Difference between revisions of "Hulshof"
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| − | + | <span style="font-size:large;">'''<span style="color: rgb(0, 51, 102); font-family: arial, helvetica, sans-serif;">No evidence that hyperbaric oxygen influences cognitive disorders after irradiation of the brain</span>'''</span> | |
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| + | | style="width: 388px;" | <span style="font-size:larger;">'''Clinical Bottom Line:''' </span><br/> <span style="font-size:medium;">1. Very small sample sizes with low power<br/> <span style="font-family: Arial, Helvetica, sans-serif;">2. No clear clinical implications</span></span> | ||
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| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Citation:'''</span> | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Citation:'''</span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Hulshof M, Stark N, Van der Kleij A, Sminia P, Smeding M, Gonzalez D. Hyperbaric oxygen therapy for cognitive disorders after irradiation of the brain. Strahlentherapie und Onkol 2001;177:192-8</span> |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Hulshof M, Stark N, Van der Kleij A, Sminia P, Smeding M, Gonzalez D. Hyperbaric oxygen therapy for cognitive disorders after irradiation of the brain. Strahlentherapie und Onkol 2001;177:192-8</span> | + | |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Lead author's name and fax:''' [[mailto:m.c.hulshof@amc.uva.nl | m.c.hulshof@amc.uva.nl]]</span> | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Lead author's name and fax:''' [[mailto:m.c.hulshof@amc.uva.nl| m.c.hulshof@amc.uva.nl]]</span> |
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Three-part Clinical Question:''' For patients with cognitive deficit following brain irradiation, dose the application of HBOT result in any improvement in function?</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Three-part Clinical Question:''' For patients with cognitive deficit following brain irradiation, dose the application of HBOT result in any improvement in function?</span> | ||
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<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Search Terms:''' Cognitive disorders, Brain irradiation, Late radiation effects</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Search Terms:''' Cognitive disorders, Brain irradiation, Late radiation effects</span> | ||
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study:''' Single-blinded randomised controlled trial without intention-to-treat.</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study:''' Single-blinded randomised controlled trial without intention-to-treat.</span> | ||
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<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study Patients:''' Adult patients with cognitive impairment at least 1.5 years after radiation</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study Patients:''' Adult patients with cognitive impairment at least 1.5 years after radiation</span> | ||
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<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Control group''' (n= 3) Nil specific treatment</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Control group''' (n= 3) Nil specific treatment</span> | ||
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<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Experimental group''' (n=4) 30 hyperbaric treatments at 3ATA for 115 minutes</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Experimental group''' (n=4) 30 hyperbaric treatments at 3ATA for 115 minutes</span> | ||
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Evidence:'''</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Evidence:'''</span> | ||
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| − | | | + | | style="width: 239px;" | <span><span>'''Non-Event Outcomes'''</span></span> |
| + | | style="width: 119px; text-align: center;" | <span><span>'''Time to outcome/s'''</span></span> | ||
| + | | style="width: 101px; text-align: center;" | <span><span>'''Control group'''</span></span> | ||
| + | | style="width: 113px; text-align: center;" | <span><span>'''HBOT group'''</span></span> | ||
| + | | style="width: 107px; text-align: center;" | <span><span>'''P-value'''</span></span> | ||
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| + | | style="width: 239px;" | <span>31 neuropsychological tests</span><br/> <span>Mean difference only indicated for one</span> | ||
| + | | style="width: 119px; text-align: center;" | <span><span>directly after HBO</span></span> | ||
| + | | style="width: 101px; text-align: center;" | <span><span>not given</span></span> | ||
| + | | style="width: 113px; text-align: center;" | <span><span>not given</span></span> | ||
| + | | style="width: 107px; text-align: center;" | <span><span>0.016</span></span> | ||
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<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Comments:'''</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Comments:'''</span> | ||
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<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">1.The one test outcome that significantly improved was a self-assesment test, and could have been influenced by not being blinded</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">1.The one test outcome that significantly improved was a self-assesment test, and could have been influenced by not being blinded</span> | ||
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<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">2. Multiple comparisons in small sample size means high probability that this finding could be due to chance</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">2. Multiple comparisons in small sample size means high probability that this finding could be due to chance</span> | ||
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<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">3. Differences between control group and experimental group in tumour type, localization and radiation field</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">3. Differences between control group and experimental group in tumour type, localization and radiation field</span> | ||
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Appraised by''': Annelies van der Hulst, Hyperbaric Unit, Prince of Wales Hospital, Randwick NSW.; Tuesday 16th August 2005 Email: [[mailto:m.bennett@unsw.edu.au | m.bennett@unsw.edu.au]]</span> | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Appraised by''': Annelies van der Hulst, Hyperbaric Unit, Prince of Wales Hospital, Randwick NSW.; Tuesday 16th August 2005 Email: [[mailto:m.bennett@unsw.edu.au| m.bennett@unsw.edu.au]]</span> |
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Kill or Update By:''' December 2020</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Kill or Update By:''' December 2020</span> | ||
| − | [[File: | + | [[File:Sumhorsa.gif|center|Sumhorsa.gif]] |
| − | <span style="color: #7c00ff; display: block; font-family: arial,helvetica,sans-serif; font-size: 26px; text-align: center;">'''[[ | + | <span style="color: #7c00ff; display: block; font-family: arial,helvetica,sans-serif; font-size: 26px; text-align: center;">'''[[Radiation_tissue_injury|BACK]]'''</span> |
Latest revision as of 01:00, 9 July 2019
No evidence that hyperbaric oxygen influences cognitive disorders after irradiation of the brain
| Clinical Bottom Line: 1. Very small sample sizes with low power 2. No clear clinical implications |
Citation: Hulshof M, Stark N, Van der Kleij A, Sminia P, Smeding M, Gonzalez D. Hyperbaric oxygen therapy for cognitive disorders after irradiation of the brain. Strahlentherapie und Onkol 2001;177:192-8
Lead author's name and fax: [m.c.hulshof@amc.uva.nl]
Three-part Clinical Question: For patients with cognitive deficit following brain irradiation, dose the application of HBOT result in any improvement in function?
Search Terms: Cognitive disorders, Brain irradiation, Late radiation effects
The Study: Single-blinded randomised controlled trial without intention-to-treat.
The Study Patients: Adult patients with cognitive impairment at least 1.5 years after radiation
Control group (n= 3) Nil specific treatment
Experimental group (n=4) 30 hyperbaric treatments at 3ATA for 115 minutes
The Evidence:
| Non-Event Outcomes | Time to outcome/s | Control group | HBOT group | P-value |
| 31 neuropsychological tests Mean difference only indicated for one |
directly after HBO | not given | not given | 0.016 |
Comments:
1.The one test outcome that significantly improved was a self-assesment test, and could have been influenced by not being blinded
2. Multiple comparisons in small sample size means high probability that this finding could be due to chance
3. Differences between control group and experimental group in tumour type, localization and radiation field
Appraised by: Annelies van der Hulst, Hyperbaric Unit, Prince of Wales Hospital, Randwick NSW.; Tuesday 16th August 2005 Email: [m.bennett@unsw.edu.au]
Kill or Update By: December 2020
