723 Sleep Apnea Care During the COVID-19 Pandemic: Perspectives on the Transition to Telemedicine from Clinicians and Patients
Bibliographic record
Abstract
Abstract Introduction Covid-19-related public health control measures have necessitated a rapid transition in healthcare delivery. We qualitatively explored clinicians’ and patients’ experiences of the pandemic’s impact on the delivery and receipt of obstructive sleep apnea (OSA) care. Methods Between September and December 2020, we conducted ten 90-minute virtual focus groups with sleep clinicians (n=19) and English and Spanish-speaking patients with OSA (n= 30) recruited through an urban academic sleep clinic, national organizations, social media, and snowball sampling. An interdisciplinary team conducted a rapid qualitative analysis that included prefigured and emergent domains. The team developed a comprehensive analytic matrix, identifying key themes within and between groups and triangulating them across participant types. Results Clinicians and patients across all groups confirmed a rapid shift to the adoption of telemedicine. Clinicians reported telemedicine enhanced evaluations by enabling direct observation of the home environment, providing opportunities to guide patients on medical equipment used in the home, and cultivating meaningful social connections for patients. Perceived benefits varied across patient subgroups (age, language, technological self-efficacy). The majority of clinicians reported that telemedicine’s initial uptake resulted in delays in care and revenue loss, but sustained use was thought to be feasible over time. Patients reported delays in care related to the pandemic’s disruption on healthcare and their personal safety concerns. Additionally, telemedicine’s adoption directly altered other elements of care, including the delivery of patient education materials and loss of tacit information gained during the in-person visit. All groups reported adequate mask fitting as a central challenge for patients using positive airway pressure therapy. Spanish-speaking patients noted concerns of increased difficulty accessing care and navigating the OSA care system due to limited English proficiency, in addition to the limited availability of OSA resources in Spanish. Conclusion During the Covid-19 pandemic, the rapid adoption of telemedicine largely facilitated OSA care but altered patient-clinician interactions, delivery of patient education materials, and mask fitting success. Given that telemedicine will likely be sustained post-pandemic, there are needs for targeted efforts aimed at addressing disparities in telemedicine, enhancing practitioner telepresence and education, and new approaches for mask fitting to ensure successful OSA care. Support (if any) Patient-Centered Outcomes Research Institute EADI-16493
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.026 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.012 | 0.010 |
| Scholarly communication | 0.011 | 0.008 |
| Open science | 0.002 | 0.010 |
| Research integrity | 0.005 | 0.006 |
| Insufficient payload (model declined to judge) | 0.008 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".