Obesity and Obstructive Sleep Apnea in the Ambulatory Patient

Kong

et al. 2021

Sci Rep

Increasing recognition of anatomical obstruction has resulted in a large variety of sleep surgeries to improve anatomic collapse of obstructive sleep apnea (OSA) and the prediction of whether sleep surgery will have successful outcome is very important. The aim of this study is to assess a machine learning-based clinical model that predict the success rate of sleep surgery in OSA subjects. The predicted success rate from machine learning and the predicted subjective surgical outcome from the physician were compared with the actual success rate in 163 male dominated-OSA subjects. Predicted success rate of sleep surgery from machine learning models based on sleep parameters and endoscopic findings of upper airway demonstrated higher accuracy than subjective predicted value of sleep surgeon. The gradient boosting model showed the best performance to predict the surgical success that is evaluated by pre- and post-operative polysomnography or home sleep apnea testing among the logistic regression and three machine learning models, and the accuracy of gradient boosting model (0.708) was significantly higher than logistic regression model (0.542). Our data demonstrate that the data mining-driven prediction such as gradient boosting exhibited higher accuracy for prediction of surgical outcome and we can provide accurate information on surgical outcomes before surgery to OSA subjects using machine learning models.

Section: Discussionmentioning

confidence: 99%

Machine learning-based preoperative datamining can predict the therapeutic outcome of sleep surgery in OSA subjects

Kong

et al. 2021

Sci Rep

“…This 7-item survey was formatted as a 5-point Likert scale, as validated by Maurer and Andrews (2000), where 1=strongly agree and 5=strongly disagree [ 28 ]. Following the recommendations of Bandra (2006), psychometric measures included confidence in general role performance and specific tasks [ 29 ]. Specifically, self-efficacy survey items allowed participants to rate their confidence level within their role during an emergency and confidence level with specific tasks, such as the administration of a facility-specific epinephrine auto-injector and the use of a bag-valve-mask device.…”

Section: Methodsmentioning

confidence: 99%

Implementation of contextualized, emergency management cognitive aids in a periodontics clinic

Siemens

Rice

Jensen³

et al. 2021

J Dent Anesth Pain Med

Background Emergencies in outpatient clinics are rare. However, potentially catastrophic events can be challenging to manage due to a variety of factors, including limited equipment and staff. The purpose of this quality improvement project was to improve the staff knowledge and familiarity with critical performance elements for emergencies encountered in the setting of a periodontics clinic. Methods Emergency cognitive aids tailored to the clinic's resources were created for anaphylaxis, airway obstruction, and sublingual hemorrhage. The project pre-post-test repeated measures design evaluated the effectiveness of cognitive aids using a combination of hands-on simulation, written knowledge assessments, and self-efficacy surveys. Training sessions and simulations were provided to the clinic's existing care teams made up of a periodontist and two dental assistants with an anesthetist who was present for simulations involving sedation. Due to the small sample size (N = 14) and non-normal distribution, all metrics were evaluated using non-parametric statistics. Results Significant improvements were found in knowledge assessment (−2.310, P = 0.021) and self-efficacy (−2.486, P = 0.013) scores when retention after a training session before and after the introduction of cognitive aid was compared. The mean simulation scores and times improved steadily or reached maximum scores during the project progression. Conclusion Training sessions before and after cognitive aid introduction were effective in improving knowledge, self-efficacy, and simulation performance. Future projects should focus on validating the process for creating contextualized cognitive aids and evaluating the effectiveness of these cognitive aids in larger samples.

“…As noted above, obesity is a high risk for OSA and at least 70% individuals with morbid obesity (BMI > 40 kg/m 2 ) have OSA [77]. Increased fat deposits around the pharynx are regarded as a key mechanism through which obesity results in OSA.…”

Section: Weight Lossmentioning

confidence: 97%

Clinical and Research Solutions to Manage Obstructive Sleep Apnea: A Review

Xia

2021

Sensors

Obstructive sleep apnea (OSA), a common sleep disorder disease, affects millions of people. Without appropriate treatment, this disease can provoke several health-related risks including stroke and sudden death. A variety of treatments have been introduced to relieve OSA. The main present clinical treatments and undertaken research activities to improve the success rate of OSA were covered in this paper. Additionally, guidelines on choosing a suitable treatment based on scientific evidence and objective comparison were provided. This review paper specifically elaborated the clinically offered managements as well as the research activities to better treat OSA. We analyzed the methodology of each diagnostic and treatment method, the success rate, and the economic burden on the world. This review paper provided an evidence-based comparison of each treatment to guide patients and physicians, but there are some limitations that would affect the comparison result. Future research should consider the consistent follow-up period and a sufficient number of samples. With the development of implantable medical devices, hypoglossal nerve stimulation systems will be designed to be smart and miniature and one of the potential upcoming research topics. The transcutaneous electrical stimulation as a non-invasive potential treatment would be further investigated in a clinical setting. Meanwhile, no treatment can cure OSA due to the complicated etiology. To maximize the treatment success of OSA, a multidisciplinary and integrated management would be considered in the future.