A Wachovia Bank equity report of the AHRQ tech assessment of home
testing is optimistic about CMS’ prospect of allowing home diagnosis
with Type II portable devices.

A technical assessment performed by the Department of Health and
Human Services Agency for Healthcare Research & Quality (AHRQ) to
determine the effectiveness of portable diagnostic units is now available
for download on the CMS website.
According to the report, type II units (which record the same data as PSG
but use fewer channels) may identify apnea-hypopnea index (AHI) suggestive
of obstructive sleep apnea with high positive likelihood ratios (>10) and
low negative likelihood ratios (<0.1) in both the home and sleep laboratory
Type III units (which do not record neurophysiologic sleep staging) and
type IV units (which do not record at least two respiratory channels) have
similar abilities when used in sleep laboratory settings. However, the
report added that type III and type IV units have better results when used
in specialized sleep laboratories. All units were considered effective in
diagnosis of OSA.
The report also noted that most studies of portable monitors have been on
patients approximately 50 years of age, a group that is younger than the
average member of the Medicare population. Medicare patients may have
additional health concerns that could complicate or cause a misdiagnosis.
To view the full report, click here.