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PubMed1997

Accuracy and efficiency of an automated system for calculating APACHE II scores in an intensive care unit.

We evaluated the reliability and efficiency of an automated system for calculating APACHE II scores. We imported an automated APACHE II scoring system developed at another institution. We scored a convenience sample of 50 consecutive intensive care unit (ICU) admissions using three methods: (1) the automated system (2) an expert scorer using a manual data abstraction method, and (3) the current manual scoring method used in the ICU. We analyzed interrater reliability among the three groups, and compared scoring time between the automated and the expert groups. Interrater reliability testing demonstrated a very high agreement between the computer and the expert scorers, (r = 0.97 p < 0.01) and a high agreement between the computer and the nursing staff (r = 0.80, p < 0.01). The mean time required to complete the data sheet manually and input data into a standalone computer manually was 4 minutes and 55 seconds, compared to total mean time of 33 seconds for the automated system. Automated APACHE II scoring yielded results more reliable than those of an expert scorer, as judged by a second researcher. The time required to score patients was reduced and reliability of scores was improved with use of an automated APACHE II scoring system.

APACHE↗

PubMed1993

The development of a strategy for the implementation of automation in a bioanalytical laboratory.

Laboratory automation is equipment, instrumentation, software and techniques that are classified into four groups: instrument automation; communications; data to information conversion; and information management. This new definition is necessary to understand the role that automation can play in achieving the aims and objectives of a laboratory within its organization. To undertake automation projects effectively, a laboratory automation strategy is outlined which requires an intimate knowledge of an organization and the target environment to implement individual automation projects.

Automation↗

PubMed2003

Automated solid-phase extraction and liquid chromatographic method for retinoid determination in biological samples.

In this study, a method for partly automated sample preparation and fully automated solid-phase extraction method for plasma, kidney and liver samples for various retinoids like all-trans-4-oxo-retinoic acid, 13-cis-4-oxo-retinoic acid, 13-cis-retinoic acid, 9-cis-retinoic acid, all-trans-retinoic acid, retinol and retinyl palmitate was established. Plasma, embryo-, kidney-and liver-homogenates were automatically mixed and extracted on multiple usage solid-phase (C2) extraction cartridges immediately before HPLC analysis. Automated cleaning, preconditioning and incorporation of the loaded cartridge to fully automated HPLC separation and quantification of the various retinoids in a single HPLC run was established. The recovery of the retinoids was generally between 80 and 90%. Intra-day repeatability was < 11.7%. As little as 1.2 ng/ml could be quantified in lipid-mixture standard samples. This method allows a highly automated sample preparation and a fully automated solid-phase extraction with good selectivity for the study of endogenous retinoids and retinoids after nutritional supplementations and pharmacological applications in several biological samples.

Animals↗

PubMed2003

The effects of total laboratory automation on the management of a clinical chemistry laboratory. Retrospective analysis of 36 years.

BACKGROUND: Thirty-six years of data and history of laboratory practice at our institution has enabled us to follow the effects of analytical automation, then recently pre-analytical and post-analytical automation on productivity, cost reduction and enhanced quality of service. METHODS: In 1998, we began the operation of a pre- and post-analytical automation system (robotics), together with an advanced laboratory information system to process specimens prior to analysis, deliver them to various automated analytical instruments, specimen outlet racks and finally to refrigerated stockyards. By the end of 3 years of continuous operation, we compared the chemistry part of the system with the prior 33 years and quantitated the financial impact of the various stages of automation. RESULTS: Between 1965 and 2000, the Consumer Price Index increased by a factor of 5.5 in the United States. During the same 36 years, at our institution's Chemistry Department the productivity (indicated as the number of reported test results/employee/year) increased from 10,600 to 104,558 (9.3-fold). When expressed in constant 1965 dollars, the total cost per test decreased from 0.79 dollars to 0.15 dollars. Turnaround time for availability of results on patient units decreased to the extent that Stat specimens requiring a turnaround time of <1 h do not need to be separately prepared or prioritized on the system. CONCLUSIONS: Our experience shows that the introduction of a robotics system for perianalytical automation has brought a large improvement in productivity together with decreased operational cost. It enabled us to significantly increase our workload together with a reduction of personnel. In addition, stats are handled easily and there are benefits such as safer working conditions and improved sample identification, which are difficult to quantify at this stage.

Automation↗

PubMed1995

Automated perimetry detects visual field loss before manual Goldmann perimetry.

PURPOSE: To determine if automated perimetry detects visual field defects before manual Goldmann perimetry. METHODS: Subjects with ocular hypertension without field loss on detailed manual perimetry were followed prospectively with annual automated and manual perimetry. Subjects with field loss on manual perimetry were age-matched post hoc to subjects who did not have field loss. The automated fields 1 year before the development of field loss on manual perimetry were compared between the two groups. Subjects were recruited from ophthalmologists' offices, eye clinics, and a population-based glaucoma survey in the Baltimore area. Abnormal results detected on the Humphrey Field Analyzer were defined using the glaucoma hemifield test, mean defect, and corrected-pattern standard deviation. RESULTS: Forty subjects who had field loss during 8 years of follow-up were compared with 145 control subjects with ocular hypertension who did not have defects. Seventy-five percent of converters had abnormal results of the glaucoma hemifield test 1 year before field loss on manual perimetry, whereas 22% of controls had abnormal results of the glaucoma hemifield test (odds ratio, 13.4). The odds ratio of field loss developing on manual perimetry within 12 months was 3.3 for those with borderline results of the glaucoma hemifield test relative to the control subjects. The odds ratio was 6.0 for corrected-pattern standard deviation (P < 0.05) and 3.9 for mean deviation (P < 0.05). CONCLUSIONS: Those with field loss on manual perimetry were more likely to have had an abnormal automated field 1 year before conversion than those who did not convert. However, 22% of subjects in whom definitive field loss did not develop on manual perimetry during the study had abnormal automated fields at one visit and 15% had abnormal automated fields on two consecutive visits.

Aged↗

PubMed1997

Manual and automated methods for the determination of leukocyte counts at extreme low levels: comparative evaluation of the Nageotte chamber and the Abbott Cell Dyn 3500 analyser.

Leukodepleted or leukocyte-poor blood products (fresh-frozen plasma, packed red cell and platelet concentrates in particular) are widely used in current clinical practice. However, because the monitoring of leukodepletion efficiency is generally carried out (if at all) using the labour-intensive and relatively inaccurate manual Nageotte chamber technique, it is clear that any increased demand for leukodepletion monitoring would be difficult, if not impossible, to meet. As the need to identify an automated alternative to the Nageotte technique is important, this study was undertaken to evaluate such a possibility. White blood cells were enumerated in a representative series of filtered and non-filtered human blood components by both microscopic counting in the Nageotte chamber, and with the Abbott CD3500 automated haematology analyser. For the Nageotte estimate, a single analysis was made in accordance with standard procedures, whereas the automated analysis was achieved by making six replicate counts and determining the mean of four replicates after excluding the highest and lowest estimates. To determine linearity limits of the manual and automated procedures, freshly isolated leukocytes were admixed with cell-free plasma-pheresis plasma. Reasonable reproducibility (mean CV 10% for cell counts exceeding 100 cells/microL) and good linearity (r > 0.9) were observed for CD3500 determinations in four separate experiments. The manual and automated measurements also correlated well (r > 0.9) with no obvious inter-method bias for cell counts up to 40 cells/microL although there was some suggestion of lower absolute CD3500 counts in the range 40-130 cells/microL. For the comparative studies with filtered and non-filtered blood products, no significant method bias was seen with 70 individual red cell concentrates, but systematically higher CD3500 white blood cell counts were observed in the series of 68 platelet concentrates (probably due to the presence of platelet clumps). This study concludes that automation of white cell counts in blood products with the CD3500 analyser is feasible for quality control in the preparation of fresh-frozen plasma and red cell concentrates but is limited for the analysis of filtered platelet concentrates.

Automation↗

PubMed2000

The dynamics of trust: comparing humans to automation.

Complex industrial environments involve cooperation between operators and automation. The strategies used to allocate tasks to automation are a crucial component of that cooperation and are known to be affected by the operators' trust in the automation. In 2 simulated process control experiments, the authors compared trust in automation with trust in human partners in equivalent situations. Experiment 1 found the relationship between trust and task allocation to be qualitatively identical, but quantitatively attenuated, for human partners as compared with automation. Experiment 2 additionally identified the operators' trustworthiness, as they thought it would be perceived by a human partner, as crucial to task allocation under human collaboration but not under automation. The results imply that human collaboration benefits from calibration of people's assessment of how others perceive them.

Adult↗

PubMed2006

Automated interpretation of regional left ventricular wall motion from cardiac magnetic resonance images.

UNLABELLED: Magnetic resonance (MR) diagnosis of regional left ventricular (LV) dysfunction relies on visual interpretation of cine images that suffers from wide inter-observer variability, especially when performed by readers not specifically trained in the assessment of LV wall motion. Quantitative analysis tools, though widely available, are rarely used because they provide large amounts of detailed information, the interpretation of which requires additional time-consuming processing. We tested the feasibility of fast automated interpretation of regional LV function using computer analysis of this wall motion information. METHODS: Dynamic, ECG-gated, steady-state free precession short-axis images were obtained in 6-10 slices in 28 subjects (10 normal volunteers; 18 patients). Images were reviewed by an expert cardiologist who provided "gold standard" grades (normal, abnormal) for regional wall motion and, independently, by four radiologists. Same images were then analyzed using custom software. Regional fractional area changes computed in normal volunteers were used to obtain the optimal segment- and slice-specific threshold values for automated classification of regional wall motion for each patient. The levels of agreement with the "gold standard" grades were compared between the radiologists and the automated interpretation. RESULTS: While the visual interpretation required 2-5 minute per patient, the automated interpretation required < 1 sec, after endocardial border detection was complete. The automated interpretation resulted in higher sensitivity, specificity, and accuracy (84%, 77%, 79%, respectively) than the radiologists' grades (80%, 76%, 77%, respectively) and eliminated the high interobserver variability. CONCLUSION: Once the endocardial boundaries are defined, computer analysis of the regional wall motion information allows accurate, fully automated, immediate, objective and experience-independent interpretation of regional LV function.

Automation↗

PubMed1993

A prospective randomized trial comparing manual and automated endoscope disinfection methods.

OBJECTIVE: To compare the efficacy of endoscope disinfection using automated and manual systems. DESIGN: Prospective randomized trial. SETTING: A 1,000-bed tertiary care referral center. METHODS: All endoscopes underwent a three-stage decontamination process including brushing and cleaning with water and detergent, manual or automated disinfection with 2% glutaraldehyde, and 70% alcohol rinse with forced air drying. Cultures were obtained from endoscopes from both groups before and after alcohol rinse and then after overnight storage. RESULTS: Cultures from 8/30 (27%) automated and 11/30 (37%) manually disinfected (P = 0.58) endoscopes grew gram-negative bacteria and/or nontuberculous mycobacteria before the alcohol rinse. After alcohol rinse, 3 (10%) of 30 automated and 8 (27%) of 30 manually disinfected endoscopes remained contaminated (P = 0.28). Manually disinfected endoscopes were contaminated more frequently with coliform bacteria, whereas endoscopes undergoing automated disinfection were more frequently contaminated with nontuberculous mycobacteria, but the differences were not statistically significant. After alcohol rinse and forced air drying, there was no difference in contamination rates between freshly disinfected endoscopes and those stored overnight (7/30 (23%) versus 4/30 (13%), P = 0.50). Colonoscopes and duodenoscopes were contaminated more often than gastroscopes (P = 0.00001). CONCLUSION: The persistent endoscope contamination after manual and automated disinfection indicates the importance of developing more reliable and effective disinfection methods.

Automation↗

PubMedDate not supplied

Automated extraction for the analysis of 11-nor-delta9-tetrahydrocannabinol-9-carboxylic acid (THCCOOH) in urine using a six-head probe Hamilton Microlab 2200 system and gas chromatography-mass spectrometry.

An automated extraction scheme for the analysis of 11 -nor-delta9-tetrahydrocannabinol-9-carboxylic acid using the Hamilton Microlab 2200, which was modified for gravity-flow solid-phase extraction, has been evaluated. The Hamilton was fitted with a six-head probe, a modular valve positioner, and a peristaltic pump. The automated method significantly increased sample throughput, improved assay consistency, and reduced the time spent performing the extraction. Extraction recovery for the automated method was > 90%. The limit of detection, limit of quantitation, and upper limit of linearity were equivalent to the manual method: 1.5, 3.0, and 300 ng/mL, respectively. Precision at the 15-ng/mL cut-off was as follows: mean = 14.4, standard deviation = 0.5, coefficient of variation = 3.5%. Comparison of 38 patient samples, extracted by the manual and automated extraction methods, demonstrated the following correlation statistics: r = .991, slope 1.029, and y-intercept -2.895. Carryover was < 0.3% at 1000 ng/mL. Aliquoting/extraction time for the automated method (48 urine samples) was 50 min, and the manual procedure required approximately 2.5 h. The automated aliquoting/extraction method on the Hamilton Microlab 2200 and its use in forensic applications are reviewed.

Automation↗

PubMed1997

Complex regional pain syndrome type 2 (causalgia) after automated laser discectomy. A case report.

STUDY DESIGN: This report identifies a case of complex regional pain syndrome Type 2 (causalgia) with sympathetically maintained pain associated with automated laser discectomy. The syndrome's clinical features and its management with sympathectomy are described. OBJECTIVES: To report an unusual complication associated with automated laser discectomy, review the possible mechanism, and discuss the management of complex regional pain syndrome Type 2 with sympathetically maintained pain. SUMMARY OF BACKGROUND DATA: Automated laser discectomy represents a minimally invasive technique to treat herniated intervertebral discs. By using small, automated probes placed in the disc under local anesthesia and fluoroscopic guidance, disc material can be removed percutaneously, eliminating the need for lumbar laminectomy with its attendant morbidity. Some complications have been reported. This case report presents a complication not previously described. METHODS: A 39-year-old woman underwent L4-L5 automated laser discectomy; an attempt was made to lase the L5-S1 disc, but the procedure was aborted because of severe pain and discomfort. The patient had pain in the left lower extremity in the L5 and S1 distribution, including the foot. There was evidence of allodynia and hyperesthesia with some dystrophic changes in the foot. A diagnosis of complex regional pain syndrome Type 2 (causalgia) was made. RESULTS: A series of two diagnostic percutaneous chemical sympathectomies were undertaken, and the pain was relieved to a significant extent for up to 2 weeks. This suggested complex regional pain syndrome Type 2 with sympathetically maintained pain, and thereafter therapeutic chemical sympathectomy resulted in resolution of the pain syndrome. CONCLUSIONS: Complex regional pain syndrome Type 2 with sympathetically maintained pain is a condition that can result in serious disability and can be associated with a number of spinal procedures, including automated laser percutaneous discectomy. Early intervention is recommended to provide long-term resolution of the condition.

Adult↗

PubMed2004

Accuracy of automated auscultatory blood pressure measurement during supine exercise and treadmill stress electrocardiogram-testing.

OBJECTIVES: Monitoring of brachial blood pressure during exercise-electrocardiogram (ECG) testing is mandatory and changes in blood pressure (BP) can provide critical management evidence. Patient movement, mechanical vibration, artifactual sounds and observer variability make standard manual techniques problematic. This was an investigator-initiated study to assess an automated auscultatory technique of BP assessment [Tango exercise blood pressure monitor (SunTech Medical Instruments, NC, USA)] to adequately measure BP during stress-ECG testing. METHODS: Initially five fit young male volunteers underwent invasive right brachial artery BP recording using a low-compliance fluid-filled catheter with simultaneous manual and automated assessment. Secondarily, during exercise-ECG testing, the system was assessed against beat-to-beat brachial blood pressures obtained from a catheter-tip solid-state pressure manometer positioned in the ipsilateral brachial artery. RESULTS: In the supine study overall mean difference (+/-SEM) between invasive and manual blood pressures was 3.26 (1.53) and 3.89 (1.90) mmHg for diastolic BP (DBP) and systolic BP (SBP) respectively. Corresponding differences between invasive and automated results, and manual and automated were 3.68 (0.84) and -7.31 (1.83) mmHg, and -0.64 (+/-1.43) and -11.42 (+/-1.59) mmHg. During treadmill exercise-ECG testing the combined mean difference (+/-SEM) between invasive and automated SBP and DBP was 4.79 (+/-0.14) and 6.33 (+/-0.10) mmHg, respectively. CONCLUSION: Automated BP assessment during exercise-ECG testing is feasible with the use of appropriate automatic devices likely to be at least as accurate as manual BP registration. The Tango device is tolerant to exercise and provides reliable automatic BP assessment with absolute differences within an acceptable clinical range.

Adult↗

PubMed2006

Automated blood pressure measurement in routine clinical practice.

OBJECTIVE: To compare blood pressure measurements taken in routine clinical practice using an automated recorder, the BpTRU (VSM MedTech Ltd, Coquitlam, Canada), with readings taken by a conventional mercury sphygmomanometer. METHODS: Fifty consecutive patients [28 women, 22 men; mean (+/-SD) age 62+/-16 years] referred to a specialist for management of hypertension had blood pressure taken on the first visit in random order using both a mercury sphygmomanometer and an automated device. RESULTS: The mean initial automated reading (mmHg) taken with the observer present (162+/-27/85+/-12) was similar to the mean manual blood pressure taken in duplicate (163+/-23/86+12). Both values were higher (P<0.001) than the mean of the next five readings taken with the automated recorder when the patient was resting quietly alone (142+/-21/80+/-12). Women exhibited a greater fall in blood pressure with the automated device than men. CONCLUSIONS: Use of an automated blood pressure recorder can eliminate some of the white-coat effect associated with readings taken by a mercury sphygmomanometer.

Aged↗

PubMed2003

Development and verification of an automated sample processing protocol for quantitation of human immunodeficiency virus type 1 RNA in plasma.

We developed and verified an automated sample processing protocol for use with the AMPLICOR HIV-1 MONITOR test, version 1.5 (Roche Diagnostics, Indianapolis, Ind.). The automated method uses the MagNA Pure LC instrument and total nucleic acid reagents (Roche Applied Science, Indianapolis, Ind.) to extract human immunodeficiency virus type 1 (HIV-1) RNA from plasma specimens. We compared the HIV-1 load results for a dilution series (1 to 5 nominal log(10) copies/ml) and 175 clinical specimens processed by the automated method to those for the same samples processed by the manual methods specified by the manufacturer. The sensitivity, dynamic range, and precision of the viral load assay obtained by automated processing of specimens were similar to those obtained by an ultrasensitive manual processing method. The results were highly correlated (R(2), 0.95), and were in close agreement, with a mean difference of 0.09 log(10) (standard deviation, 0.292). The limits of agreement were +/-0.58 log(10) for results for samples processed by both the manual and the automated methods. These performance characteristics were achieved with a smaller sample volume (200 versus 500 microl) and without a high-speed centrifugation step and required only 15 min of labor for a batch of 32 samples. In conclusion, the automated sample preparation protocol can replace both the standard and the ultrasensitive manual methods used with the AMPLICOR HIV-1 MONITOR test and can substantially reduce the labor associated with this test.

Automation↗

PubMed1997

Left ventricular performance assessed by echocardiographic automated border detection and arterial pressure.

Automated echocardiographic measures of left ventricular (LV) cavity area are closely correlated with changes in volume and can be coupled with LV pressure (PLV) to construct pressure-area loops in real time. The objective was to rapidly estimate LV contractility from end-systolic relationships of cavity area (as a surrogate for LV volume) and central arterial pressure (Pa) (as a surrogate for PLV) in a canine model using automated algorithms. In eight anesthetized mongrel dogs, we simultaneously measured PLV, LV area, and Pa (fluid-filled catheter). End-systolic pressure-area relationships in terms of pressure-area elastance (E'es)] from pressure-area loops during inferior vena caval occlusions were determined during basal conditions (control), dobutamine infusion (5-10 micrograms.mg-1.min-1), and after bolus propranolol (2 mg/kg) with both PLV and Pa by semiautomated and automated iterative regression methods. E'es increased during dobutamine infusion and decreased after propranolol infusion in all animals and with all iterative methods. Estimates of Ees from Pa were closely correlated with E'es from PLV by both the semiautomated and automated methods (r = 0.93; P < 0.01). The relationship between E'es obtained from Pn for the two methods was also closely correlated. Although the automated methods displayed larger differences from the semiautomated iterative technique by Bland-Altman analysis, the change in E'es with all techniques during dobutamine infusion and after propranolol infusion was of similar magnitude and direction among the three techniques. Greater variability with the dobutamine runs was partially due to abnormally conducted ventricular beats that minimized the number of consecutive beats that could be used for these analyses. We conclude that on-line Pa recordings from fluid-filled catheters can be used with echocardiographic automated border detection to rapidly calculate E'es as a means to estimate LV contractility.

Algorithms↗

PubMedDate not supplied

Automated immunofluorometric assay for MUC1.

The aim of the present study was to establish a robust, reliable and fully automated immunofluorometric assay for the breast cancer serum marker MUC1. This would further serve as a prototype assay for evaluation of other MUC1 assays based on new antibody combinations. Using time-resolved fluorescence as tracer signal we developed an automated immunofluorometric assay for MUC1 (MUC1 IFMA). This assay was compared with two commercial assays. The CA15-3 EIA (CanAg) which use the same antibodies as the MUC1 IFMA, and the ETI-CA-15-3 K (Sorin) which use the original antibodies defining the CA 15-3 assay. The three assays showed comparable results. The coefficient of variation was below 10% from 9 to 2,400 kU/l for the MUC1 IFMA, from 15 to 250 kU/l for the CA15-3 EIA, and from 25 to 200 kU/l for the ETI-CA-15-3 K assay. At a specificity of 0.94 the overall diagnostic sensitivities for the MUC1-IFMA, CA15-3 EIA and ETI-CA-15-3 K assays were 0.40, 0.37, and 0.38, respectively. When applied to metastatic breast cancer, all assays had sensitivities close to 0.80. There was a close correlation (Spearman rank = 0.99) between results from the new assay and the CA15-3EIA. The new automated assay was not strictly immunometric as we could not achieve conditions where solid phase or tracer antibodies were in apparent excess. However, the assay performed well at a wide range of assay conditions. The automation, which minimizes imprecision in pipetting and handling of samples, and the high capacity of the AutoDELFIA instrument enabling measurement of all samples in a single run, were important aspects for establishing a reliable assay. The principle of the new automated immunofluorometric assay will be used as a rapid and reliable evaluation of a wide range of monoclonal antibody combinations in our search for the optimal MUC1 assay. This new automated immunofluorometric assay will be useful in the rapid and reliable evaluation of a wide range of monoclonal antibody combinations in our search for the optimal MUC1 assay.

Adult↗

PubMed1995

Performance, workload, and fatigue changes associated with automation.

The experiments discussed in this article addressed the influence of part-task automation on operator performance, workload, and fatigue in a multitask environment. The overall task environment included tracking, resource management, and multiple monitoring subtasks. Slower, more accurate monitoring and better resource management were observed when the tracking subtask was automated. Although lower workload was reported when tracking was automated, fatigue increased equally during periods of manual and automatic tracking. When participants could control workload by shifting between manual and automatic tracking, participants with 7 hr of training switched between automatic and manual tracking. Their performance during optional automation periods was superior to their performance in conditions in which only manual control or only automated control was available. The findings argue for the utility of discretionary control of automated systems.

Adult↗

PubMed2003

Evaluation of unattended automated titration to determine therapeutic continuous positive airway pressure in patients with obstructive sleep apnea.

BACKGROUND: Determination of the therapeutic pressure during continuous positive airway pressure (CPAP) therapy is usually performed by a technician during polysomnography. In recent years, several devices for automated adjustment of the therapeutic pressure by the means of computerized algorithms were developed. The aims of the present study were to compare two different devices for automated titration and to verify if unattended automated titration is a feasible strategy to determine the therapeutic CPAP. METHODS: We enrolled 16 consecutive patients with obstructive sleep apnea syndrome (OSAS) defined by an apnea-hypopnea index > 20/h. Automated titration was performed in the hospital using two CPAP devices (Autoset; Resmed; North Ryde, Australia; and Somnosmart; Weinmann; Hamburg, Germany) in random order for 2 consecutive nights, based on different signals for the detection of respiratory events. During titration, there was no direct supervision by a technician, and polysomnography was not recorded. We defined the therapeutic pressure as the 95th percentile of the airway pressure over time (P95). RESULTS: We observed significant differences of the P95 between the two devices, with an average of 7.0 +/- 2.5 cm H(2)O for the Somnosmart and 9.9 +/- 2.6 cm H(2)O for the Autoset (p = 0.005) [mean +/- SD]. There was a considerable lack of agreement between the two devices, with a bias of 3.0 cm H(2)O and limits of agreement ranging from + 9.3 to - 3.2 cm H(2)O. We found no significant correlation between the paired differences of P95 and either indexes of severity of OSAS or lung function variables. CONCLUSION: Automated titration based on the analyses of flow (Autoset) or forced oscillations (Somnosmart) predicted significant different therapeutic pressures for fixed CPAP therapy. Thus, unattended automated titration performed during 1 night of hospital stay with commercially available devices cannot be used to determine accurately the therapeutic CPAP in patients with OSAS.

Automation↗