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John J. Moore - One of the best experts on this subject based on the ideXlab platform.

  • Weekly Telephone Contact Does Not Enhance the Compliance of Home Apnea Monitoring
    Journal of Perinatology, 1999
    Co-Authors: Chandrakala G Mohan, Dennis M. Super, Terry M Baird, Alanna K Chan, John J. Moore
    Abstract:

    OBJECTIVE: To evaluate the effect of weekly telephone contact with families in enhancing the use of home Apnea monitors. STUDY DESIGN: This was a prospective, randomized, single-blinded study of 65 infants who were prescribed home Apnea Monitoring at the time of initial discharge from the hospital. Exclusion criteria included participation in any other study involving home Monitoring or nonavailability of home telephone. Infants were randomized either to the “standard” or “telephone” group by a stratified balanced block technique. All families were instructed to use the monitor during the first 4-week period at all times except during bathing and during the second 4-week period at all unattended times and at night. The families in the telephone group were contacted weekly for 8 weeks. The telephone interview reviewed the events of the previous week but did not include specific encouragement to use the monitor. Both groups received routine pediatric care and follow-up at our high-risk premature clinic. The primary outcome measure was compliance measured as the percentage of time as well as the hours per day that the infant spent on the monitor as recorded by the documented monitor. RESULTS: The telephone ( n = 30) and standard ( n = 32) groups were similar ( p > 0.10) with respect to birth weight (1567 ± 778 versus 1710 ± 777 gm), gestational age (30.9 ± 4.2 versus 31.1 ± 4.6 weeks), maternal age (24.9 ± 6.0 versus 25.3 ± 5.4 years), and commercial insurance (46.7% versus 46.9%), a marker of higher socioeconomic status. Compliance of the telephone versus the standard group was similar during thefirst 4-week period (74.7 ± 24.9 versus 75 ± 27.8%, p = 0.85) (17.9 ± 5.9 versus 18.2 ± 6.6 hours/day), the second 4 week period (63.4 ± 29.1 versus 58.9 ± 30.9%, p = 0.59) (15.2 ± 7.0 versus 14.1 ± 7.4 hours/day) and the entire 8-week period (69.3 ± 24.7 versus 67.7 ± 26.2%, p = 0.82, Mann-Whitney U -test) (16.7 ± 6.0 versus 16.1 ± 6.5 hours/day), respectively. An abnormal pneumocardiogram at the time of discharge was the only identified factor that improved the compliance for the entire 8-week period (73.1 ± 22 versus 52.1 ± 28.5%, p = 0.02) (17.5 ± 5.2 versus 12.5 ± 6.8 hours/day) and the first 4-week period of Monitoring (81.7 ± 22.9 versus 59.5 ± 31.3%, p = 0.01) (19.6 ± 5.5 versus 14.2 ± 7.5 hours/day). CONCLUSION: Weekly telephone contact, without specific encouragement to use the monitor, did not improve compliance. Compliance was greater in subjects who had abnormal pneumocardiogram results at the time of discharge from hospital regardless of their telephone/standard group assignment. We speculate that in this already compliant population, more targeted advice is necessary to increase compliance.

  • Does Weekly Telephone Contact Enhance the Compliance of Home Apnea Monitoring? † 1299
    Pediatric Research, 1998
    Co-Authors: Chandrakala G Mohan, Dennis M. Super, Alanna Chan, John J. Moore
    Abstract:

    Objective:To evaluate the efficacy of weekly telephonic contact with families in enhancing the use of home Apnea Monitoring.Methods: This was a prospective randomized single blinded study of 38 infants who were prescribed home Apnea Monitoring for the following indications 1.Apnea of prematurity (92%)2.Other pulmonary, cardiac or neurologic problems(8%). Exclusion criteria included 1.No home telephone 2.Participation in any other study involving home Monitoring. Infants were assigned to a 'standard care' or 'Weekly telephone call' group by a stratified balanced block technique. All families were given the following instructions for monitor use: 1.During the first 4 week period the monitor was to be used at night and unattended times (appox 95%); 2.During the second 4 week period the monitor was to be used at night and unattended times (appox 60%). The families in the telephone group were contacted weekly for 8 weeks. The telephone contact reviewed the events of the previous week but did not include specific encouragement to use the monitor to avoid the Hawthorne effect. Both groups received routine Pediatric care and follow up at high risk premature clinic. Our primary outcome measure was compliance which was defined as the percentage of time the infant spent on the monitor as recorded by the event Monitoring. Results:The Telephone (n=18) and Standard care (n=20) groups were similar (p>.40) with respect to birth weight (1647 +/- 856 vs 1509 +/- 678gms), gestational age (31.4 +/- 4.3 vs 29.8 +/- 4.0wks); maternal age (24.1 +/- 5.4 vs 25.3 +/- 5.7yr) and commercial insurance (44% vs 40%), a marker of higher socioeconomic status. Compliance of the telephone verses the standard care group was similar (70.0 +/- 21.3 vs 70.2 +/- 24.6%; p=.715, MannWhitney U):1st 4 week period (76.9 +/- 21 vs 81.4 +/- 25.5, p=.143); 2nd 4 week period (54.9 +/- 32 vs 61.1 +/- 29, p=.564). The only factor which improved compliance was rehospitalisation (88.0 +/- 15.6% vs 75.8 +/- 24.8%; p=.037) Conclusions:Weekly telephone contact, without specific encouragement to use the monitor, did not improve compliance. Compliance was greater in subjects who were rehospitalised regardless of their telephone/standard care group status. We speculate that in this already compliant population, more targeted advice is necessary to further improve compliance.

Bhavandeep V. Kang - One of the best experts on this subject based on the ideXlab platform.

  • validation of a portable sleep Apnea Monitoring device
    Chest, 1995
    Co-Authors: Godfrey C.w. Man, Bhavandeep V. Kang
    Abstract:

    Objective To assess the sensitivity and specificity of a portable sleep Apnea Monitoring device (PolyG; CNS Inc; Chantassen, Minn) using standard polysomnography (PSG) as a gold standard. Setting The University of Alberta Hospitals Sleep Disorders Laboratory. Participants One hundred and four consecutive patients referred for assessment of sleep complaints. Measurements Patients underwent simultaneous PSG and PolyG overnight recordings. The PSG included recordings of EEG, Chin electromyogram, electro-oculogram, ECG, oronasal airflow, thorax and abdomen respiratory movements, bilateral tibialis anterior electromyogram, and ear oximetry. The PolyG Monitoring included oronasal airflow (thermistors), chest and abdomen pneumobelts, oximetry, ECG, and body position sensor. The raw data were screened and analyzed separately by two technicians without knowledge of results of the other system. Results The coefficient of correlation for Apnea index (AI) was 0.94. The r value for Apnea-hypopnea index (AHI) was 0.97. Using the criteria of AI more than 5 as diagnostic for sleep Apnea syndrome, 23 out of the 104 patients had the disease based on PSG results. Twenty-six patients had AI more than 5 based on PolyG results. The sensitivity was 82.6% and the specificity was 91.4%. The positive predictive value was 73.1% and the negative predictive value was 94.9%. The overall accuracy was 89.4%. Using the criteria of AHI more than 15 as diagnostic for sleep Apnea syndrome, 28 of the 104 patients had the disease based on the PSG results. Twenty-four patients had AHI more than 15 based on PolyG results. The sensitivity was 85.7% and the specificity was 94.7%. The positive predictive value was 85.7% and the negative predictive value was 94.7%. The overall accuracy was 92.3%. Conclusion The PolyG Monitoring device is useful in identifying patients without significant sleep Apnea. (CHEST 1995; 108:388-93)

  • Validation of a Portable Sleep Apnea Monitoring Device
    Chest, 1995
    Co-Authors: Godfrey C.w. Man, Bhavandeep V. Kang
    Abstract:

    To assess the sensitivity and specificity of a portable sleep Apnea Monitoring device (PolyG; CNS Inc; Chantassen, Minn) using standard polysomnography (PSG) as a gold standard. The University of Alberta Hospitals Sleep Disorders Laboratory. One hundred and four consecutive patients referred for assessment of sleep complaints. Patients underwent simultaneous PSG and PolyG overnight recordings. The PSG included recordings of EEG, Chin electromyogram, electroculogram, ECG, oronasal airflow, thorax and abdomen respiratory movements, bilateral tibialis anterior electromyogram, and ear oximetry. The PolyG Monitoring included oronasal airflow (thermistors), chest and abdomen pneumobelts, oximetry, ECG, and body position sensor. The raw data were screened and analyzed separately by two technicians without knowledge of results of the other system. The coefficient of correlation for Apnea index (AI) was 0.94. The r value for Apnea-hypopnea index (AHI) was 0.97. Using the criteria of AI more than 5 as diagnostic for sleep Apnea syndrome, 23 out of the 104 patients had the disease based on PSG results. Twenty-six patients had AI more than 5 based on PolyG results. The sensitivity was 82.6% and the specificity was 91.4%. The positive predictive value was 73.1% and the negative predictive value was 94.9%. The overall accuracy was 89.4%. Using the criteria of AHI more than 15 as diagnostic for sleep Apnea syndrome, 28 of the 104 patients had the disease based on the PSG results. Twenty-four patients had AHI more than 15 based on PolyG results. The sensitivity was 85.7% and the specificity was 94.7%. The positive predictive value was 85.7% and the negative predictive value was 94.7%. The overall accuracy was 92.3%. The PolyG Monitoring device is useful in identifying patients without significant sleep Apnea.

Chandrakala G Mohan - One of the best experts on this subject based on the ideXlab platform.

  • Weekly Telephone Contact Does Not Enhance the Compliance of Home Apnea Monitoring
    Journal of Perinatology, 1999
    Co-Authors: Chandrakala G Mohan, Dennis M. Super, Terry M Baird, Alanna K Chan, John J. Moore
    Abstract:

    OBJECTIVE: To evaluate the effect of weekly telephone contact with families in enhancing the use of home Apnea monitors. STUDY DESIGN: This was a prospective, randomized, single-blinded study of 65 infants who were prescribed home Apnea Monitoring at the time of initial discharge from the hospital. Exclusion criteria included participation in any other study involving home Monitoring or nonavailability of home telephone. Infants were randomized either to the “standard” or “telephone” group by a stratified balanced block technique. All families were instructed to use the monitor during the first 4-week period at all times except during bathing and during the second 4-week period at all unattended times and at night. The families in the telephone group were contacted weekly for 8 weeks. The telephone interview reviewed the events of the previous week but did not include specific encouragement to use the monitor. Both groups received routine pediatric care and follow-up at our high-risk premature clinic. The primary outcome measure was compliance measured as the percentage of time as well as the hours per day that the infant spent on the monitor as recorded by the documented monitor. RESULTS: The telephone ( n = 30) and standard ( n = 32) groups were similar ( p > 0.10) with respect to birth weight (1567 ± 778 versus 1710 ± 777 gm), gestational age (30.9 ± 4.2 versus 31.1 ± 4.6 weeks), maternal age (24.9 ± 6.0 versus 25.3 ± 5.4 years), and commercial insurance (46.7% versus 46.9%), a marker of higher socioeconomic status. Compliance of the telephone versus the standard group was similar during thefirst 4-week period (74.7 ± 24.9 versus 75 ± 27.8%, p = 0.85) (17.9 ± 5.9 versus 18.2 ± 6.6 hours/day), the second 4 week period (63.4 ± 29.1 versus 58.9 ± 30.9%, p = 0.59) (15.2 ± 7.0 versus 14.1 ± 7.4 hours/day) and the entire 8-week period (69.3 ± 24.7 versus 67.7 ± 26.2%, p = 0.82, Mann-Whitney U -test) (16.7 ± 6.0 versus 16.1 ± 6.5 hours/day), respectively. An abnormal pneumocardiogram at the time of discharge was the only identified factor that improved the compliance for the entire 8-week period (73.1 ± 22 versus 52.1 ± 28.5%, p = 0.02) (17.5 ± 5.2 versus 12.5 ± 6.8 hours/day) and the first 4-week period of Monitoring (81.7 ± 22.9 versus 59.5 ± 31.3%, p = 0.01) (19.6 ± 5.5 versus 14.2 ± 7.5 hours/day). CONCLUSION: Weekly telephone contact, without specific encouragement to use the monitor, did not improve compliance. Compliance was greater in subjects who had abnormal pneumocardiogram results at the time of discharge from hospital regardless of their telephone/standard group assignment. We speculate that in this already compliant population, more targeted advice is necessary to increase compliance.

  • Does Weekly Telephone Contact Enhance the Compliance of Home Apnea Monitoring? † 1299
    Pediatric Research, 1998
    Co-Authors: Chandrakala G Mohan, Dennis M. Super, Alanna Chan, John J. Moore
    Abstract:

    Objective:To evaluate the efficacy of weekly telephonic contact with families in enhancing the use of home Apnea Monitoring.Methods: This was a prospective randomized single blinded study of 38 infants who were prescribed home Apnea Monitoring for the following indications 1.Apnea of prematurity (92%)2.Other pulmonary, cardiac or neurologic problems(8%). Exclusion criteria included 1.No home telephone 2.Participation in any other study involving home Monitoring. Infants were assigned to a 'standard care' or 'Weekly telephone call' group by a stratified balanced block technique. All families were given the following instructions for monitor use: 1.During the first 4 week period the monitor was to be used at night and unattended times (appox 95%); 2.During the second 4 week period the monitor was to be used at night and unattended times (appox 60%). The families in the telephone group were contacted weekly for 8 weeks. The telephone contact reviewed the events of the previous week but did not include specific encouragement to use the monitor to avoid the Hawthorne effect. Both groups received routine Pediatric care and follow up at high risk premature clinic. Our primary outcome measure was compliance which was defined as the percentage of time the infant spent on the monitor as recorded by the event Monitoring. Results:The Telephone (n=18) and Standard care (n=20) groups were similar (p>.40) with respect to birth weight (1647 +/- 856 vs 1509 +/- 678gms), gestational age (31.4 +/- 4.3 vs 29.8 +/- 4.0wks); maternal age (24.1 +/- 5.4 vs 25.3 +/- 5.7yr) and commercial insurance (44% vs 40%), a marker of higher socioeconomic status. Compliance of the telephone verses the standard care group was similar (70.0 +/- 21.3 vs 70.2 +/- 24.6%; p=.715, MannWhitney U):1st 4 week period (76.9 +/- 21 vs 81.4 +/- 25.5, p=.143); 2nd 4 week period (54.9 +/- 32 vs 61.1 +/- 29, p=.564). The only factor which improved compliance was rehospitalisation (88.0 +/- 15.6% vs 75.8 +/- 24.8%; p=.037) Conclusions:Weekly telephone contact, without specific encouragement to use the monitor, did not improve compliance. Compliance was greater in subjects who were rehospitalised regardless of their telephone/standard care group status. We speculate that in this already compliant population, more targeted advice is necessary to further improve compliance.

Howard J. Hoffman - One of the best experts on this subject based on the ideXlab platform.

  • Home Apnea Monitoring and sudden infant death syndrome.
    Preventive medicine, 1996
    Co-Authors: Michael Malloy, Howard J. Hoffman
    Abstract:

    To estimate the U.S. national prevalence of Apnea monitor use by birth weight classification and to examine the relationship between the use of Apnea monitors and the occurrence of Sudden Infant Death Syndrome (SIDS). Data obtained from the 1988 National Maternal and Infant Health Survey (NMIHS) were used. Prevalence estimates of Apnea monitor use were obtained by weighting survey data, and the relationship between monitor use and SIDS was accomplished by a case-control analysis using SIDS deaths and live controls obtained from the NMIHS. Weighted estimates of the prevalence of Apnea monitor use and odds ratios for the odds of use of an Apnea monitor among SIDS victims compared with the odds of use of an Apnea monitor among living controls. The national prevalence estimates for home Apnea monitor use among birth weight strata of 500 to 1,499 g, 1,500 to 2,499 g, and 2,500 g or more for blacks were 19.9, 2.6, and 1.1% compared with 44.0, 8.8, and 1.2% for non-blacks. The only significant association between the use of Apnea monitors and SIDS was for black 500- to 1,499-g infants. The adjusted odds ratio for SIDS among monitored black 500- to 1,499-g infants vs unmonitored infants was 3.93 (1.09, 14.17). This analysis suggests a marked difference in reported monitor use between U.S. black and non-black infants. In addition, black very low birth weight infants at highest risk for SIDS appear to be preferentially selected for Monitoring. The protective effect of home Apnea Monitoring in this survey population is unclear.

Michael Malloy - One of the best experts on this subject based on the ideXlab platform.

  • Home Apnea Monitoring and sudden infant death syndrome.
    Preventive medicine, 1996
    Co-Authors: Michael Malloy, Howard J. Hoffman
    Abstract:

    To estimate the U.S. national prevalence of Apnea monitor use by birth weight classification and to examine the relationship between the use of Apnea monitors and the occurrence of Sudden Infant Death Syndrome (SIDS). Data obtained from the 1988 National Maternal and Infant Health Survey (NMIHS) were used. Prevalence estimates of Apnea monitor use were obtained by weighting survey data, and the relationship between monitor use and SIDS was accomplished by a case-control analysis using SIDS deaths and live controls obtained from the NMIHS. Weighted estimates of the prevalence of Apnea monitor use and odds ratios for the odds of use of an Apnea monitor among SIDS victims compared with the odds of use of an Apnea monitor among living controls. The national prevalence estimates for home Apnea monitor use among birth weight strata of 500 to 1,499 g, 1,500 to 2,499 g, and 2,500 g or more for blacks were 19.9, 2.6, and 1.1% compared with 44.0, 8.8, and 1.2% for non-blacks. The only significant association between the use of Apnea monitors and SIDS was for black 500- to 1,499-g infants. The adjusted odds ratio for SIDS among monitored black 500- to 1,499-g infants vs unmonitored infants was 3.93 (1.09, 14.17). This analysis suggests a marked difference in reported monitor use between U.S. black and non-black infants. In addition, black very low birth weight infants at highest risk for SIDS appear to be preferentially selected for Monitoring. The protective effect of home Apnea Monitoring in this survey population is unclear.

  • Access to home Apnea Monitoring and its impact on rehospitalization among very-low-birth-weight infants
    Archives of pediatrics & adolescent medicine, 1995
    Co-Authors: Michael Malloy, Barry I. Graubard
    Abstract:

    To examine the relationship between home Apnea Monitoring and sociodemographic, socioeconomic, and medical factors and the risk for rehospitalization among very-low-birth-weight infants (birth weight < 1500 g). Analysis of live infants born weighing less than 1500 g; these data were obtained from the 1988 National Maternal and Infant Health Survey. Data from this survey were obtained by maternal questionnaires and from birth certificates and medical records. One or more hospitalizations after discharge from the hospital of delivery. Home Apnea monitor use was strikingly lower among black infants (19.8%) compared with nonblack infants (43.7%) (P < .001). The rate of rehospitalization for blacks was 24.8%, which was lower than the rate of 34.3% for nonblacks (P = .001). Neither annual family income nor method of hospital payment was associated with rehospitalization. The use of an Apnea monitor in the home was associated with an increased odds ratio for rehospitalization for both blacks (odds ratio, 2.56; 95% confidence interval, 1.56 to 4.21) and nonblacks (odds ratio, 2.28; 95% confidence interval, 1.51 to 3.45). With adjustment for the use of an Apnea monitor, the odds ratio for rehospitalization of blacks vs nonblacks was no longer significant (odds ratio, 0.80; 95% confidence interval, 0.60 to 1.08). The use of an Apnea monitor in the home was highly associated with an increased risk for rehospitalization. Whether this increased risk was attributable to a valid reason for rehospitalization or to closer scrutiny of the infant could not be determined. The lower prevalence of Apnea monitor use among blacks is unexplained.