Interrater reliability between in-person and telemedicine evaluations in obstructive sleep apnea

被引:5
|
作者
Yurcheshen, Michael E. [1 ]
Pigeon, Wilfred [1 ]
Marcus, Carolina Z. [1 ]
Marcus, Jonathan A. [1 ]
Messing, Susan [1 ]
Nguyen, Kevin [2 ]
Marsella, Jennifer [1 ]
机构
[1] Univ Rochester, Sch Med & Dent, Rochester, NY USA
[2] Saddleback Med Ctr, Laguna Hills, CA USA
来源
JOURNAL OF CLINICAL SLEEP MEDICINE | 2021年 / 17卷 / 07期
关键词
telemedicine; interrater reliability; obstructive sleep apnea; sleep-disordered breathing; clinical study; telehealth; AMERICAN ACADEMY; AGREEMENT; DIAGNOSIS; POSITION; INTERVIEW; UTILITY; RISK;
D O I
10.5664/jcsm.9220
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Objectives: We examined how telemedicine evaluation compares to face-to-face evaluation in identifying risk for sleep-disordered breathing. Methods: This was a randomized interrater reliability study of 90 participants referred to a university sleep center. Participants were evaluated by a clinician investigator seeing the patient in-person, then randomized to a second clinician investigator who performed a patient evaluation online via audio-video conferencing. The primary comparator was pretest probability for obstructive sleep apnea, Results: The primary outcome comparing pretest probability for obstructive sleep apnea showed a weighted kappa value of 0.414 (standard error 0.090, P = .002), suggesting moderate agreement between the 2 raters. Kappa values of our secondary outcomes varied widely, but the kappa values were lower for physical exam findings compared to historical elements. Conclusions: Evaluation for pretest probability for obstructive sleep apnea via telemedicine has a moderate interrater correlation with in-person assessment. A low degree of interrater reliability for physical exam elements suggests telemedicine assessment for obstructive sleep apnea could be hampered by a suboptimal physical exam. Employing standardized scales for obstructive sleep apnea when performing telemedicine evaluations may help with risk-stratification and ultimately lead to more tailored clinical management.
引用
收藏
页码:1435 / 1440
页数:6
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