The development and testing of a new communication tool to help clinicians inform patients with obstructive sleep apnoea syndrome about treatment options

The objective of this study was to develop a tool to help clinicians inform patients about mechanical treatment options, continuous positive airway pressure and oral appliances for obstructive sleep apnoea syndrome, and to assess its validity, reliability and acceptability. Continuous positive airway pressure is always indicated as a first-line treatment in patients with severe obstructive sleep apnoea syndrome. However, oral appliances might be an effective treatment option in patients who fail treatment attempts, and also as a first-line treatment for patients with mild to moderate obstructive sleep apnoea. To help patients choose their initial treatment, we developed an electronic decision board to present information regarding the potential benefits and side effects of the two treatment options, using the best available evidence. In 34 healthy volunteers, to test validity we evaluated the extent to which the respondents' preferences for a treatment changed predictably when the rate of effectiveness and side effects were modified. Reliability was tested by readministering the decision board 2 weeks afterwards (kappa test). The decision-board acceptability was evaluated in 99 consecutive patients newly diagnosed with obstructive sleep apnoea syndrome. We found that the decision board was valid. Reliability was excellent (κ = 0.94). Concerning acceptability, 72% of the patients were satisfied with the information provided in the decision board and 71% indicated that it helped them to make a decision. The average score of true/false test of knowledge was 7.9 of 10 (range 3-10). The decision board we developed is a valid, reliable and acceptable tool to assess patients' preferences.