Feasibility, Validity and Economic Impact of a Home‐Based Sleep Screening Test in the Detection of Sleep‐Related Breathing Disorders in Individuals Living With Spinal Cord Injury: A Multi‐Method Study and Cost‐Minimisation Analysis
Bibliographic record
Abstract
This prospective multi-method study was performed to assess the feasibility and validity of an unattended home-based sleep screening test (HBSST) in the detection of sleep-related breathing disorders (SRBDs) among individuals with spinal cord injury (SCI). Further, the economic impact of the HBSST was compared with polysomnography using cost-minimisation analysis. Adults with subacute/chronic (> 1 month) SCI were recruited for the multi-method study. Feasibility analysis included quantitative and qualitative data. A pilot validity analysis compared the apnea-hypopnea index (AHI) from the HBSST and from polysomnography in nine individuals with mild-to-severe SRBD. Notably, HBSST and polysomnography tests were separately performed. Of the 28 participants (11 females, 17 males; mean age: 54.9 years) with subacute/chronic, complete (n = 7) or incomplete SCI at cervical (n = 18), thoracic (n = 8) or lumbosacral levels, nine individuals were diagnosed with a moderate-to-severe SRBD. All participants successfully completed the HBSST. Most of the participants (60.71%) set up the device for the HBSST without any assistance. The AHI from the HBSST was significantly correlated with the AHI from the polysomnography (r = 0.717; p = 0.0248; n = 9). Finally, our results indicated that the use of HBSST was a cost-saving approach when compared with polysomnography. In conclusion, the results of our prospective multi-method study provided novel and clinically important data to support the feasibility and suggest criterion validity of a HBSST when compared with the findings from polysomnography completed during different nights. The results of our cost-minimisation analysis indicated that the HBSST is a more cost-effective strategy for detection of SRBDs in the SCI population than polysomnography.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".