CHEST Guidelines-From-Telemedicine-to-a-Critical-Care-Database

From-Telemedicine-to-a-Critical-Care-Database_ches

Pdf Summary

The document discusses findings and insights regarding oral appliance therapy for Obstructive Sleep Apnea (OSA) and the development of databases for national benchmarking in Critical Care Medicine (CCM) and telemedicine. The first part suggests that oral appliances are effective in reducing snoring and apnea-hypopnea index (AHI) scores in OSA patients, with subjects experiencing satisfaction despite a significant increase in BMI. It indicates that allowing patients to try different appliances might improve outcomes, but cost and insurance coverage are challenges. The findings point towards the efficacy of oral devices over surgical options like uvulo-palato-pharyngo-plasty (UPPP) which involves risks and limited benefits. Further studies are called for to delineate the utility of various sleep apnea treatments.<br /><br />The second part focuses on the role of databases in improving CCM through telemedicine. The Society of Critical Care Medicine had commissioned surveys and programs like Project Impact to address gaps in national CCM data. Electronic Medical Records (EMR) and telemedicine are emphasized as they collect a wide array of ICU data, allowing for comprehensive research and outcome predictions, yet historically, they were designed for local, rather than national, aggregation of critical care data. A large data set from the eICU Research Institute is analyzed, highlighting its value in providing CCM benchmarks although the applicability of results might be confined to telemedicine-using hospitals. The study underscores the limitations inherent to self-selected and region-specific samples, raising questions about the broad applicability of the findings and the "telemedicine effect." As telemedicine systems progress, they offer promising prospects for generating standardized data sets for national healthcare insights. Overall, both areas underline the potential for advancements in the management and treatment of sleep apnea and critical care through patient-centered approaches and data-driven insights.

Keywords

Obstructive Sleep Apnea

oral appliance therapy

Critical Care Medicine

telemedicine

apnea-hypopnea index

uvulo-palato-pharyngo-plasty

Electronic Medical Records

ICU data

eICU Research Institute

national benchmarking