A new report from the American Thoracic Society (ATS), published in the Proceedings of the American Thoracic Society, identifies barriers preventing incorporation of portable monitor testing into clinical management pathways and recommends research and development needed to address those barriers. It summarizes the recommendations of an international workshop sponsored by the ATS, AASM, the American College of Chest Physicians, and the European Respiratory Society.

“The consensus of the workshop participants was that outcomes-based research studies are needed to demonstrate the efficacy and cost-effectiveness of portable monitor testing,” said Samuel Kuna, MD, associate professor of medicine at the University of Pennsylvania and chief of the Pulmonary, Critical Care & Sleep Section at Philadelphia Veterans Affairs Medical Center, and chair of the workshop’s steering committee. “There is also a need to develop clinical sleep research networks capable of performing large, prospective studies.”

Recommendations were developed regarding research study design and methodology that include the need to standardize technology, identify the patients most appropriate for ambulatory management of obstructive sleep apnea, ensure patient safety, and identify sources of research funding.

“Current portable-monitor technology seems to be most applicable in populations having a high likelihood of OSA,” Kuna said. “Ideally, alternative approaches should also be made available to underserved and remote populations that do not have access to gold-standard testing.”

The evidence resulting from high-quality comparative effectiveness studies that include cost-effectiveness as an outcome will allow decision-makers to develop health care policies regarding the clinical application of portable monitor testing for the ambulatory management of patients with obstructive sleep apnea, according to the ATS.