Airway Changes After Sleep Apnea Surgery Using Drug‐Induced Sedation Endoscopy: A Systematic Review and Meta‐analysis
Bibliographic record
Abstract
OBJECTIVE: To characterize drug-induced sleep endoscopy as a method of evaluating the efficacy of sleep apnea surgical procedures at different airway sites. DATA SOURCES: PubMed, Scopus, and CINAHL. REVIEW METHODS: Two independent investigators selected studies on sleep apnea surgeries with presurgical and postsurgical drug-induced sedation endoscopy (DISE) evaluations. Primary research studies were included, and data that overlapped with another study were excluded. Investigators performed data extraction, quality rating, and risk-of-bias assessment using the ROBINS-I tool. Data were analyzed using a comparison of proportions and means. RESULTS: Ultimately, 10 studies (N = 320) were included, with 81.2% male (95% CI: 72.0-88.9), and an average age of 46.8. Significant reductions in VOTE (velum, oropharynx, tongue, and epiglottis) scoring were observed in postsurgical DISE findings at the level of the velum and oropharynx within the palate group (P < .05), and at the velum, oropharynx, and tongue within the maxillomandibular advancement (MMA) group. There were also accompanying reductions in traditional measures such as apnea-hypopnea index (AHI) and Epworth sleepiness score (ESS). No significant reductions in VOTE scores at any level were observed within the nasal surgery group. CONCLUSION: DISE allows clinicians a nuanced view in postoperative changes in upper airway collapse patterns and may provide a unique perspective in the evaluation of surgical outcomes in sleep apnea. Further research should be done to correlate these findings to existing outcome measures.
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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 | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".