Calidad de vida relacionada con la salud y adhesión terapéutica a la presión positiva continua en la vía aérea (CPAP) en pacientes con apnea obstructiva del sueño (AOS)
Bibliographic record
Abstract
Los beneficios de la presión positiva continua en la vía aérea (CPAP) en pacientes con apnea obstructiva del sueño (AOS) no se alcanzan sin adhesión terapéutica (AT). La percepción de beneficio es uno de los principales predictores de adhesión. Sin embargo, se desconoce si el impacto de la CPAP sobre la calidad de vida relacionada con la salud (CVRS) guarda relación con la AT. 1) Evaluar si los cambios en la CVRS tras iniciar CPAP se asocian con AT. 2) Analizar la influencia de diversos determinantes de AT, incluyendo la CVRS basal. Estudio prospectivo observacional y longitudinal sobre una cohorte de pacientes con AOS moderada-grave e indicación de CPAP. Se evaluó la CVRS basal y tras terapia utilizando el Quebec Sleep Questionnaire (QSQ), así como otros posibles determinantes de AT. Se realizó un análisis multivariado. Se incluyeron 364 pacientes (78% hombres), con una edad media de 55 ± 11 años e índice de apnea-hipopnea de 42 ± 19/hora. El 33,3% sin AT. No hubo asociación entre los cambios de la CVRS tras 3 meses de CPAP y la AT ni entre la puntuación basal del QSQ y la AT. Un mayor ODI4%, una mejoría global y en las interacciones sociales (QSQ) se asociaron con AT. Los síntomas ansioso-depresivos basales, un empeoramiento de la ansiedad y efectos secundarios con CPAP se asociaron con peor AT. El impacto de la CPAP sobre la CVRS con respecto a la percepción de interacciones sociales parece condicionar la AT. La repercusión basal de la enfermedad, en términos de CVRS, no se asocia a AT. The benefits of CPAP in patients with obstructive sleep apnea (OSA) are not achieved without therapeutic adherence (TA). The perception of benefit is one of the main predictors of adherence. However, it is unknown whether the impact of CPAP on health-related quality of life (HRQoL) is related to TA. 1) To evaluate whether changes in HRQoL after initiating CPAP are associated with AT. 2) To analyze the influence of various TA determinants, including baseline HRQoL. Prospective observational and longitudinal study on a cohort of patients with moderate-severe OSA and indication of CPAP. Baseline and after-therapy HRQoL were evaluated using the Quebec Sleep Questionnaire (QSQ), as well as other possible AT determinants. A multivariate analysis was performed. A total of 364 patients (78% men) were included, with mean age of 55 ± 11 years and apnea-hypopnea index of 42 ± 19/hour. 33.3% without TA. There was no association between HRQoL changes after 3 months of CPAP and AT and between QSQ baseline score and AT. A higher ODI4%, a global improvement and social interactions (QSQ), were associated with AT. Baseline anxiety-depressive symptoms, worsening anxiety, and side effects with CPAP were associated with worse AT. The impact of CPAP on HRQoL with respect to the perception of social interactions seems to condition TA. The basal impact of the disease, in terms of HRQoL, is not associated with AT.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".