Difference between revisions of "Porubsky"
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| − | <span style="font-size:x-large;"><span style="line-height:normal">'''<span style="font-family: | + | <span style="font-size:x-large;"><span style="line-height:normal">'''<span style="font-family:"><span style="color:black">There was no difference in the outcome from the treatment of tinnitus with two different hyperbaric oxygen regimens.</span></span>'''</span></span> |
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| − | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:">Clinical Bottom Line:</span></span>'''</span> |
| − | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:">1. No difference in outcome between the two HBOT groups</span></span>'''</span> |
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| − | <span style="line-height:normal">'''<span style="font-size:13.5pt"><span style="font-family: | + | <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.Porubsky, C., Stiegler, P., Matzi, V., Lipp, C., Kontaxis, A., Klemen, H., Smolle-Jüttner, F. Hyperbaric oxygen in tinnitus: Influence of psychological factors on treatment results? ORL : Journal for Oto - Rhino - Laryngology and its Related Specialties,2007; 69(2):107-12.</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Lead author's name and fax:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Christian Porubsky: christian.porubsky@klinikum-graz.at</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Three-part Clinical Question:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">For patients with tinnitus, does HBOT at 2.2 ATA for 60 mins daily for 15 days compared to a 2.5 ATA treatment on the same schedule result in any greater resolution of symptoms?<br/> '''Search Terms:''' tinnitus, hearing loss, retraining</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">The Study:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Non-blinded randomised controlled trial with intention-to-treat.<br/> '''The Study Patients:''' Patients presenting for the treatment of tinnitus (time from onset from < 2 wks to > 1 year).<br/> '''Control group''' (N = 180; 180 analysed): 100% oxygen breathing at 2.2 ATA for 60 minutes daily for 15 working days.<br/> '''Experimental group''' (N = 180; 180 analysed): As above but at 2.5 ATA.</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">The Evidence:</span></span></span>'''</span> |
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| − | | style="width:68.4pt; 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-family: | + | | style="width:68.4pt; 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-family:">Outcome</span>'''</span></p> |
| − | | style="width:45.3pt; border:solid windowtext 1.0pt" width="64" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family: | + | | style="width:45.3pt; border:solid windowtext 1.0pt" width="64" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:">Time to Outcome</span>'''</span></p> |
| − | | style="width:43.85pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family: | + | | style="width:43.85pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:">HBOT 2.2 ATA</span>'''</span></p> |
| − | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family: | + | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:">HBOT 2.4 ATA</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-family: | + | | 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-family:">Relative Risk Reduction</span>'''</span></p> |
| − | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family: | + | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:">Absolute Risk Reduction</span>'''</span></p> |
| − | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family: | + | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-family:">NNT</span>'''</span></p> |
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| rowspan="2" style="width:68.4pt; border:solid windowtext 1.0pt" width="94" | | | rowspan="2" style="width:68.4pt; border:solid windowtext 1.0pt" width="94" | | ||
| − | <span style="line-height:normal">'''<span style="font-family: | + | <span style="line-height:normal">'''<span style="font-family:">Complete or partial relief</span>'''</span> |
| − | | style="width:45.3pt; border:solid windowtext 1.0pt" width="64" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:45.3pt; border:solid windowtext 1.0pt" width="64" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">1 month</span></span></p> |
| − | | style="width:43.85pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:43.85pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">0.50</span></span></p> |
| − | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">0.49</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-family: | + | | 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-family:">2%</span></span></p> |
| − | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">0.01</span></span></p> |
| − | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">91</span></span></p> |
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| − | | colspan="3" style="width:140.25pt; border:solid windowtext 1.0pt" width="191" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | colspan="3" style="width:140.25pt; border:solid windowtext 1.0pt" width="191" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">95% CIs:</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-family: | + | | 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-family:">-18% to 23%</span></span></p> |
| − | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">-0.09 to 0.11</span></span></p> |
| − | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">NNT = 9 to INF; NNH = 11 to INF</span></span></p> |
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| − | <span style="line-height:normal">'''<span style="font-family: | + | <span style="line-height:normal">'''<span style="font-family:">No change in symptoms</span>'''</span> |
| − | | style="width:45.3pt; border:solid windowtext 1.0pt" width="64" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:45.3pt; border:solid windowtext 1.0pt" width="64" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">1 month</span></span></p> |
| − | | style="width:43.85pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:43.85pt; border:solid windowtext 1.0pt" width="60" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">0.50</span></span></p> |
| − | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:48.1pt; border:solid windowtext 1.0pt" width="66" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">0.51</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-family: | + | | 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-family:">-2%</span></span></p> |
| − | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">-0.01</span></span></p> |
| − | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">-91</span></span></p> |
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| − | | colspan="3" style="width:140.25pt; border:solid windowtext 1.0pt" width="191" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | colspan="3" style="width:140.25pt; border:solid windowtext 1.0pt" width="191" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">95% CIs:</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-family: | + | | 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-family:">-23% to 18%</span></span></p> |
| − | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:76.5pt; border:solid windowtext 1.0pt" width="104" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">-0.11 to 0.09</span></span></p> |
| − | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family: | + | | style="width:87.3pt; border:solid windowtext 1.0pt" width="119" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-family:">NNT = 11 to INF; NNH = 9 to INF</span></span></p> |
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| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">1. The authors were primarily interested in the effect of pre-treatment expectations on resolution of symptoms and the RCT aspect was a relatively minor aim.<br/> 2. I have assumed '2.2 bar' here was in fact 2.2 ATA.<br/> 3. Pre-treatment expectations influenced the chance of improvement (positive expectation 60.3% improved; negative expectation 19% improved. P < 0.05).<br/> 4. Time to HBOT did not have any statistically significant influence on outcome.<br/> 5. On non-random analysis the authors concluded HBOT was not better than placebo treatment results.</span></span></span></span> |
| − | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family: | + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Mike Bennett m.bennett@unsw.edu.au ; Tuesday, 3 January 2023<br/> '''Kill or Update By:''' January 2030</span></span></span></span> |
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Revision as of 02:53, 3 January 2023
There was no difference in the outcome from the treatment of tinnitus with two different hyperbaric oxygen regimens.
|
Clinical Bottom Line: 1. No difference in outcome between the two HBOT groups |
Citation/s:1.Porubsky, C., Stiegler, P., Matzi, V., Lipp, C., Kontaxis, A., Klemen, H., Smolle-Jüttner, F. Hyperbaric oxygen in tinnitus: Influence of psychological factors on treatment results? ORL : Journal for Oto - Rhino - Laryngology and its Related Specialties,2007; 69(2):107-12.
Lead author's name and fax:Christian Porubsky: christian.porubsky@klinikum-graz.at
Three-part Clinical Question:For patients with tinnitus, does HBOT at 2.2 ATA for 60 mins daily for 15 days compared to a 2.5 ATA treatment on the same schedule result in any greater resolution of symptoms?
Search Terms: tinnitus, hearing loss, retraining
The Study:Non-blinded randomised controlled trial with intention-to-treat.
The Study Patients: Patients presenting for the treatment of tinnitus (time from onset from < 2 wks to > 1 year).
Control group (N = 180; 180 analysed): 100% oxygen breathing at 2.2 ATA for 60 minutes daily for 15 working days.
Experimental group (N = 180; 180 analysed): As above but at 2.5 ATA.
The Evidence:
Outcome |
Time to Outcome |
HBOT 2.2 ATA |
HBOT 2.4 ATA |
Relative Risk Reduction |
Absolute Risk Reduction |
NNT |
|
Complete or partial relief |
1 month |
0.50 |
0.49 |
2% |
0.01 |
91 |
95% CIs: |
-18% to 23% |
-0.09 to 0.11 |
NNT = 9 to INF; NNH = 11 to INF | |||
|
No change in symptoms |
1 month |
0.50 |
0.51 |
-2% |
-0.01 |
-91 |
95% CIs: |
-23% to 18% |
-0.11 to 0.09 |
NNT = 11 to INF; NNH = 9 to INF | |||
Comments:
1. The authors were primarily interested in the effect of pre-treatment expectations on resolution of symptoms and the RCT aspect was a relatively minor aim.
2. I have assumed '2.2 bar' here was in fact 2.2 ATA.
3. Pre-treatment expectations influenced the chance of improvement (positive expectation 60.3% improved; negative expectation 19% improved. P < 0.05).
4. Time to HBOT did not have any statistically significant influence on outcome.
5. On non-random analysis the authors concluded HBOT was not better than placebo treatment results.
Appraised by:Mike Bennett m.bennett@unsw.edu.au ; Tuesday, 3 January 2023
Kill or Update By: January 2030
