Medicare criteria may hinder timely diagnosis and treatment of patients
This issue of the MJA includes a timely analysis of the value of questionnaires in screening for obstructive sleep apnoea (OSA) in primary care.1 It has particular relevance for contemporary Australian health care, given the new Medicare provisions for pre‐test OSA screening. The study by Senaratna and colleagues is valuable for health care providers and administrators because it illustrates the limitations of questionnaires for screening, let alone for diagnosing, OSA.
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- 1. Senaratna CV, Perret JL, Lowe A, et al. Detecting sleep apnoea syndrome in primary care with screening questionnaires and the Epworth sleepiness scale. Med J Aust 2019; 210: 65–71.
- 2. Boynton G, Vahabzadeh A, Hammoud S, et al. Validation of the STOP‐BANG questionnaire among patients referred for suspected obstructive sleep apnea. J Sleep Dis 2013; 2: doi: 10.4172/2325-9639.1000121.
- 3. Douglas JA, Chai‐Coetzer CL, McEvoy D, et al. Guidelines for sleep studies in adults: a position statement of the Australasian Sleep Association. Sleep Med 2017; 36 (Suppl 1): S2–S22.
- 4. Medicare Benefits Schedule Review Taskforce. Final report from the Thoracic Medicine Clinical Committee. Canberra: Department of Health, 2016. http://www.health.gov.au/internet/main/publishing.nsf/content/C195FC32CB2DBAD6CA25801800175428/$File/MBS%20Thoracic%20Report%20FINAL.pdf (viewed Mar 2019).
- 5. Centers for Medicare and Medicaid Services (United States). Decision memo for sleep testing for obstructive sleep apnea (OSA) (CAG‐00405N). Mar 2009. https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?NCAId=227&ver= (viewed Mar 2019).
- 6. El Shayeb M, Topfer LA, Stafinski T, et al. Diagnostic accuracy of level 3 portable sleep tests versus level 1 polysomnography for sleep‐disordered breathing: a systematic review and meta‐analysis. CMAJ 2014; 186: E25–E51.
- 7. Chai‐Coetzer CL, Antic NA, Rowland LS, et al. A simplified model of screening questionnaire and home monitoring for obstructive sleep apnoea in primary care. Thorax 2011; 66: 213–219.
- 8. Pereira EJ, Driver HS, Stewart SC, Fitzpatrick MF. Comparing a combination of validated questionnaires and level III portable monitor with polysomnography to diagnose and exclude sleep apnea. J Clin Sleep Med 2013; 9: 1259–1266.
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