Difference between revisions of "Massey"
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| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 19px;">'''Some evidence that bladder function was improved following hyperbaric oxygen treatment in chronic progressive multiple sclerosis.'''</span> |
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| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">''' | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Clinical Bottom Line:''' </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">1.Possible improvement in bladder function for patients after hyperbaric oxygen exposure. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">2.Reportedly no change in neurologic examination, Kurtze disability scale, ambulation, visual acuity or evoked potentials.</span> |
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| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">''' | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Appraised by:''' Mike Bennett, Dept of Diving and Hyperbaric Medicine, Prince of Wales Hospital </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Sydney; Friday, 12 March 1999</span> |
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| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">''' | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Clinical Scenario:''' A patient with chronic progressive multiple sclerosis presented for consideration of hyperbaric oxygen therapy. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Three-part Question: For patients with chronic progressive multiple sclerosis, does the addition of hyperbaric oxygen treatment to the usual care result in any improvement in disability or symptoms? </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Search Terms:''' Hyperbaric oxygenation, multiple sclerosis</span> |
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| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Study:''' </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Double-blinded randomised controlled trial without intention-to-treat. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Patients with chronic progressive multiple sclerosis. No other details. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Control group (N = 18; 18 analysed): Sham hyperbaric oxygen treatments on 10% oxygen at 2ATA for 90 minutes daily for 20 treatments over four weeks. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Experimental group (N = 18; 18 analysed): Oxygen at 2ATA for 90 minutes on the same schedule as above.</span> |
| − | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Evidence:'''</span> | |
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| + | {| class="Table" style="border:solid windowtext 1.0pt" | ||
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| − | | < | + | | style="border:solid windowtext 1.0pt" | <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:" times="" new="" roman",serif"="">Outcome</span></span>'''</span></p> |
| + | | style="width:55.1pt; border:solid windowtext 1.0pt" width="75" | <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:" times="" new="" roman",serif"="">Time to Outcome</span></span>'''</span></p> | ||
| + | | style="width:41.05pt; border:solid windowtext 1.0pt" width="57" | <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:" times="" new="" roman",serif"="">Air group</span></span>'''</span></p> | ||
| + | | style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <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:" times="" new="" roman",serif"="">HBO group</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:" times="" new="" roman",serif"="">Relative risk reduction</span></span>'''</span></p> | ||
| + | | style="width:76.45pt; 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-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Absolute risk reduction</span></span>'''</span></p> | ||
| + | | style="width:66.05pt; border:solid windowtext 1.0pt" width="91" | <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:" times="" new="" roman",serif"="">NNT</span></span>'''</span></p> | ||
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| − | | <span style'''" | + | | style="border:solid windowtext 1.0pt" | |
| + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">Bladder function improved</span></span>'''</span> | ||
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| + | | style="width:55.1pt; border:solid windowtext 1.0pt" width="75" | <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:" times="" new="" roman",serif"="">unknown</span></span></span></p> | ||
| + | | style="width:41.05pt; border:solid windowtext 1.0pt" width="57" | <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:" times="" new="" roman",serif"="">0.11</span></span></span></p> | ||
| + | | style="width:41.0pt; border:solid windowtext 1.0pt" width="57" | <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:" times="" new="" roman",serif"="">0.5</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:" times="" new="" roman",serif"="">78%</span></span></span></p> | ||
| + | | style="width:76.45pt; 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-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.39</span></span></span></p> | ||
| + | | style="width:66.05pt; border:solid windowtext 1.0pt" width="91" | <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:" times="" new="" roman",serif"="">-3</span></span></span></p> | ||
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| + | | style="border:solid windowtext 1.0pt" | | ||
| + | <span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">95% CI:</span></span>'''</span> | ||
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| + | | style="width:55.1pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="75" | | ||
| + | | style="width:41.05pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="57" | | ||
| + | | style="width:41.0pt; border:solid windowtext 1.0pt; padding:.75pt .75pt .75pt .75pt" width="57" | | ||
| + | | 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:" times="" new="" roman",serif"="">23% - 100%</span></span></span></p> | ||
| + | | style="width:76.45pt; 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-size:12.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.12 to 0.67</span></span></span></p> | ||
| + | | style="width:66.05pt; border:solid windowtext 1.0pt" width="91" | <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:" times="" new="" roman",serif"="">-2 to -9</span></span></span></p> | ||
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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%;">1. Abstract reports only with little detail. </span> | + | |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">2. No explanation of how bladder function was evaluated. </span> | + | <span style="font-family: Arial, Helvetica, sans-serif; font-size: 120%;">'''Comments:''' </span> <span style="font-family: Arial, Helvetica, sans-serif; font-size: 120%;">1. Abstract reports only with little detail. </span> <span style="font-family: Arial, Helvetica, sans-serif; font-size: 120%;">2. No explanation of how bladder function was evaluated. </span> <span style="font-family: Arial, Helvetica, sans-serif; font-size: 120%;">3. Multiple other parameters used as outcome measures were reported to show no differences between the groups. </span> <span style="font-family: Arial, Helvetica, sans-serif; font-size: 120%;">4. Follow-up was 10 months but it is not clear when the data reported was taken.</span> |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">3. Multiple other parameters used as outcome measures were reported to show no differences between the groups. </span> | + | |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">4. Follow-up was 10 months but it is not clear when the data reported was taken. </span> | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Expiry date:''' January 2015</span> |
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| + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''References:'''</span> | ||
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| + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">1. Massey EW, Shelton DL, Pact V, Greenburg J, Erwin W, Satzman H, Bennett P. Hyperbaric oxygen in multiple sclerosis: a double-blind crossover study of 18 patients. Neurology 1985; 35 (suppl 1):104.</span> | ||
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| + | <span style="font-family: verdana,arial,helvetica; font-size: 120%;">2. Erwin CW, Massey EW, Brendle AC, Shelton DL, Bennett PB. Hyperbaric oxygen influences on the visual evoked potentials in multiple sclerosis patients. Neurology 1985; 35(suppl 1):104.</span> | ||
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| − | + | <span style="display: block; text-align: center;"><span style="color: #7c00ff; font-family: arial,helvetica,sans-serif; font-size: 22px;">'''[[Multiple_Sclerosis|BACK]]'''</span></span> | |
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Revision as of 02:19, 7 April 2020
Some evidence that bladder function was improved following hyperbaric oxygen treatment in chronic progressive multiple sclerosis.
Clinical Bottom Line: 1.Possible improvement in bladder function for patients after hyperbaric oxygen exposure. 2.Reportedly no change in neurologic examination, Kurtze disability scale, ambulation, visual acuity or evoked potentials.
Appraised by: Mike Bennett, Dept of Diving and Hyperbaric Medicine, Prince of Wales Hospital Sydney; Friday, 12 March 1999
Clinical Scenario: A patient with chronic progressive multiple sclerosis presented for consideration of hyperbaric oxygen therapy. Three-part Question: For patients with chronic progressive multiple sclerosis, does the addition of hyperbaric oxygen treatment to the usual care result in any improvement in disability or symptoms? Search Terms: Hyperbaric oxygenation, multiple sclerosis
The Study: Double-blinded randomised controlled trial without intention-to-treat. Patients with chronic progressive multiple sclerosis. No other details. Control group (N = 18; 18 analysed): Sham hyperbaric oxygen treatments on 10% oxygen at 2ATA for 90 minutes daily for 20 treatments over four weeks. Experimental group (N = 18; 18 analysed): Oxygen at 2ATA for 90 minutes on the same schedule as above.
The Evidence:
Outcome |
Time to Outcome |
Air group |
HBO group |
Relative risk reduction |
Absolute risk reduction |
NNT |
|
Bladder function improved |
unknown |
0.11 |
0.5 |
78% |
0.39 |
-3 |
|
95% CI: |
23% - 100% |
0.12 to 0.67 |
-2 to -9 |
Comments: 1. Abstract reports only with little detail. 2. No explanation of how bladder function was evaluated. 3. Multiple other parameters used as outcome measures were reported to show no differences between the groups. 4. Follow-up was 10 months but it is not clear when the data reported was taken.
Expiry date: January 2015
References:
1. Massey EW, Shelton DL, Pact V, Greenburg J, Erwin W, Satzman H, Bennett P. Hyperbaric oxygen in multiple sclerosis: a double-blind crossover study of 18 patients. Neurology 1985; 35 (suppl 1):104.
2. Erwin CW, Massey EW, Brendle AC, Shelton DL, Bennett PB. Hyperbaric oxygen influences on the visual evoked potentials in multiple sclerosis patients. Neurology 1985; 35(suppl 1):104.
