New AASM-developed questionnaire offers a validated, quick-to-use method for tracking patient-reported outcomes in obstructive sleep apnea care
Key takeaways:
- PLATO is an 11-item questionnaire that can be completed in under four minutes and is available in English and Spanish.
- Validation studies confirmed strong internal consistency, test-retest reliability, and correlations with established sleep apnea measures.
Scores can differentiate between OSA severity levels and BMI groups and are sensitive to treatment-related symptom improvement. - The tool is accessible in paper and electronic formats, EHR-compatible, and will be licensed for free via Mapi Research Trust.
The American Academy of Sleep Medicine (AASM) has developed and validated a patient-reported outcome tool for use in a clinical setting to monitor treatment response and longitudinal symptom progression in adults who have obstructive sleep apnea (OSA).
Results show that the “Patient-reported Longitudinal Assessment Tool for OSA” demonstrates strong internal consistency and test-retest reliability, and it exhibits robust construct validity through moderate-to-strong correlations with established measures. Scores from the PLATO questionnaire also discriminate between sleep apnea severity levels and body mass index groups, and they are responsive to symptom improvement.
“The PLATO questionnaire is a valid and reliable patient-reported outcome tool that fills a significant void in the field of sleep medicine,” says lead author Douglas Kirsch, MD, FAAN, FAASM, a board-certified sleep medicine physician and past president of the AASM, in a release. “The 11-item questionnaire can be completed in less than four minutes and is easy to score, making it simple to implement, even in busy clinical settings.”
An AASM task force previously evaluated outcome assessment tools for sleep apnea, finding that no single tool met all the criteria for clinical validity and feasibility. To address this need, the AASM engaged ICON, a contract research organization, to develop PLATO in collaboration with a medical expert advisory panel of AASM members.
They developed PLATO in accordance with Food and Drug Administration guidance on developing and validating outcome measures, utilizing a multi-phase, mixed-methods approach. The process included:
- cognitive interviews with patients,
- pilot testing in 10 AASM-accredited sleep centers,
- and psychometric validation using longitudinal online surveys in 560 adults with sleep apnea and 40 controls.
PLATO comprises 11 questions that assess patients’ sleep-related experiences in the past seven days and nights. The questions address topics such as feeling tired or sleepy, experiencing morning headaches or snoring, and overall sleep quality. Patients can complete PLATO during clinic visits before therapy is implemented and at various times after treatment begins to monitor a patient’s response to any form of sleep apnea therapy.
PLATO was written at a 5th-grade reading level and is available in English and Spanish. It is accessible in both paper and electronic formats, allowing for easy scoring through a manual or electronic process. The electronic format is compatible with electronic health record platforms.
“The PLATO questionnaire is ready for clinical implementation, and longitudinal data collection using this tool will improve our understanding of the value of sleep apnea treatment to patients, health care professionals, payers, and health systems,” Kirsch says.
A related commentary in the Journal of Clinical Sleep Medicine emphasizes that PLATO “has several advantages over prior instruments to assess outcomes,” and it notes that a “thoughtful and statistically sound process was used to develop and modify this tool.”
PLATO can be licensed for free for use in clinical practice. Licensing information will be available soon from Mapi Research Trust.
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