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Q:
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Do I have to use the AASM Inter-Scorer Reliability Testing Program to be in compliance
with the Standards for Accreditation?
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A:
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No. The program is optional. The AASM program was designed in response to
requests from centers having trouble meeting the requirements for inter-scorer reliability
in the Standards for Accreditation. It is intended to provide a convenient,
easy to use alternative to a center-specific program. Centers that currently have
functional inter-scorer reliability programs that meet the Standards do not
need to change.
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Q:
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How are scoring records chosen for this program?
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A:
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Actual patient records are submitted from several accredited sleep centers. Patient
identification information is removed. They are screened for artifacts but are not
modified. They include normal research subjects, adult patients with and without
CPAP and pediatric patients. They are not ideal or perfect records that might be
used for examination purposes – they are actual recordings such as those that would
be encountered in a typical sleep center.
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Q:
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How are the correct answers determined?
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A:
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The records are scored by a senior board certified sleep specialist and reviewed
by at least 2 other board certified sleep specialists before posting. Data is monitored
on a regular basis and scores that fall below an average of 50% agreement are reviewed
by a committee to ensure accuracy.
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Q:
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What are the AASM Standards for Accreditation regarding inter-scorer reliability?
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A:
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To review the AASM Standards for Accreditation, including those specific to inter-scorer reliability,
visit the Center Accreditation Standards page on the AASM website.
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Q:
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Is there a penalty if my technologists don’t reach 85% agreement with the gold standard
scorer?
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A:
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There is no penalty. The 85% criterion is, at this point, arbitrary. Center administrators
can set their own criterion for agreement at 90%, 80% or any level they wish. Centers
using the AASM Inter-scorer Reliability testing program may wish to incorporate
the data into their quality assurance program. Consistent low agreement among all
technologists should lead to a review of the AASM Manual for the Scoring of Sleep
and Associated Events. Low agreement by a particular scorer should lead
to additional training, such as the AASM A-STEP Scoring Modules. Center administrators
will be able to compare their center and their staff to national scoring averages.
Review of this data may, at some point in the future, lead to the establishment
of a national standard for agreement.
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Q:
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How long should it take to score 200 epochs in the program?
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A:
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The length of time it takes to score 200 epochs will depend on the user.
It should take no more than two hours; experienced scorers may be able to complete the test in less than half an hour.
Because of the learning curve, you are encouraged to use the AASM Inter-scorer Reliability Demo to familiarize yourself with the testing system.
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Q:
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Can I take an exam over again if I did poorly or did not complete all questions?
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A:
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No. For the purposes of maintaining compliance with Standards for Accreditation,
the AASM Inter-scorer Reliability Testing Program allows individuals to take each
month’s exam only once. Once you click on the “Start My Exam” button, you will have
48 hours to complete the exam or your answers will be submitted as-is.
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Q:
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Do I need to take the exam from start to finish, or can I leave and come back?
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A:
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You are allowed to leave and come back to an exam. However, you must complete an
exam within 48 hours of when it was started, or your results will
be submitted based on the portion of the exam that you have completed.
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Q:
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Do the Scoring Manual FAQs found
on the AASM website apply to this program?
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A:
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Yes. FAQ answers should be considered part of the required scoring rules. For example,
the “pre-event” baseline oxygen saturation used to score hypopneas should follow
FAQ R.25.
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Q:
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What if I do not know my center’s accreditation number or primary e-mail address?
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A:
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You may obtain your center’s accreditation number by contacting the AASM’s accreditation
department by e-mail at accreditation@aasmnet.org
or by phone at (630) 737-9700.
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Q:
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Does the contact person for this program (account administrator) need to be the
same person as the primary contact for our facility’s accreditation?
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A:
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No. You may designate any individual at your center to serve as your Inter-scorer
Reliability testing program account administrator. This individual will receive
e-mail confirmations when new individual users set up accounts using your facility’s
access code and when your credit balance is low.
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Q:
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How do we change the account administrator for our center?
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A:
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Log in to your center’s account and enter the Account Information page. Click on
the “Edit” button under the Contact Information section and update your center’s
information.
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Q:
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How do I add individuals to my center’s account?
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A:
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To allow an individual to contribute their exam results to your center’s account
(and give them permission to use your facility’s exam credits), go to the Staff
Management page of your account, click on the “Send Access Code” button, and enter
their e-mail address. Once they have registered an Individual User Account using
your facility’s access code, you will receive an e-mail notification to confirm
that you wish to provide this individual with access to your center’s exam credits.
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Q:
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Someone has set up an individual user account using my facility’s access code, but
I don’t know who they are. Will this person now have access to our purchased exam
credits?
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A:
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No. Until you confirm that an individual is a member of your staff (by clicking
on the link in the confirmation e-mail or approving them under the Staff Management
page in your account), they will not have access to your center’s credits, nor will
their results be added to your center’s account. If someone uses your facility’s
access code to set up an account, you can simply click on the “Deny pending” next
to their name under the Staff Management page in your account to delete this individual.
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Q:
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One of our scorers has left our center or is no longer scoring sleep studies. Should
I delete them from our account?
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A:
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There are two ways of removing an individual’s access to your center’s exam credits:
- By deactivating their account, the individual will no longer contribute results
to your facility; however, if you wish to reactive them at some point in the future,
you will be able to do so without the need to re-register with your facility.
- By deleting their account, the individual will no longer contribute results
to your facility but their results from previously taken exams will not be lost.
In the future if you wish to provide this individual with access to your center’s
exam credits, they will need to add your center’s access code once again.
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Q:
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I sent our access code to our facility’s scorers and they have all set up individual
accounts, but cannot take any exams. What’s wrong?
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A:
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Either these individuals have not been confirmed as users of your account (to check
this, go to the Staff Management page of your administrator account) or your center
does not have any credits remaining under your account (you can purchase additional
credits by clicking on the “+” symbol in the upper right corner in your administrator
account).
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Q:
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What is the difference between a “Regular” and a “Temporary” individual user?
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A:
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A “Regular” individual user is one of your staff’s scorers whose exam results each
month should be added to your center’s overall data. A “Temporary” individual is
someone who is using this system through your center, but whose results should not
be included with your center’s data for accreditation purposes. Examples of temporary
individuals would be those who are using this program to test scoring ability while
applying for a job at your facility or staff who wish to use the program for training
purposes only.
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Q:
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I work at more than one center that uses this program. Do I need to have a separate
account for each center?
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A:
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No. Through the AASM’s Inter-scorer Reliability testing program, you can work at
multiple centers using your one Individual User account (take the exam once, and
your results will be added to all center’s accounts!).
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Q:
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How do I add another center to my account?
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A:
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Log in to your account and go to the Account Information page. At the bottom of
the page, you will see a list of the centers that you are affiliated with. Below
this table is a link to add additional centers.
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Q:
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What happens if one of my centers does not have any credits when I’m ready to take
the next exam?
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A:
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You may either contact the center that does not have credits and wait until they
have added them to take the exam, or you can take the exam using only the centers’
credits that are currently available. If you take the exam when a center does not
have credits, your results will not be added to the center’s account; however, the
center administrator will have the ability to add your results to their account
at a later time through the center's administrator account.
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