Difference between revisions of "Stiegler"
 
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<span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:"><span style="color:black">No difference in tinnitus outcome between two hyperbaric oxygen protocols</span></span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:18.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">No difference in tinnitus outcome between two hyperbaric oxygen protocols</span></span></span>'''</span>
  
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<span style="line-height:normal">'''<span style="font-size:16.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Clinical Bottom Line:</span></span></span>'''</span>
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">1. There was no difference in outcome depending on the HBOT protocol<br/> 2. No information on the efficacy of HBOT comapred to no HBOT</span></span></span>'''</span>
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<span style="line-height:normal"><span style="font-size:16.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">1. There was no difference in outcome depending on the HBOT protocol<br/> 2. No information on the efficacy of HBOT compared to no HBOT</span></span></span></span>
  
 
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<span style="line-height:normal">'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Citation/s:</span></span></span>'''<span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">1. Stiegler P, Matzi V, Lipp C, Kontaxis A, Klemen H, Walch C, Smolle-Jüttner F. Hyperbaric oxygen (HBO2) in tinnitus: influence of psychological factors ontreatment results? Undersea Hyperb Med. 2006 Nov-Dec;33(6):429-37.<br/> '''Lead author's name and fax: '''Stiegler: None given</span></span></span></span>
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<span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Citation/s:</span></span></span>'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">1. Stiegler P, Matzi V, Lipp C, Kontaxis A, Klemen H, Walch C, Smolle-Jüttner F. Hyperbaric oxygen (HBO2) in tinnitus: influence of psychological factors ontreatment results? Undersea Hyperb Med. 2006 Nov-Dec;33(6):429-37.<br/> '''Lead author's name and fax: '''Stiegler: None given</span></span></span></span>
  
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<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 adult patients with tinnitus, does treatment with hyperbaric oxygen at 2.2 ATA compared to 2.5 ATA result in any improvement in outcome?<br/> '''Search Terms:''' Tinnitus, hyperbaric protocol</span></span></span></span>
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<span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Three-part Clinical Question:</span></span></span>'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">For adult patients with tinnitus, does treatment with hyperbaric oxygen at 2.2 ATA compared to 2.5 ATA result in any improvement in outcome?<br/> '''Search Terms:''' Tinnitus, hyperbaric protocol</span></span></span></span>
  
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<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 without intention-to-treat.<br/> '''The Study Patients:''' Adult patients where a decsion has been made to treat with hyperbaric oxygen therapy<br/> '''Control group''' (N = 156; 156 analysed): 100% oxygen treatments at 2.2ATA for 60 minutes daily for 15 consecutive days<br/> '''Experimental group''' (N = 156; 156 analysed): Methods as above but at 2.5ATA.</span></span></span></span>
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<span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">The Study:</span></span></span>'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Non-blinded randomised controlled trial without intention-to-treat.<br/> '''The Study Patients:''' Adult patients where a decision has been made to treat with hyperbaric oxygen therapy<br/> '''Control group''' (N = 156; 156 analysed): 100% oxygen treatments at 2.2ATA for 60 minutes daily for 15 consecutive days<br/> '''Experimental group''' (N = 156; 156 analysed): Methods as above but at 2.5ATA.</span></span></span></span>
  
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<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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<span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">The Evidence:</span></span></span>'''</span>
  
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| style="width:96.6pt" width="132" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">Outcome</span></span>'''</span></p>  
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| style="width:99.75pt; border:solid windowtext 1.0pt" width="142" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Outcome</span></span>'''</span></p>  
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| style="width:48.1pt" 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-size:10.0pt"><span style="font-family:">Time to Outcome</span></span>'''</span></p>  
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| style="width:55.5pt; border:solid windowtext 1.0pt" width="79" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Time to Outcome</span></span>'''</span></p>  
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| style="width:41.05pt" 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:10.0pt"><span style="font-family:">2.2 ATA rate</span></span>'''</span></p>  
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| style="width:47.25pt; border:solid windowtext 1.0pt" width="68" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">2.2 ATA rate</span></span>'''</span></p>  
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| style="width:41.0pt" 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:10.0pt"><span style="font-family:">2.5 ATA rate</span></span>'''</span></p>  
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| style="width:51.75pt; border:solid windowtext 1.0pt" width="83" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">2.5 ATA rate</span></span>'''</span></p>  
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| style="width:62.3pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">Relative risk reduction</span></span>'''</span></p>  
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| style="width:66.0pt; 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:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Relative risk reduction</span></span>'''</span></p>  
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| style="width:62.3pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">Absolute risk difference</span></span>'''</span></p>  
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| style="width:93.75pt; border:solid windowtext 1.0pt" width="132" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Absolute risk difference</span></span>'''</span></p>  
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| style="width:87.15pt" 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-size:10.0pt"><span style="font-family:">NNT</span></span>'''</span></p>  
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| style="width: 103px; border: 1pt solid windowtext;" width="133" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">NNT</span></span>'''</span></p>  
 
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| rowspan="2" style="width:96.6pt" width="132" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">Improved or resolved after treatment</span></span>'''</span></p>  
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| rowspan="2" style="width:99.75pt; border:solid windowtext 1.0pt" width="142" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">Improved or resolved after treatment</span></span>'''</span></p>  
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| style="width:48.1pt" 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-size:10.0pt"><span style="font-family:">1 month</span></span>'''</span></p>  
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| style="width:55.5pt; border:solid windowtext 1.0pt" width="79" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">1 month</span></span>'''</span></p>  
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| style="width:41.05pt" 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:10.0pt"><span style="font-family:">0.49</span></span>'''</span></p>  
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| style="width:47.25pt; border:solid windowtext 1.0pt" width="68" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.49</span></span>'''</span></p>  
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| style="width:41.0pt" 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:10.0pt"><span style="font-family:">0.48</span></span>'''</span></p>  
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| style="width:51.75pt; border:solid windowtext 1.0pt" width="83" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.48</span></span>'''</span></p>  
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| style="width:62.3pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">2%</span></span>'''</span></p>  
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| style="width:66.0pt; 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:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">2%</span></span>'''</span></p>  
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| style="width:62.3pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:">0.01</span></span>'''</span></p>  
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| style="width:93.75pt; border:solid windowtext 1.0pt" width="132" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">0.01</span></span>'''</span></p>  
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| style="width:87.15pt" 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-size:10.0pt"><span style="font-family:">83</span></span>'''</span></p>  
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| style="width: 103px; border: 1pt solid windowtext;" width="133" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal">'''<span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">83</span></span>'''</span></p>  
 
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| colspan="3" style="width:133.15pt" 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:10.0pt"><span style="font-family:">95% CIs:</span></span></span></p>  
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| colspan="3" style="width:164.25pt; border:solid windowtext 1.0pt" width="230" | <p align="right" style="margin-bottom:.0001pt; text-align:right; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">95% CIs:</span></span></span></p>  
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| style="width:62.3pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">-20% to 25%</span></span></span></p>  
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| style="width:66.0pt; 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:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">-20% to 25%</span></span></span></p>  
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| style="width:62.3pt" width="85" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:">-0.099 to 0.123</span></span></span></p>  
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| style="width:93.75pt; border:solid windowtext 1.0pt" width="132" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">-0.10 to 0.12</span></span></span></p>  
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| style="width:87.15pt" 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-size:10.0pt"><span style="font-family:">NNT = 8 to INF; NNH = 10 to INF</span></span></span></p>  
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| style="width: 103px; border: 1pt solid windowtext;" width="133" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:.75pt .75pt .75pt .75pt"><span style="line-height:normal"><span style="font-size:10.0pt"><span style="font-family:" times="" new="" roman",serif"="">NNT = 8 to INF; NNH = 10 to INF</span></span></span></p>  
 
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<span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Comments:</span></span></span>'''<br/> <span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">1. 360 patients treated in the whole cohort, but only 312 had outcomes recorded. It is not clear why.<br/> 2. No comparison made between HBOT and no HBOT in this study.<br/> 3. Randomisation method not specified and no other randomised outcomes reported.<br/> 4. Authors suggest the outcome is dependent on expectations for success prior to treatment</span></span></span></span>
  
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<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. 360 patients treated in the whole cohort, but only 312 had outcomes recorded. It is not clear why.<br/> 2. No comparison made between HBOT and no HBOT in this study.<br/> 3. Randomisation method not specified and no other randomised outcomes reported.<br/> 4. Authors suggest the outcome is dependent on expectations for success prior to treatment</span></span></span></span>
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<span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Appraised by:</span></span></span>'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Mike Bennett m.bennett@unsw.edu.au; Sunday, 5 January 2020</span></span></span></span><br/> &nbsp;
  
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<span style="line-height:normal"><span style="font-size:12.0pt"><span style="font-family:"><span style="color:black">Appraised by: Mike Bennett m.bennett@unsw.edu.au; Sunday, 5 January 2020<br/> Email:<br/> '''Kill or Update By:''' January 2023</span></span></span></span>
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<span style="line-height:normal">'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">Kill or Update By:</span></span></span>'''<span style="font-size:14.0pt"><span style="font-family:" times="" new="" roman",serif"=""><span style="color:black">January 2023</span></span></span></span>
  
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Latest revision as of 01:59, 30 September 2021

No difference in tinnitus outcome between two hyperbaric oxygen protocols

Clinical Bottom Line:

1. There was no difference in outcome depending on the HBOT protocol
2. No information on the efficacy of HBOT compared to no HBOT

Citation/s:1. Stiegler P, Matzi V, Lipp C, Kontaxis A, Klemen H, Walch C, Smolle-Jüttner F. Hyperbaric oxygen (HBO2) in tinnitus: influence of psychological factors ontreatment results? Undersea Hyperb Med. 2006 Nov-Dec;33(6):429-37.
Lead author's name and fax: Stiegler: None given

Three-part Clinical Question:For adult patients with tinnitus, does treatment with hyperbaric oxygen at 2.2 ATA compared to 2.5 ATA result in any improvement in outcome?
Search Terms: Tinnitus, hyperbaric protocol

The Study:Non-blinded randomised controlled trial without intention-to-treat.
The Study Patients: Adult patients where a decision has been made to treat with hyperbaric oxygen therapy
Control group (N = 156; 156 analysed): 100% oxygen treatments at 2.2ATA for 60 minutes daily for 15 consecutive days
Experimental group (N = 156; 156 analysed): Methods as above but at 2.5ATA.

The Evidence:

Outcome

Time to Outcome

2.2 ATA rate

2.5 ATA rate

Relative risk reduction

Absolute risk difference

NNT

Improved or resolved after treatment

1 month

0.49

0.48

2%

0.01

83

95% CIs:

-20% to 25%

-0.10 to 0.12

NNT = 8 to INF; NNH = 10 to INF

Comments:
1. 360 patients treated in the whole cohort, but only 312 had outcomes recorded. It is not clear why.
2. No comparison made between HBOT and no HBOT in this study.
3. Randomisation method not specified and no other randomised outcomes reported.
4. Authors suggest the outcome is dependent on expectations for success prior to treatment

Appraised by:Mike Bennett m.bennett@unsw.edu.au; Sunday, 5 January 2020
 

Kill or Update By:January 2023

 

Sumhorsa.gif

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