Diagnosis of Obstructive Sleep Apnea in Adults.pdf

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1、ClinicalGuidelineDiagnosisofObstructiveSleepApneainAdults:AClinicalPracticeGuidelineFromtheAmericanCollegeofPhysiciansAmirQaseem,MD,PhD,MHA;PaulDallas,MD;DouglasK.Owens,MD,MS;MelissaStarkey,PhD;Jon-ErikC.Holty,MD,MS;andPaulShekelle,MD,PhD,fortheClinicalGuidelinesCo

2、mmitteeoftheAmericanCollegeofPhysicians*Description:TheAmericanCollegeofPhysicians(ACP)developedrecommendationsbyusingACP’sclinicalpracticeguidelinesgradingthisguidelinetopresenttheevidenceandprovideclinicalre-system.commendationsonthediagnosisofobstructivesleepapn

3、eainRecommendation1:ACPrecommendsasleepstudyforpatientsadults.withunexplaineddaytimesleepiness.(Grade:weakrecommenda-Methods:Thisguidelineisbasedonpublishedliteratureonthistion,low-qualityevidence)topicthatwasidentifiedbyusingMEDLINE(1966throughMayRecommendation2:A

4、CPrecommendspolysomnographyfordi-2013),theCochraneCentralRegisterofControlledTrials,andagnostictestinginpatientssuspectedofobstructivesleepapnea.theCochraneDatabaseofSystematicReviews.Searcheswerelim-ACPrecommendsportablesleepmonitorsinpatientswithoutseri-itedtoEng

5、lish-languagepublications.Theclinicaloutcomesevalu-ouscomorbiditiesasanalternativetopolysomnographywhenpoly-atedforthisguidelineincludedall-causemortality,cardiovascularsomnographyisnotavailablefordiagnostictesting.(Grade:weakmortality,nonfatalcardiovasculardisease

6、,stroke,hypertension,recommendation,moderate-qualityevidence)type2diabetes,postsurgicaloutcomes,andqualityoflife.Sensi-tivities,specificities,andlikelihoodratioswerealsoassessedasout-AnnInternMed.2014;161:210-220.doi:10.7326/M12-3187www.annals.orgcomesofdiagnostict

7、ests.ThisguidelinegradestheevidenceandForauthoraffiliations,seeendoftext.Obstructivesleepapnea(OSA)iscausedbyrepetitivetheU.S.population,withthevariationdueinparttoobstructionoftheupperairwayduringsleep,result-variablecriteriausedtodefinedisease(forexample,theinginh

8、ypopnea(reducedairflowduringsleep)orapneanumberofapneicepisodesperhourorwhetherindividuals(completeairflowcessationduringsleep).Personswitharerequi