
Till lärosätets databas
- Av författaren/redakt...
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Grote, Ludger, 1 ...
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Anderberg, C. P.
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Friberg, Daniell ...
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Grundstrom, G.
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Hinz, K.
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Isaksson, G.
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visa fler...
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Murto, T.
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Nilsson, Z.
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Spaak, J.
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Stillberg, G.
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Soderberg, K.
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Tegelberg, A.
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Theorell-Haglöw, ...
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Ulander, Martin, ...
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Hedner, Jan A, 1 ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Odontologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Radiologi och bi ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Oto rhino laryng ...
- Artiklar i publikationen
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Diagnostics
- Av lärosätet
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Göteborgs universitet
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Malmö universitet
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Linköpings universitet
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Uppsala universitet
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Karolinska Institutet