Table A-5.1 AMSTAR scores of included systematic reviews Author, Year Overall AMSTAR Score a (1) Provided study design (2) Duplicate study selection (3) Broad literature search (4) Considered status of publication (5) List of studies (6) Provided study (7) Assessed scientific quality (8) Considered quality in report (9) Methods to combine appropriate (10) Assessed publication bias (11) Stated conflict of interest Cranston et al (2006) 6 1 0 1 1 1 1 0 1 NA 0 0 José et al (2014) 3 1 0 0 0 1 1 0 0 NA 0 0 Langdown and Peckham (2014) 7 1 0 1 1 1 1 1 1 NA 0 0 Wilt et al (2005) [HTA for AHRQ] 8 1 CA 1 1 1 1 1 1 1 0 0 Wilt et al (2007) 10 1 1 1 1 1 1 1 1 1 0 1 Abbreviations: AHRQ, Agency for HealthCare Research and Quality; AMSTAR, Assessment of Multiple Systematic Reviews; CA, can’t answer; HTA, health technology assessment; NA, not applicable a 1 = Yes, 0 = No; maximum possible score is 11. Details of AMSTAR Score are described in Shea et al (2007).
based spirometry for testing in a laboratory (11509; 11512). New item – Spirometry pre OR post bronchodilator Similar to the test done in a doctor’s surgery (item 11506) but done either before OR after using an inhaler such as Ventolin. For diagnosing and monitoring asthma and other lung diseases. Create a new MBS item. This service will be billed under its own MBS item. The Committee has suggested a MBS fee of $20.55. This test is done currently but there is no MBS payment for it. The new item and rebate will improve the assessment and monitoring of patients with asthma and other lung diseases. New item – Laboratory based spirometry with Fraction of Exhaled Nitric Oxide (FeNO) FeNO is a test to measure airway inflammation which may help in finding the best treatment. Create a new MBS item for FeNO with spirometry. This test is used for patients with more complex lung disease who are under the care of a specialist. It is laboratory based. FeNO is not useful if it is performed alone. This will provided a separate MBS fee for FeNO with spirometry for patients who have airway inflammation as a cause of their symptoms. New item Cardiopulmonary Exercise Testing A relatively non-invasive way to assess how the heart and lungs work at the same time and during exercise. Introduce a new item with a higher MBS fee than for MBS 11503. This test is currently billed under two existing items. It would now be billed under one item and be available for patients: with breathlessness but standard tests do not result in a diagnosis; or who are having major surgery and are at high risk of a complication due to their lung or heart disease. An MBS fee that is equivalent to that for item 11503 plus item 1172 is recommended for the new item as these are the items doctors are currently using. At present, when doctors perform this test they bill two items (11503 and 1172). The new item, with fee equivalent to item 11503 plus item 1172, will mean that doctors will only need to bill one item. The test will target patients with specific symptoms who might benefit the most from the test
based adult treatment initiation study the nose via mask that keeps the airway open to ensure unobstructed breathing. A treatment initiation test occurs in a sleep centre following diagnosis of a sleep disorder and the recommending of PAP therapy. be claimed once in a 12 month period. initiation studies are billed under MBS 12203. These services will transfer to the new item. that is needed to ensure the patient’s airway stays open. New item – Laboratory based adult treatment effectiveness study This test is used when a patient has been diagnosed with a sleep disorder and received treatment but symptoms recur or there is a significant change in weight or other medical conditions. A new MBS item specifically for treatment effectiveness which may be claimed once in a 12 month period. At present, there are no items for this service. However, some effectiveness studies may be being billed under MBS 12203. These services are expected to transfer to the new item. A change in symptoms, weight or other medical conditions may affect how well the PAP treatment works for a patient. An effectiveness study is used to check whether the air pressure needs to be changed. New item – Home based adult automatic positive airway pressure (APAP) titration study Titration is a process used with PAP treatment where the air pressure is adjusted until the right pressure to keep the airway open is identified. This item will allow patients who are diagnosed with uncomplicated sleep apnoea to undergo titration at home. The Committee noted that this proposal should be placed on hold for 2-3 years until the impact of the changes to items 12203 and 12250 is known. Not applicable at this stage. Not applicable at this stage. New item – Laboratory based adult vigilance testing This study involves an assessment of excessive daytime sleepiness or the ability to stay alert using several tests. The Committee recommend that vigilance testing be evaluated by the Medical Services Advisory Committee as this service is not currently funded. Not applicable at this stage. Not applicable at this stage.
(viii) position; (e) continuous electro-cardiogram (ECG); and (f) polygraphic records are analysed (for assessment of sleep stage, arousals, respiratory events, cardiac abnormalities and limb movements) with manual scoring, or manual correction of computerised scoring in epochs not more than one minute, and the data are stored for interpretation and preparation of a report; and (g) interpretation and preparation of a permanent report are provided by a qualified adult sleep medicine practitioner with direct review of raw data from the original recording of polygraphic data from the patient. One in a 12-month period. New item 122XX for an additional sleep study where initial item 12203 has failed. OVERNIGHT INVESTIGATION FOR SLEEP APNOEA FOR A PERIOD OF AT LEAST 8 HOURS DURATION, FOR AN ADULT AGED 18 YEARS AND OVER WHERE: a sleep scientist is in continuous attendance under the supervision of a qualified sleep medicine practitioner; AND continuous monitoring and recording of the following measures which are to be performed in accordance with current Australasian Sleep Association guidelines for the performance of Type 1 sleep studies: (i) airflow; (ii) submental electro-myogram (EMG); (iii) anterior tibial electro-myogram (EMG); (iv) continuous electro-cardiogram (ECG); (v) continuous electro-encephalogram (EEG); (vi) electro-oculogram (EOG); (vii) oxygen saturation; (viii) respiratory movement (chest and abdomen); (ix) position; AND polygraphic records are analysed (for assessment of sleep stage, arousals, respiratory events, cardiac abnormalities and limb movements) with manual scoring, or manual correction of computerised scoring in epochs of not more than 1 minute, and stored for interpretation and preparation of report; AND