Economic evaluation of diagnostic sleep studies for obstructive sleep apnoea in the adult population: a systematic review

• Published in: Sleep medicine reviews Vol. 62; p. 101608
• Main Authors: Natsky, Andrea N., Chai-Coetzer, Ching L., Vakulin, Andrew, McEvoy, R.D., Adams, Robert J., Kaambwa, Billingsley
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-04-2022
• Subjects: Adult; Cost-Benefit Analysis; Cost-effectiveness; Economic evaluation; Humans; Obstructive sleep apnoea; Polysomnography; Research Design; Sleep; Sleep Apnea, Obstructive - diagnosis; Sleep breathing disorder; Systematic review; Systematic review; Obstructive sleep apnoea; Cost-effectiveness; Sleep breathing disorder; Economic evaluation
• ISSN: 1087-0792; 1532-2955
• DOI: 10.1016/j.smrv.2022.101608

Evidence regarding the cost-effectiveness of limited channel tests compared to laboratory and home polysomnography (PSG) in diagnosing obstructive sleep apnoea (OSA) is unclear. Eligible studies were systematically sought across the following databases: MEDLINE, PsychINFO, SCOPUS, CINAHL, Cochrane, Emcare, Web of Science and ProQuest. Title and abstracts were screened before full-text review. Only full and partial economic evaluations reporting at least one economic outcome were included. A standardised template was used for critical appraisal and data extraction. Relevant findings were summarised using a qualitative approach adhering to economic reporting standards. Literature searches identified 999 non-duplicate abstracts, where 85 studies were retrieved for full-text review. The number of studies that met eligibility criteria and were included in the final analyses was 35, of which 31 investigated Level 3 and four assessed Level 4 tests. Based on the dominance ranking framework, both Level 3 and Level 4 tests were cost-effective compared to PSG. Although study designs and methodologies differ broadly, the findings indicated that using limited channel diagnostic sleep tests for OSA is associated with lower costs and non-inferior health outcomes relative to PSG. Limited channel tests also resulted in shorter waiting times and improved access to diagnostic services for patients with OSA.
CRD42020150130.