To the Editor Dr Chai-Coetzer and colleagues1 compared management models of obstructive sleep apnea (OSA) and found that primary care physicians and advanced practice nurses did not provide inferior screening and diagnosis of OSA vs physicians with specialized training in sleep medicine. I believe that several relevant issues suggest this conclusion is premature.
First, more than twice as many patients in the primary care group than in the sleep specialist group withdrew from the study. Second, the primary care pathway included a telephone call to the patient 2 weeks after starting continuous positive airway pressure (CPAP) and a total of 5 follow-up appointments. The follow-up with the sleep specialist group was unclear, which suggests the study methods may have been biased.
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