Tag Archives: Sleep Disorders

Wikipedia is No Substitute for Doctors


The “Mail online” recently trumpeted what physicians have been lamenting since the beginning of the Internet age: the web is not necessarily reliable for medical information. Call it a validation of sorts, courtesy of Dr. Robert Hasty of Campbell University in North Carolina colleagues.


The team concluded that many entries in Wikipedia, especially medical entries, contain false information. The message? Don’t use Wikipedia in place of your doctor.


The team published its study titled “Wikipedia vs Peer-Reviewed Medical Literature for Information About the 10 Most Costly Medical Conditions” in the Journal of the American Osteopathic Association, calling the information published in 20,000-plus medical related Wikipedia entries into question.

Click Here to read study

According to the report, researchers identified the “10 costliest conditions in terms of public and private expenditure”—which included diabetes, back pain, lung cancer and major depressive disorder—and compared the content of Wikipedia articles about those conditions to peer-reviewed medical literature. Two randomly assigned investigators found that 90% of the articles contained false information, which could affect the diagnosis and treatment of diseases.


Also from the Post, “Pew research suggests that 72 percent of Internet users have looked up health information online in the last year. False information on Wikipedia accounts — like a edited information about the side effects of a medication or false information about the benefits of one course of treatment over another — could encourage some patients to push their doctors toward prescribing a certain drug or treatment.”


Source: Mail Online

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SomnoMed Appoints New President

Somnomed Ltd appoints new head for North American Region

SomnoMed announced the appointment of Kien T. Nguyen as President for SomnoMed Inc., the US subsidiary of SomnoMed Limited.

Kien has a lifelong career in the healthcare industry, working for leading companies such as Stryker Corporation, Kinetic Concepts, Inc. (KCI) and various medical device divisions of Johnson & Johnson. Most recently, he was Vice President and General Manager of OtisMed, a business unit of Stryker Orthopaedics, a division of the $8 billion Stryker Corporation. At KCI, he fulfilled various functional Vice President positions, including Global Portfolio Management, Global Research & Ideation, and Global Marketing of the Active Healing Solutions division, with revenues responsibilities of $1.4 billion. Most of his earlier career was spent with Ethicon, Inc., a Johnson & Johnson company, where he held roles in product development, product marketing, clinical sales and finally as Worldwide Marketing Director for the biosurgical business unit within Johnson & Johnson Wound Management.

SomnoMed is a public company providing diagnostic and treatment solutions for Sleep-related Breathing Disorders including obstructive sleep apnea, snoring and bruxism. SomnoMed was commercialized on the basis of extensive clinical research. Supporting independent clinical research, continuous innovation and instituting medical manufacturing standards has resulted in SomnoDent® becoming the state-of-the-art and clinically proven medical oral appliance therapy for obstructive sleep apnea. SomnoDent® is the most comfortable and effective design and treatment solution for over 100,000 patients in 22 countries. For additional information, visit SomnoMed at http://www.somnomed.com.

Read Full Annoucement

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The Economic Cost of Sleep Disorders

SLEEP, Vol. 29, No. 3, 2006

“The overall cost of sleep disorders in Australia in 2004 (population: 20.1 million) was $7494 million. This comprised direct health costs
of $146 million for sleep disorders and $313 million for associated conditions, $1956 million for work-related injuries associated with sleep disorders (net of health costs), $808 million for private motor vehicle accidents
(net of health costs), $1201 million for other productivity losses, $100 million for the real costs associated with raising alternative taxation revenue,
and $2970 million for the net cost of suffering.

The overall cost of sleep disorders in Australia in 2004 (population: 20.1 million) was $7494 million. This comprised direct health costs of $146 million for sleep disorders and $313 million for associated conditions, $1956 million for work-related injuries associated with sleep disorders (net of health costs), $808 million for private motor vehicle accidents (net of health costs), $1201 million for other productivity losses, $100 million for the real costs associated with raising alternative taxation revenue, and $2970 million for the net cost of suffering.”

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East Coast Lab Preps for Potential

Image1 East Coast Lab Preps for Potential

New York-based Winthrop Center made the difficult decision to switch database vendors in an effort to remain a step ahead of progress.

By any measure, the Winthrop Sleep Disorders Center, Garden City, NY, brings a wealth of experience to the relatively young field of sleep medicine. As Associate Director of the Winthrop Sleep Disorders Center, Claude Albertario, RPSGT, has helped the academic facility evolve from modest roots in the late 1980s to its current position as a respected laboratory in the Northeast.

Leveraging their knowledge and experience gained over more than two decades, the hospital recognized the need to expand in 2006. Albertario seized the opportunity to take a long, hard look at equipment needs. The investigation led the 26-year sleep veteran to only consider systems with database constructs that could change with the times.

Expand and Integrate

Later in 2008, the () came out with the H5 guideline that requires all , even for those not getting a study, to be amassed in a central database. As a result, going beyond a mere “ acquisition” system suddenly became a top priority. “As an academic institution, we typically like to keep things in-house, so we did not go with a web-based design,” says Albertario. “However, we did want the ability to interact from the outside through the Internet.”

Narrowing it down to two major database systems was relatively easy, since virtually everything else was cobbled together using third party databases. “We wanted something integrated and cohesive,” says Albertario. “The push over the edge was the solidarity of what the vendor showed us they could provide. The Grael High-Definition /EEG system and their nexus system had what we wanted, as well as the potential to grow as technology changed.”

As the first accredited and paperless laboratory in the world (1990), Winthrop officials knew early on that patients in the population-dense Long Island region wanted not only the best, but the latest. Cutting edge technology kept people coming back and fueled an expansion from four beds at the turn of the century, to eight beds in their new facility—with all recordings digitally recorded and managed. “Our institution has allowed us to plug into the archiving infrastructure used for and Cardiology, thereby allowing digitized, seamless, online archiving”, says Albertario.

Keeping the door open for new millennium technology gave Compumedics the slight advantage in a competitive market. Vendor representatives simply could not “fake it” at Winthrop. “They had to know their stuff,” confirms Albertario. Albertario questions vendors with vigor, because he knows that better equipment/database management leads to real-world results, such as decreased turnaround time for patients, while strongly appealing to referral sources. With Compumedics, the idea is to adapt to whatever challenges the industry may throw, while continuing to evolve technologically.

“You have to know sleep, and Compumedics has a good clinical understanding of what we do,” says Albertario. “We have not even finished installing all of the elements, such as digital audio and next-level digital video. The cameras are installed, but the higher-grade software is not written as of yet. I see where they are going with multi-screen video capabilities— one screen zoomed into the face, one into the legs, and all synchronized. They offer it in their EEG platform, so I know it is on the horizon as promised,” says Albertario.

Like a Hotel

Even though the market changes and reimbursement changes with it, Winthrop officials are poised to help the 7.5 million patients on geographic Long Island. Moreover, when these residents show up, the facility they walk into does not look like a laboratory in the slightest. “We literally built a hotel,” says Albertario. “One of the inspectors upon opening the door to a bedroom said, ‘You literally built the Winthrop Hotel.’ And, anybody who visits says the same thing.”

In a state that boasts “The city that never sleeps,” it is appropriate to also open “the hotel” for daytime guests. “We realized that a special segment of our market, and one that not many facilities touch upon, is the shift-worker market,” explains Albertario. “We staff the laboratory around the clock, and every day we have the ability to perform daytime PSGs for patients who sleep and work in this 24 hour New York market.”

Added services and capabilities mean that more in-depth clinical trials are on the horizon for Winthrop, a prospect that officials welcome in the coming years. “We believe we are perfectly poised to help the academic world, and the clinical realm of those New Yorkers who seek treatments and understanding of sleep disorders,” adds Albertario. “In fact, those who have recently visited from Australia and Europe, realize how much thought we have actually put into this facility and comment on our ability to keep all of the technology in the background, thusly allowing the design team’s calming and soothing accents and highlights to shine through. It has truly been a labor of love for all parties involved, says Albertario, a once-in-a-career kind of thing.

Claude Albertario, RPSGT, is associate director of the Sleep Disorders Center, Winthrop-University Hospital, Mineola, NY. Albertario began his career in Sleep Medicine at New York Hospital’s Institute of Chronobiology, after obtaining his undergraduate training in Psychobiology at SUNY Purchase. He obtained his RPSGT credential in 1990. As an early advocate of digital recording methods, he spearheaded the effort to become the first accredited, paperless sleep center in the world (1990). He helped form the New York State Society of Sleep Medicine in 1998, and presently serves as its secretary. His research interests revolve around his invention, z-ratio, a unified metric of sleep/wake (http://www.zzzratio.com). Albertario is also a sleep apnea sufferer.

Man vs. Machine

Giving Automatic Scoring a Second Thought

Changes in technology have been exponential over the last two decades. The industry has advanced significantly by software innovation. In our to wholeheartedly welcome these enhancements to our processes, we sometimes forget that technology in the form of automation is meant to assist, not replace, our skilled technologists.

To automate or not to automate the scoring of sleep studies remains an ongoing debate in our industry and with software giants looking for ways to expand service offerings, the discussion is unlikely to end any time soon. While the notion of computerized analysis holds the promise of decreased staffing costs and increased efficiency, the reality of this premise is far less simplistic. One would no doubt question the rationale behind the insistence that a plane does not require a pilot in light of autopilot technology. Yet there exists a movement that would apply such logic, resulting in the ultimate redundancy of scoring technologists.

Whether as a primary or secondary resource, a registered technologist is essential for an accurate analysis of a patient study—period.

Sleep medicine is still very much a human-centered industry. With over 80 different currently documented, nothing comes close to replicating the and contextually- reliant assessments made possible by intensive, real-life training and experience.

Any sleep facility or homecare company that are uses automatic scoring as a one-for-one alternative to human analysis is neglecting the clinical aspect of patient care. What begins as a well-intentioned, cost-cutting measure emerges as a practice that risks undermining the credibility of an entire industry.

Like every industry, efforts to streamline business and make processes leaner are present in sleep medicine. What we are seeing, however, are moves to market such software as a turnkey solution—completely undermining the specialized nature of sleep scoring and the skills, knowledge and training that go into delivering this process. Laboratories that wish to remain reputable should take a critical look at automated scoring and question whether the absence of registered technologists involved in this process is putting patient care in jeopardy.

The Reality of No Regulations

None of this is to say that automated scoring is without value. On the contrary, it can prove to help the technologist become a more effective clinician—especially as automation matures and is improved.

Early detection, of irregularities, cost-efficiency and timely performance are just some of the benefits that automated systems bring to the table. To ignore these benefits would be denying progress for the sake of it. However, as the sleep industry is itself still coming of age, it remains vulnerable to unscrupulous business models that risk tarnishing an entire sector by making patient care an after thought.

Discount scoring services have gained significant traction with unsustainably low price points underwritten by unregistered and clinically inexperienced scoring staff. What such practices fail to respect is that scoring is far more than an objective matter of computation. There are qualitative factors that only trained, registered and clinically experienced technologists can assess.

With minimal regulation of the effects of automatic scoring currently in place, the credibility of an entire industry rests on education and best practices. While sleep medicine awaits increased governance to prevent such fly-by-nights from infiltrating a valuable healthcare service, automation could aid in the standardization of certain scoring processes. As long as laboratories incorporate the technology primarily as a labour- cutting device, it may prove to be detrimental.

Assist not Replace

Another area of concern lies in the homecare and sectors. Level III sleep studies are being conducted and automatic analysis is being used for diagnosing patients going against the recommendation to have a secondary review by a Registered Technologist.

In such a case, automated scoring is not only the primary but the solitary mode of analysis. But scoring software can never comprehensively analyze a Level III study—results must be reviewed and assessed against clinical correlation. Software should be viewed as serving a complementary function in that it assists an RPSGT, who later verifies the automated scores manually and cross-references them with clinically-obtained observations.

Furthermore, one must consider the long-term impact of reliance on scoring software. Crucial information is gathered in the RPSGT’s current role as a front-line, integrated health- care professional. The knowledge and skills that arise from working with different patients and various symptoms and conditions could be lost should technologists be removed from the equation.

Know What You’re Getting Into

Pharmacists have also found their profession impacted by automated “advances”. The automated dispensing model they were recently introduced to have raised questions about accountability as dispensing errors can put patients (and businesses) at risk.

It goes without saying that human error can, has and will occur in any facet of healthcare. To be certain, accuracy is one of the dominant selling points of many automated systems used in other fields. However, the rush to market this form of technology may fail because the underlying technology is immature and needs time to evolve as it finds a permanent home within the sleep medicine industry. Even if automatic scoring technology matures to the point that algorithms can account for most variables, it still cannot contend with even the common clinical problems and complexities that come with sleep disorders in order to perform accurate scoring.

This is not to say that automatic scoring has no place in the streamlining of sleep laboratory operations. On the contrary, as time progresses and automated software has been tried and tested perhaps this may well become a fixture in sleep facilities.

But with no current regulations governing the use of such software, it is imperative that we consider the following disclaimer: automatic scoring exists to assist technologists, not replace them.

Natalie Morin, RPSGT is president and CEO of Sleep Strategies Inc., a provider of professional scoring and consulting services for sleep disorders facilities worldwide.