Telemedicine System for Early Assessment of Obstructive Sleep Apnea

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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