Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 1 Definitions and Diagnosis

Abstract

Seeking consensus on definitions and diagnosis of snoring and obstructive sleep apnea (OSA) among sleep surgeons is important, particularly in this relatively new field with variability in knowledge and practices. A set of statements was developed based on the literature and circulated among eight panel members of European experts, utilizing the Delphi method. Responses in agreement and disagreement on each statement and the comments were used to assess the level of consensus and develop a revised version. The new version with the level of consensus and anonymized comments was sent to each panel member as the second round. This was repeated a total of five rounds. The total number of statements included in the initial set was 112. In the first round, of all eight panelists, the percentage of questions that had consensus among the eight, seven, and six panelists were 45%, 4.5%, and 7.1%, respectively. In the final set of statements consisting of 99, the percentage of questions that had consensus among the 8, 7, and 6 panelists went up to 66.7%, 24.2%, and 6.1%, respectively. Delphi’s method demonstrated an efficient method of interaction among experts and the establishment of consensus on a specific set of statements.

Consensus Statements among European Sleep Surgery Experts on Snoring and Obstructive Sleep Apnea: Part 2 Decision-Making in Surgical Management and Peri-Operative Considerations

“…As described in the previous publication [20], the primary author analyzed the feedback, considering both the quantitative responses and the qualitative comments. This review developed a refined set of statements, which served as the second-round survey instrument.…”

“…The revised document was organized to ensure clarity and precision, as described in Part 1. Definitions and Diagnosis [20]. Modified statements were marked, with summary metrics for each statement detailing the number of panelists who had responded and the count and percentage of those who agreed and disagreed with each statement.…”

“…To establish consensus statements among European experts on diagnosing and treating snoring and obstructive sleep apnea (OSA), experts in the field were invited to a panel. As outlined in our previous work [20], a structured approach was implemented, incorporating the modified Delphi method to determine the level of consensus [20][21][22][23][24]. After a thorough literature review conducted by the first author, an initial draft of the consensus statements was created.…”

“…In comparison, 13.2% received the endorsement of just one panelist, and a mere 1.1% faced unanimous rejection, with none agreeing on that specific statement. As described in the previous publication [20], the primary author analyzed the feedback, considering both the quantitative responses and the qualitative comments. This review developed a refined set of statements, which served as the second-round survey instrument.…”

“…Therefore, we established a panel of otolaryngology/head and neck experts in the surgical treatment of sleep-related breathing disorders, such as snoring and OSA, to develop statements on decision-making regarding this treatment and peri-operative considerations regarding snoring and OSA in adults, with the aim of reaching a shared statement's consensus. In the first phase, the expert panel explored the agreement/disagreement on definitions, patient criteria, and diagnosis of snoring and OSA [20]. In the second phase, our goal was to assess the level of agreement in decision-making and peri-operative considerations.…”