Chest
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Positive airway pressure (PAP) therapy is first-line therapy for OSA, but consistent use is required for it to be effective. Previous studies have used Medicare fee-for-service claims data (eg, device, equipment charges) as a proxy for PAP adherence to assess its effects. However, this approach has not been validated in a US commercially insured population, where coverage rules are not standardized. ⋯ In aggregate US commercial data with nonstandardized PAP coverage rules, concordance between existing claims-based definitions and objective PAP use was low. Caution is warranted when applying existing claims-based algorithms to commercial populations.
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Comparative Study
Sub-Lobar Resection, Stereotactic Body Radiation Therapy, and Percutaneous Ablation Provide Comparable Outcomes for Lung Metastasis-Directed Therapy.
Prolonged survival of patients with metastatic disease has furthered interest in metastasis-directed therapy (MDT). ⋯ This study performs a propensity weighted analysis of SLR, SBRT, and PA and shows no impact of lung MDT modality on overall survival. Given excellent local control across MDT options, a multidisciplinary approach is beneficial for patient triage and longitudinal management.
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Standard treatment for early-stage or locoregionally advanced non-small cell lung cancer (NSCLC) includes surgical resection. Recurrence after surgery is commonly reported, but a summary estimate for postsurgical recurrence-free survival (RFS) in patients with NSCLC is lacking. ⋯ This study presents a comprehensive assessment of reported RFS from published clinical literature, offering estimates at multiple postsurgical time points and by geographic region. Findings can inform treatment decisions, clinical trial design, and future research to improve outcomes among patients with NSCLC.
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Multicenter Study Observational Study
Epidemiology of intensive care patients classified as a third sex in Australia and New Zealand.
Patient sex affects treatment and outcomes in critical illness. Previous studies of sex differences in critical illness compared female and male patients. In this study, we describe the group of patients classified as a third sex admitted to ICUs in Australia and New Zealand. ⋯ Patients classified as third sex composed a small minority group of adult ICU patients. This group had a different diagnostic case mix but similar outcomes to the groups classified as female or male. Further characterizing a third sex group will require improved processes for recording sex and gender in health records.
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Review
Sleep Education - A Narrative Review on Barriers and Opportunities to Grow a Diverse Sleep Team.
The increased recognition of sleep-wake disorders and their effects, along with the anticipated shortage of sleep medicine specialists, heralds a concomitant need to have more health care providers with dedicated training in the evaluation and management of sleep disorders across the life span. A narrative review of published literature on sleep education was conducted and identified factors related to diversity within the sleep team, barriers to implementation of sleep education, and strides in sleep education. Implementation of novel sleep education strategies will require creative navigation of barriers such as allocation of curricular time, availability of teaching faculty, and funding to train more members of the sleep team. Deliberate coordination within and across health professions programs, with efforts to share resources and leverage technology, will be instrumental to guide the next phase of growth in sleep education.