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In Reply I thank Dr Villa et al1 for their comments regarding our article2 and appreciate their bringing my attention to their work to develop and validate the sleep clinical record.3- 5 I agree with these authors that, while sleep studies are considered to have the best combination of sensitivity and specificity to diagnose obstructive sleep apnea (OSA), their routine use to diagnose all children suspected of OSA is neither cost-effective nor feasible.
Ishman S. Screening and Follow-up of Children Who Snore When Polysomnography is Not Available—Reply. JAMA Otolaryngol Head Neck Surg. 2016;142(7):711-712. doi:10.1001/jamaoto.2016.0468