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Sleep Apnea Screening for Commercial Drivers: A Retrospective Comparison of the 2016 FMCSA MRB Recommendations and
Clifton Wilcox1, Justin Yang, Robert Filler
1Environmental & Occupational Medicine & Epidemiology Program, Department of Environmental Health Harvard T.H. Chan School of Public Health (Dr Wilcox, Dr Yang, Dr Filler, Ms Hyun, Dr Rielly, Dr Kales); Occupational Medicine, Cambridge Health Alliance/Harvard Medical School (Dr Wilcox, Dr Yang, Dr Filler, Dr Chen, Dr Rielly, Dr Kales); Occupational Medicine, Naval Hospital Jacksonville, Jacksonville, Florida (Dr Wilcox); Department of Medicine, Boston University School of Medicine (Dr Yang), Boston; Manet Community Health Center, North Quincy (Dr Yang); Harvard College (Ms Hyun), Cambridge, Massachusetts.
Objective:
Compare the 2016 Federal Motor Carrier Safety Administration (FMCSA) and 2006 Joint Task Force (JTF) Guidelines for commercial drivers' obstructive sleep apnea (OSA) screening.
Methods:
Retrospective review of all commercial driver medical examinations performed in 2017 at an academic occupational medicine clinic. Screening criteria from both the JTF and FMCSA were applied, separately, and jointly. Statistical tests were applied as appropriate.
Results:
Applying the FMCSA or JTF criteria separately to 706 commercial drivers, the positive OSA screening yields were 15.7% and 16.9%, respectively. Using both criteria produced an overall positive OSA screen yield of 20.1%. Positive predictive values for applying both guidelines ranged from 72.7% to 95.5%.
Conclusions:
The combined use of the 2016 FMCSA and 2006 JTF OSA screening criteria in series has a higher screening yield than using either guideline individually.
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