PGY4 Resident Indiana University School of Medicine
Educational Objective: At the conclusion of this presentation, the participants should be able to utilize a standardized questionnaire to analyze five outcome measures for sensor lead function in upper airway stimulation.
Objectives: There are no reported objective or subjective measures to evaluate sensor lead electrode function in upper airway stimulation surgery (INSPIRE). This study describes the development of functional outcome measures for intraoperative sensor electrode function.
Study Design: Retrospective cohort study of 100 consecutive patients who underwent UAS placement by the senior author between June 2019 and September 2021.
Methods: Waveforms were collected and utilized to develop five outcome measures to standardize analysis of sensor lead function, as follows 1) waveform syncing (the rise of waveforms coincides with blue lines (inhalation) while the fall of waveforms coincides with red lines (exhalation); graded using a Likert scale with 1 ( <25%), 2 (25-49%), 3 (50-74%), 4 (75-100%); 2) waveform amplitude (there is continuity of the waveform between inspiratory and expiratory phases; graded using a Likert scale with 1 ( <25%), 2 (25-49%), 3 (50-74%), 4 (75-100%); 3) presence or absence of sensory current leakage (yes or no); 4) presence or absence of cardiac artifact; graded using a Likert scale with 1 (none), 2 ( < 1/3 of amplitude), 3 (> 1/3 of amplitude), or 4 (unstable/inconsistent); and 5) overall impression (this sensory waveform shows clear detection of inspiration and expiration), graded on a Likert scale as follows: 1 (strongly disagree), 2 (disagree), 3 (agree), 4 (strongly agree). Two sleep surgeons compared all 100 waveforms in a blinded fashion and assigned scores as noted above, and these were then statistically compared.
Results: Interrater reliability (interclass correlation coefficient) was greater than 0.8 (excellent) for all comparisons.
Conclusions: This study demonstrates a method of sensor electrode outcome measurement that is reproducible for surgeons and sleep medicine specialists looking to evaluate function. Consideration should be given to utilizing this novel tool in the clinical/research setting.