The Impact of the Philips Positive Airway Pressure (PAP) Medical Device Recall on PAP Adherence: A Retrospective Observational Study of an Alberta Clinical Cohort.
Bibliographic record
Abstract
Obstructive sleep apnea (OSA) is a common sleep related breathing disorder that can have numerous detrimental impacts to the individual and society. Positive airway pressure (PAP) therapy is an effective treatment method for OSA that can help reduce symptoms of daytime sleepiness, decrease risk of motor vehicle accidents, and improve quality of life. In June 2021, Philips Respironics, a major PAP device manufacturer, issued a recall of their devices due to sound abatement foam degrading and entering users’ airways. This retrospective single-centre observational cohort study aimed to determine if there were changes in PAP adherence from before to after the Philips recall was announced, and if there were differences in adherence among those with recalled versus non-recalled devices. A secondary aim was to determine if there was an association between social vulnerability and change in PAP adherence after the recall, using a validated measure (Canadian Index of Multiple Deprivation – CIMD). We used routinely collected clinical data from a tertiary care sleep clinic, including objective PAP adherence data from device downloads, and postal code-derived social vulnerability measures from Census data. The cohort consisted of 2,049 unique patients at the Foothills Medical Centre Sleep Centre in Calgary, Alberta, with a total of 4,573 PAP device adherence downloads. Overall, there were no significant effects on PAP adherence due to the recall after adjustment for potential confounders including by device manufacturer. There were modest but statistically significant associations found between two CIMD domains and increased PAP adherence post-recall suggesting a potential relationship between social vulnerability and PAP adherence in the context of a device recall. Overall, we did not find strong evidence to suggest that the Philips Respironics PAP recall significantly impacted PAP use at this tertiary care sleep centre.
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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 | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| 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 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".