International Stakeholder Engagement on Clinical Care and Research for Sleep Assessment and Nocturnal Hypoxemia in Pulmonary Fibrosis
Bibliographic record
Abstract
BACKGROUND: Nocturnal hypoxemia commonly affects people with pulmonary fibrosis (PF). RESEARCH QUESTION: What are the current practices for assessment of sleep and nocturnal hypoxemia in PF, and what are the research priorities and outcome measures of importance for nocturnal oxygen therapy (NOT)? STUDY DESIGN AND METHODS: People with PF and health care professionals (HCPs) with expertise in PF, sleep medicine, and/or oxygen therapy, were recruited internationally to participate in mixed-methods online surveys followed by online focus groups. RESULTS: A total of 68 people with PF and 73 HCPs from 29 countries completed the survey, with 14 and 39 joining the focus groups, respectively. Of these, 51% of people with PF had previous sleep assessment. In those that had not, 75% advocated its inclusion in routine PF management. Of HCPs, 64% performed sleep assessments routinely or as clinically indicated, with 82% reporting the assessments as very or somewhat important. The effect of treating nocturnal hypoxemia on symptom burden (including health-related quality of life) was considered the top research priority for people with PF and HCPs. Other research priorities identified were safety and tolerability of NOT, effect of treating nocturnal hypoxemia on mortality and pulmonary hypertension, diagnostic approaches for assessing sleep and nocturnal hypoxemia, predictors of nocturnal hypoxemia, developing a user-friendly oxygen therapy device, and patient awareness of the significance of nocturnal hypoxemia. Both groups prioritized health-related quality of life as the most important outcome measure for evaluating NOT. Additionally, people with PF highly ranked FVC, apnea-hypopnea index, and nocturnal oxygenation status, whereas HCPs selected survival and development of pulmonary hypertension. People with PF raised impact of nocturnal hypoxemia and sleep disturbance on cognitive performance as a key research topic, which was agreed by HCPs. INTERPRETATION: This study provides important insights into stakeholders' priorities to guide future research on sleep assessment and treatment of nocturnal hypoxemia in PF.
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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 | 0.266 | 0.236 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.008 | 0.010 |
| Scholarly communication | 0.013 | 0.008 |
| Open science | 0.004 | 0.041 |
| Research integrity | 0.017 | 0.027 |
| Insufficient payload (model declined to judge) | 0.016 | 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".