M. Kwiatkowska, M.S. Atkins, N.T. Ayas, and C.F. Ryan (Canada)
Underserviced communities and demand for telehealth, decision support systems, diagnostics, sleep medicine, obstructive sleep apnea, clinical decision rules
This paper describes a telemedicine system for early assessment of obstructive sleep apnea (OSA) based on clinical prediction rules and simple tests, such as nocturnal pulse oximetry. The Web-based system provides support for general practitioners working in remote rural areas with limited access to in-clinic overnight polysomnography tests (PSGs) and specialized sleep disorders clinics. The system has three major functions: (1) collecting patient data and test results, (2) supporting the analysis of OSA risk factors to expedite diagnosis and treatment for the serious cases and to limit unnecessary tests for low-probability cases, and (3) preparing patient referrals to sleep disorders clinic and communicating with sleep specialists. The telemedicine system consists of four modules: (1) a Web-based interface for general health practitioners and sleep specialists, (2) a database with data acquisition, storage, and retrieval, (3) an adaptive decision support subsystem based on a rule-based reasoning approach, and (4) rule learning subsystems using data mining techniques for refinement of the clinical decision rules.
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