An Open Note regarding Integrity

[rested gal]

I hope this thread doesn't scare away any potential Respironics buyers. My feeling is that not everyone will read everything written in this thread. Many newbies will only read the highlights and perhaps will come away with a negative feeling. And I'm not saying that the thread started with the intent to give negative thoughts.

I agree, Linda.

I've owned two Respironics Autos. One with cflex and one without. I've never, ever had a problem with either one. I have no complaints whatsoever.

-----
How do you feel about your Respironics machine? Would you buy one again? I definitely would.

I owned those two models too, and liked both of them. Yes, I'd buy a Respironics machine again. In fact, I did, when I bought the BiPAP Auto.

I've also gotten good treatment from other brands I've used. For years, even when I was using another brand of machine, I've often recommended the Respironics Auto, especially after they added C-flex to their Auto. They make very good machines, imho. Saying that does not mean I think other manufacturers don't make equally good machines.

ANY of the machines have some features, or something about their software, that one person might love and another hate.

Any individual might find that one brand or type of machine treats their particular form of sleep disordered breathing better than another brand or type does. -SWS explained very well why that is so. His words are worth reading, re-reading, and re-re-reading, imho:

In May 2006, -SWS cautioned against labeling technical limitations as "bugs" in algorithms; listing reasons for current technical limitations in xpap machines:

Just be aware that many of those problems truly are limitations of today's technology. I'll underscore the crux of today's technical limitations one more time for the non-technical readers who are following:

1) Patient airflow signals are highly complex composite signals that are comprised of many contributing factors

2) Those highly complex composite signals, unfortunately, manifest with great diversity across the human population

3) The SDB events themselves can never be directly measured via the patient airflow signal

4) Rather, each SDB event type must be indirectly derived on a probability basis from that airflow signal

5) Because airflow signals are so complex and diverse across the human population (even more so across the SDB patient population) there are no 100% probability airflow signals.

6) The lack of "100% probability" airflow signals across the SDB patient population is precisely why any given algorithm cannot achieve a 100% compatibility or efficacy rate across the patient population.

So simply being aware of the fact that many of the problems you document have to do with technical limitations versus "bugs" will probably go a long way toward interfacing with manufacturers.

[mtandst]

[quote="Linda3032"]I hope this thread doesn't scare away any potential Respironics buyers. My feeling is that not everyone will read everything written in this thread. Many newbies will only read the highlights and perhaps will come away with a negative feeling. And I'm not saying that the thread started with the intent to give negative thoughts.

I've owned two Respironics Autos. One with cflex and one without. I've never, ever had a problem with either one. I have no complaints whatsoever. True, I've not tried other machines. I'm just too pleased with the Respironics to switch.

How do you feel about your Respironics machine? Would you buy one again? I definitely would.

[DreamStalker]

So simply being aware of the fact that many of the problems you document have to do with technical limitations versus "bugs" will probably go a long way toward interfacing with manufacturers.

As a relative newbie to the xPAP technology, I am curious if there are other “technological limitations” other than the algorithms used for APAP? I assume that “bugs” are fixable flaws of the intended design.

It seems there is a wide open field of research for the algorithm technology of APAPs. Wouldn’t it be nice if the manufacturers were able to provide more than one algorithm (sort of like the SUV of APAPs) … with current microchip technology, I don’t see why it is not being done other than there needs to be more competition. Perhaps it is not so much technological limitations but rather a lack of research initiative(s).

- roberto

[dsm]

Rested Gal,

There are issues here that should be resolved else they will fester, lets try to boil this issue down to its' basics.

I am interpreting your remarks as along the lines
'no one has the right to criticise aspects of a machine because you believe we don't have the expertise to do so'


Pls can you answer these questions, it will help me better understand your POV ...

Q1) If someone has a reason to want to discuss a feature of a particular machine that could be a flaw how do they do it without having the thread hijacked or squashed ?

Q2) Are you making a case that argues that xpap machines have no problems ?


Q3) If you acknowledge that some machines may have problems, how do we discuss them without the typical burst of 'so and so doesn't have that problem' posts long before any details have emerged as to circumstances ? (anyone using cpap knows that machines will work differently for different people. The full circumstances have to be taken into account).


Q4) Do you or don't you think people here are smart enough to work out for themselves if a particular issue being discussed has relevance to them ?

Q5) Why do you seem to lead the charge to scuttle discussions any time they involve issues with Respironics machines ?

I would like to clear the air on these matters as I take my research seriously and have spent a lot of my own money to back up the things I look into. I do get frustrated when topics get sidelined with deliberate distractions before any serious analysis is discussed.

Thanks

DSM

[wading thru the muck!]

I even bought a very old (Respironics) Bipap S/T-D model

I'll admit that I'm a Respironics fan, but in no way am I going to use a machine called an S-T-D. LOL!

[roster]

[quote="Fletch"]People get surprisingly combative when their buying decisions are questioned. I bought a new pickup truck earlier this year and never having owned one before I went to forums very similar to this one to get user opinions. You would be amazed at the level of flamewars that can erupt over a small truck!

People don't want to appear stupid, they especially don't want to be seen to have made a stupid or illinformed purchase of a big ticket item. That alone seems enough for them to wish to justify their purchasing decision if it is questioned by others.

Trust me Resmed vs Resprionics is like nothing compared to Tacoma vs Frontier, and let's never have the Mac vs PC debate!

[GoofyUT]

[quote="Fletch"]People get surprisingly combative when their buying decisions are questioned. I bought a new pickup truck earlier this year and never having owned one before I went to forums very similar to this one to get user opinions. You would be amazed at the level of flamewars that can erupt over a small truck!

People don't want to appear stupid, they especially don't want to be seen to have made a stupid or illinformed purchase of a big ticket item. That alone seems enough for them to wish to justify their purchasing decision if it is questioned by others.

Trust me Resmed vs Resprionics is like nothing compared to Tacoma vs Frontier, and let's never have the Mac vs PC debate!



Fletch-

Thanks so much for your post! It is exquisitely on the mark! As a psychologist, I CAN say that the phenomenon that you describe is SO common that it has been well studied and written about in the literature of psychology. Its called "Attribution theory." If I buy I Chevy, then I gotta believe that Chevys are THE BEST. Otherwise, I am stupid and worthless for choosing to buy one. In fact, to make myself feel REALLY good, I have to try to convince others too, that Chevys are the BEST! (I hate Chevys! Just my opinion, tho.)

Though I recognize therefore, that attribution theory figures prominently in the opinions that all of us express here, I nonetheless simply want to urge my colleagues to offer the most objective and uninfluenced or unbiased impressions that they can muster in order for us to provide the greatest possible support to one another. We are all sufferers of SDB with hopes, and I take seriously my opportunity to learn from everyone else here, and to occasionally provide some assistance to others who come here looking for it.

Howver, I do recognize that this is simply an ideal (though one that I am proud to articulate). In the meantime, I'll continue to urge honesty in making disclosures of possible biases and influences affecting posted impressions, for those with the integrity to heed those urgings. And, I'll take EVERYTHING that I read here with a grain of salt, and with respect for the principle of CAVEAT EMPTOR. Above all else, I continue to PLEAD with my fellow members of this and the larger SDB community to insist on being given the RIGHT to TRY BEFORE YOU BUY!!!

BTW, I use a Macintosh and I think that anyone who uses a PC is JUST PLAIN STUPID!!!! (Just KIDDING!!! HONEST!!!)

Chuck

[GoofyUT]

My head hurts a little bit from reading through this whole post, but I knew I shouldn't comment until I had. The only thing that I see missed, is if people are representatives from any company the last thing they would do is tell you. They are not going to provide any disclaimer, nor are they going to read a thread about integrity.

Given that, the only audience I think this thread is geared towards are the regular posters. Which leads me to believe there is some question in regards to their integrity. So if you are excited about a new product you have tried and it works for you, then how can you express that without falling under suspicion?

I know this happened to me recently regarding my Hybrid review. It was not free to me, but the perception was I had been compensated for a postive review. I tried to make sure I gave a balanced review, addressing the plusses and minusses of what I was experiencing and what I look for in a mask. But for some, my positive response in how it worked for me was taken as a paid endorsement.

My best advice is balance everything you read, but don't discount the fact that people are sometimes just excited and wanting to help. There is another board where everyone is called a manufacturer shill, and the negativity of that made me adopt this board as my home. The practice does happen, but they usually aren't constant contributors.

My take is to assume integrity unless you have specific proof to the contrary.

Mike-

I feel compelled to point out that you are one of tghe members of this community who's integrity, honesty, wit and wisdom is beyond question in my opinion, and I for one, remain tremendously grateful for the life and spirit that you bring us that has well seen me through my darkest and most skeptical moments in this wild and crazy adventure.

Howver, I wish that I could agree that the presumption of integrity is warranted here. I've been sad to witness the repeated instances of vitriol, often personalized, when someone occasions an opinion that runs against the prevailing loyalties of certain members here. These instances have occured with greater frquency and with greater venom than I can simply write off to attribution theory or pride in our purchases.

Anyhow, the beauty of this forum is that we are free to disagree. I do not for an instant though, regret raising the issues that have been so vitally discussed in this thread.

Chuck

[Moogy]

Rested Gal,

There are issues here that should be resolved else they will fester, lets try to boil this issue down to its' basics.

I am interpreting your remarks as along the lines
'no one has the right to criticise aspects of a machine because you believe we don't have the expertise to do so'

DSM,

I read RestedGal's post, and I CERTAINLY did not see anything close to this this in her remarks.

Moogy

[Moogy]

My take is to assume integrity unless you have specific proof to the contrary.

YES! AMEN! Thanks Mike!

Moogy

[mikemoran]

Chuck,

Maybe my post got lost or misconstured. So I want to be a little clearer.

Who is this thread directed towards?

If someone is really in the manufacturer's pocket, by payolla or payroll, do you really think they will disclose?

I have no doubt there is good intention behind your initial post, but if I was new to the board it would create suspicion on everyones motive who posted here.

On another board if you are not a frequent poster, if you make any comment regarding equipment (good or bad), you are confronted as if you are working for a manufacturer.

I strongly hope we don't start the same level of distructive paranoia.

My disclaimer - The only thing that buys my positive response to a product or supplier, is its effectiveness and the service I receive.

Mike who is too often accused of not being serious in my posts, but feels strongly about this one.

[GoofyUT]

Ya know, I've stumbled through life, and I haven't learned much along the way. One thing that life HAS taught me is to extend a warm and welcoming hand in friendship to anyone I happen upon, while keeping my other hand planted firmly on my wallet. At least until I've learned that there is no further need for me to do so.

So, my posts are directed to our communtiy as a whole. I agree that those with other than compassionate motives will be sitting here chuckling over all of this. But what the hell....

Chuck

[mikemoran]

Chuck,

Yeah, you are right. almost feel better about someone picking my pocket for my wallet, than getting me to hand it over to them willingly. Now I guess its time for me to start touting my ResMed Autopap as the greatest thing since blown air. Just as soon as their check clears. LOL

[Guest]

Just be aware that many of those problems truly are limitations of today's technology. I'll underscore the crux of today's technical limitations one more time for the non-technical readers who are following:

1) Patient airflow signals are highly complex composite signals that are comprised of many contributing factors

2) Those highly complex composite signals, unfortunately, manifest with great diversity across the human population

3) The SDB events themselves can never be directly measured via the patient airflow signal

4) Rather, each SDB event type must be indirectly derived on a probability basis from that airflow signal

5) Because airflow signals are so complex and diverse across the human population (even more so across the SDB patient population) there are no 100% probability airflow signals.

6) The lack of "100% probability" airflow signals across the SDB patient population is precisely why any given algorithm cannot achieve a 100% compatibility or efficacy rate across the patient population.

So simply being aware of the fact that many of the problems you document have to do with technical limitations versus "bugs" will probably go a long way toward interfacing with manufacturers.

Thanks for posting that, rested gal.

I'm one of the 'non-technical readers' -SWS mentioned and I appreciate that he took the time to clarify this issue so well. What I take away from this discussion is that the differing results users have (even when using identical machines) are caused by the idiosyncracies of the user and not because the machine has a "bug" or "flaw"... otherwise everyone using the same machine would experience the same issues.

Though it's clear from reading all the posts in this thread not everyone using the same machine experiences the same issues, that doesn't lead me to question that these issues actually occur. I value every bit of input I read from every user about what they've learned in researching how a particular machine works (or doesn't work) for them. When I read about problems someone has with a machine, I keep in mind it is that individual's findings based on their experience. Most people are pretty conscientious about relaying this because they'll report their findings and follow up with, "This was my experience, YMMV," and not, "This was my experience, so there's obviously something wrong with the machine."

I realize different people using the exact same machine can have different results and I understand these differences are caused by technical limitations (thanks to -SWS for that terminology) and not by "bugs" or "flaws". I'm aware these technical limitations are present for every manufacturer, whether it be Resmed, Respironics, Purtian Bennett, etc. If I were to assume someone who reports they don't have the problems described by another user of a particular manufacturer's machine is doing so because they must have a vested interest in that manufacturer, then I would have to assume anyone who reports a problem with a particular manufacturer's machine must have a vested interest in the competitor. I assume neither.

[Snoredog]

This is all like reading a Horoscope