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Duane I agree with you for the most part. A straight pressure that has been titrated in a lab is or should be the best way for a pt to go. the truth of the matter is that fully data capable auto machines are here to stay. They are not going to go away just because you,me, or the doctors we work for don't agree with them. We can either accept them and try to help or get pushed out of the way. You yourself have said that the parameters on these machines need to be tightened in order for them to work.
jnk said:
"Terminology often has technical use and layman use. And since most home machines do not even attempt to differentiate the obstructive event from the central, then in the context of home machines and their scoring, the concept that a hypopnea is a kind of flow limitation may be the most salient point."
I don't believe it's excusable to use incorrect terminology under the umbrella of "Well, it's okay, cause we're only talking Layman here" lest the crop of shrooms will remain a crop of shrooms. The overall concept is more appropriately termed "amplitude reduction" with the subsets of normal ("bell-shaped") and the Seven Sisters of Flow Limitation. This is critical to the discussion in that most machines do differentiate this. For instance, the ResMed hypopnea response is specifically designed to address flow limitation hypopneas, but not normals:
http://www.resmed.com/au/clinicians/compliance_and_efficacy/autoset...
Lastly, it would be far more accurate to say, "Most machines attempt to differentiate obstructive from central". This is seen in the NR of Respironics, A10 and flow limitation differentiation of ResMed, FOT of Weinmann and ballistocardiography of PB/Sandman.
mollete
"Automated scoring (ie, autoscoring) programs assist technologists in scoring records more quickly. . . . The programs are designed only to assist in scoring . . . A salesperson's pitch often leaves the impression that an autoscoring program is capable of scoring and analyzing data without human involvement. In actuality, the accuracy of autoscoring programs is less than that of manual scoring. . . . Autoscoring programs agreed with manual scoring 70% to 72% of the time. . . . Although autoscoring programs can aid a technologist in scoring faster, their lower reliability increases the likelihood of improper diagnosis and treatment. To avoid this, scientists strongly recommend that an autoscored PSG be reviewed manually."
http://www.sleepreviewmag.com/issues/articles/2008-06_04.asp
Rock Hinkle said:I do not know of any labs that use the auto scoring feature.
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