Krajcovicová - Revision history

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M.bennett at 06:16, 13 January 2021

2021-01-13T06:16:01Z

M.bennett at 06:14, 13 January 2021

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'''Some evidence of better hearing outcome with hyperbaric oxygen added to a polypharmacy regimen including steroids for idiopathic sudden hearing loss'''

{| class="Table" style="width: 739px;" width="0"
|- style="height:29.7pt"
| style="width: 727px;" |
'''Clinical Bottom Line'''

'''1. More individuals improved when HBOT was added to a pharmacological treatment regimen.'''

|}

'''Citation/s:'''1. Krajcovicova Z, Melus V, Zigo R, Matisáková I, Vecera J, Kalíková K. Efficacy of hyperbaric oxygen therapy as a supplementary therapy of sudden sensorineural hearing loss in the Slovak Republic. Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc. 2018;45(3):363-70. '''Lead author's name and fax: '''Zdenka Krajcovicová zdenka.krajcovicova@tnuni.sk

'''Three-part Clinical Question:'''For patients with idiopathic sudden sensorineural hearing loss (ISSNHL), does the addition of hyperbaric oxygen to standard treatment result in any further improvement in hearing? '''Search Terms:''' Sudden hearing loss; steroids; pentoxifylline

'''The Study:'''Non-blinded randomised controlled trial with intention-to-treat. '''The Study Patients:''' Adults with unilateral ISSNHL (41 to 60dB loss). '''Control group''' (N = 21; 20 analysed): Polypharmacy including steroids intravenously days 1 to 5 then orally to day 15, pentoxifylline and betahistine. '''Experimental group''' (N = 47; 47 analysed): As above plus 100% oxygen breathing at 2.0 ATA for 90 minutes daily for 10 days.

'''The Evidence:'''

{| class="Table" style="border:solid windowtext 1.0pt"
|-
| style="width:110.9pt; border:solid windowtext 1.0pt" width="151" | '''Outcome'''
| style="width:49.2pt; border:solid windowtext 1.0pt" width="68" | '''Time to Outcome'''
| style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | '''Control group'''
| style="width:38.5pt; border:solid windowtext 1.0pt" width="53" | '''HBO group'''
| style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | '''Relative risk reduction'''
| style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | '''Absolute risk reduction'''
| style="width:58.95pt; border:solid windowtext 1.0pt" width="82" | '''NNT'''
|-
| rowspan="2" style="width:110.9pt; border:solid windowtext 1.0pt" width="151" | '''Improvement in ave pure tone hearing threshold (>10dB)'''
| style="width:49.2pt; border:solid windowtext 1.0pt" width="68" | day15?
| style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | 0.29
| style="width:38.5pt; border:solid windowtext 1.0pt" width="53" | 0.62
| style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | 116%
| style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | 0.33
| style="width:58.95pt; border:solid windowtext 1.0pt" width="82" | 3
|-
| colspan="3" style="width:133.2pt; border:solid windowtext 1.0pt" width="180" | 95% CIs:
| style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | 32% to 199%
| style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | 0.09 to 0.57
| style="width:58.95pt; border:solid windowtext 1.0pt" width="82" | 2 to 11
|}

 

{| class="Table" style="border:solid windowtext 1.0pt"
|-
| rowspan="2" style="width:139.25pt; border:solid windowtext 1.0pt" width="189" | '''Measure'''
| colspan="2" style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | '''Control Group'''
| colspan="2" style="width:76.45pt; border:solid windowtext 1.0pt" width="104" | '''HBO Group'''
| rowspan="2" style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | '''Difference'''
| rowspan="2" style="width:94.4pt; border:solid windowtext 1.0pt" width="129" | '''95% CI'''
|-
| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | Mean
| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | SD
| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | Mean
| style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | SD
|-
| style="width:139.25pt; border:solid windowtext 1.0pt" width="189" |
'''Mean threshold at mid-frequency 1000-2000 Hz after treatment (dB)'''

| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | 28.9
| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | 18.8
| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | 26.5
| style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | 23.5
| style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | 2.4
| style="width:94.4pt; border:solid windowtext 1.0pt" width="129" | -260.7 to 265.5
|-
| style="width:139.25pt; border:solid windowtext 1.0pt" width="189" |
'''Mean threshold at high frequencies (4000 to 8000 Hz) after treatment (dB)'''

| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | 45.1
| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | 21.6
| style="width:33.95pt; border:solid windowtext 1.0pt" width="47" | 37.5
| style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | 29.6
| style="width:62.3pt; border:solid windowtext 1.0pt" width="85" | 7.6
| style="width:94.4pt; border:solid windowtext 1.0pt" width="129" | -395.1 to 410.3
|}

'''Comments:''' 1. No indication of any sample size calculation. Patients were randomised to hyperbaric/control in a ratio of 2:1. 2. Method of randomisation not stated, but control patient ratio 'determined by the capacity of the hyperbaric chamber for individuals with a given diagnosis'. 3. Complete recovery to within 10dB loss compared to the other ear in the higher frequencies was only 6.4% in the HBOT group and 0% with pharmacology only.

'''Appraised by:'''Mike Bennett m.bennett@unsw.edu.au; Tuesday, 12 January 2021 '''Kill or Update By:''' January 2023

@@ Line 10: / Line 10: @@
 |}
 <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Citation/s:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">1. Krajcovicova Z, Melus V, Zigo R, Matisáková I, Vecera J, Kalíková K. Efficacy of hyperbaric oxygen therapy as a supplementary therapy of sudden sensorineural hearing loss in the Slovak Republic. Undersea & hyperbaric medicine: journal of the Undersea and Hyperbaric Medical Society, Inc. 2018;45(3):363-70.<br/> '''Lead author's name and fax: '''Zdenka Krajcovicová zdenka.krajcovicova@tnuni.sk</span></span></span></span>
@@ Line 19: / Line 21: @@
 <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">The Evidence:</span></span></span>'''</span>
-{| class="Table" style="border:solid windowtext 1.0pt"
+{| class="Table" style="border: 1pt solid windowtext; width: 660px;"
 |-
 | style="width:110.9pt; border:solid windowtext 1.0pt" width="151" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Outcome</span></span>'''</span></p>
@@ Line 25: / Line 27: @@
 | style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Control group</span></span>'''</span></p>
 | style="width:38.5pt; border:solid windowtext 1.0pt" width="53" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">HBO group</span></span>'''</span></p>
-| style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Relative risk reduction</span></span>'''</span></p>
+| style="width: 107px; border: 1pt solid windowtext;" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Relative risk reduction</span></span>'''</span></p>
-| style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Absolute risk reduction</span></span>'''</span></p>
+| style="width: 90px; border: 1pt solid windowtext;" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Absolute risk reduction</span></span>'''</span></p>
-| style="width:58.95pt; border:solid windowtext 1.0pt" width="82" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">NNT</span></span>'''</span></p>
+| style="width: 79px; border: 1pt solid windowtext;" width="82" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">NNT</span></span>'''</span></p>
 |-
 | rowspan="2" style="width:110.9pt; border:solid windowtext 1.0pt" width="151" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:">Improvement in ave pure tone hearing threshold (>10dB)</span></span>'''</span></p>
@@ Line 33: / Line 35: @@
 | style="width:42.5pt; border:solid windowtext 1.0pt" width="59" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.29</span></span></span></p>
 | style="width:38.5pt; border:solid windowtext 1.0pt" width="53" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.62</span></span></span></p>
-| style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">116%</span></span></span></p>
+| style="width: 107px; border: 1pt solid windowtext;" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">116%</span></span></span></p>
-| style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.33</span></span></span></p>
+| style="width: 90px; border: 1pt solid windowtext;" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.33</span></span></span></p>
-| style="width:58.95pt; border:solid windowtext 1.0pt" width="82" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">3</span></span></span></p>
+| style="width: 79px; border: 1pt solid windowtext;" width="82" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">3</span></span></span></p>
 |-
 | colspan="3" style="width:133.2pt; border:solid windowtext 1.0pt" width="180" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">95% CIs:</span></span></span></p>
-| style="width:69.35pt; border:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">32% to 199%</span></span></span></p>
+| style="width: 107px; border: 1pt solid windowtext;" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">32% to 199%</span></span></span></p>
-| style="width:69.4pt; border:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.09 to 0.57</span></span></span></p>
+| style="width: 90px; border: 1pt solid windowtext;" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">0.09 to 0.57</span></span></span></p>
-| style="width:58.95pt; border:solid windowtext 1.0pt" width="82" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2 to 11</span></span></span></p>
+| style="width: 79px; border: 1pt solid windowtext;" width="82" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:">2 to 11</span></span></span></p>
 |}
@@ Line 81: / Line 83: @@
 <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">1. No indication of any sample size calculation. Patients were randomised to hyperbaric/control in a ratio of 2:1.<br/> 2. Method of randomisation not stated, but control patient ratio 'determined by the capacity of the hyperbaric chamber for individuals with a given diagnosis'.<br/> 3. Complete recovery to within 10dB loss compared to the other ear in the higher frequencies was only 6.4% in the HBOT group and 0% with pharmacology only.</span></span></span></span>
-<span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au; Tuesday, 12 January 2021<br/> '''Kill or Update By:''' January 2023</span></span></span></span>
+<span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au; Tuesday, 12 January 2021<br/> '''Kill or Update By:''' June 2023</span></span></span></span>
-<p style="text-align: center;">&nbsp;</p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;">&nbsp;</p> <p style="text-align: center;"><span style="font-size:xx-large;">[http://hboevidence.wikis.unsw.edu.au/Audiovestibular BACK]</span></p>
+<p style="text-align: center;">&nbsp;</p> <p style="text-align: center;">[[File:Sumhorsa.gif|center|Sumhorsa.gif]]</p> <p style="text-align: center;">&nbsp;</p> <p style="text-align: center;"><span style="font-size:xx-large;">[[Audiovestibular|BACK]]</span></p>

← Older revision		Revision as of 06:16, 13 January 2021
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	<span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">1. No indication of any sample size calculation. Patients were randomised to hyperbaric/control in a ratio of 2:1.<br/> 2. Method of randomisation not stated, but control patient ratio 'determined by the capacity of the hyperbaric chamber for individuals with a given diagnosis'.<br/> 3. Complete recovery to within 10dB loss compared to the other ear in the higher frequencies was only 6.4% in the HBOT group and 0% with pharmacology only.</span></span></span></span>		<span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">1. No indication of any sample size calculation. Patients were randomised to hyperbaric/control in a ratio of 2:1.<br/> 2. Method of randomisation not stated, but control patient ratio 'determined by the capacity of the hyperbaric chamber for individuals with a given diagnosis'.<br/> 3. Complete recovery to within 10dB loss compared to the other ear in the higher frequencies was only 6.4% in the HBOT group and 0% with pharmacology only.</span></span></span></span>
−	~~<p style="text-align: center;">~~<span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au; Tuesday, 12 January 2021<br/> '''Kill or Update By:''' January 2023</span></span></span></span>~~</p>~~ <p style="text-align: center;"> </p> <p style="text-align: center;"></p> <p style="text-align: center;"> </p> <p style="text-align: center;"><span style="font-size:xx-large;">[http://hboevidence.wikis.unsw.edu.au/Audiovestibular BACK]</span></p>	+
		+	<span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:13.5pt"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au; Tuesday, 12 January 2021<br/> '''Kill or Update By:''' January 2023</span></span></span></span>
		+	<p style="text-align: center;"> </p> <p style="text-align: center;">[[File:Sumhorsa.gif\|center\|Sumhorsa.gif]]</p> <p style="text-align: center;"> </p> <p style="text-align: center;"><span style="font-size:xx-large;">[http://hboevidence.wikis.unsw.edu.au/Audiovestibular BACK]</span></p>