Difference between revisions of "Raskin"
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| − | <span style="font- | + | <span style="font-size:x-large;"><span style="font-family: Arial, Helvetica, sans-serif;">'''There was no improvement in memory, behaviour or psychometric testing with hyperbaric oxygen therapy in patients with cognitive impairment of the elderly.'''</span></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> |
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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%;">1. No evidence of a benefit from hyperbaric oxygen therapy in memory function or psychometric performance in cognitive impairment of the elderly.</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; Tuesday, 9 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 75 year old patient with cognitive impairment related to age.</span> |
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| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''hree-part Question:''' In patients with a diagnosis of cognitive impairment of the elderly, does the application of hyperbaric oxygen compared to normobaric oxygen or air, result in any demonstrable improvement in intellectual ability or memory? </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Search Terms:''' Hyperbaric oxygenation, dementia</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%;">'''The Study:''' </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Double-blind randomised controlled trial without intention-to-treat. </span> <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Ambulatory patients aged 60 to 85 years who tested to a minimum on an age-related adult intelligence scale vocabulary sub-test (to allow completion of outcome measures) and had a demonstrated deficit of 1 standard deviation or more on 3 out of 5 sub-tests of memory.</span> |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">1. Complex outcome measures not presented with clarity. </span> | + | |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">2. This study also tested normobaric oxygen against placebo in a further two arms (not reported here). </span> | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Control group (N = 22; 20 analysed): 10% oxygen at 2.3ATA for 90 minutes twice daily for 15 days.</span> |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">3. There were eight significant differences in 101 F tests across the four groups. </span> | + | |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">4. There was an 'acclimatisation period' of seven days, during which 38 patients were withdrawn and replaced by others. It is not clear what effect this may have had on the outcome. </span> | + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">Experimental group (N = 27; 20 analysed): 100% oxygen at 2.5ATA for 90 minutes twice daily for 15 days.</span> |
| − | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">5. Authors mention repeated assessment up to 8 weeks but have not given supporting results in this paper. </span> | + | |
| + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''The Evidence:'''</span> | ||
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| + | {| class="MsoTableGrid" style="border-collapse:collapse; border:solid windowtext 1.0pt" | ||
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| + | | style="width:127.35pt; border:solid windowtext 1.0pt" width="170" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal">'''<span style="font-size:13.0pt">Non-Event Outcomes</span>'''</span></p> | ||
| + | | style="width:4.0cm; border:solid windowtext 1.0pt; border-left:none" width="151" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal">'''<span style="font-size:13.0pt">Time to outcome</span>'''</span></p> | ||
| + | | style="width:70.85pt; border:solid windowtext 1.0pt; border-left:none" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal">'''<span style="font-size:13.0pt">Air group</span>'''</span></p> | ||
| + | | style="width:70.9pt; border:solid windowtext 1.0pt; border-left:none" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal">'''<span style="font-size:13.0pt">HBO group</span>'''</span></p> | ||
| + | | style="width:68.3pt; border:solid windowtext 1.0pt; border-left:none" width="91" | <p align="center" style="text-align:center; padding:0cm 5.4pt 0cm 5.4pt">'''<span style="font-size:13.0pt"><span style="font-family:" calibri",sans-serif"="">P-value</span></span>'''</p> | ||
| + | |- | ||
| + | | style="width:127.35pt; border:solid windowtext 1.0pt; border-top:none" width="170" | | ||
| + | <span style="line-height:normal">'''<span style="font-size:12.0pt">Recall of faces scale (undefined)</span>'''</span> | ||
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| + | | style="width:4.0cm; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="151" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal"><span style="font-size:12.0pt">Two weeks</span></span></p> | ||
| + | | style="width:70.85pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal"><span style="font-size:12.0pt">3.29</span></span></p> | ||
| + | | style="width:70.9pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal"><span style="font-size:12.0pt">3.93</span></span></p> | ||
| + | | style="width:68.3pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="91" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal"><span style="font-size:12.0pt">NS</span></span></p> | ||
| + | |- | ||
| + | | style="width:127.35pt; border:solid windowtext 1.0pt; border-top:none" width="170" | | ||
| + | <span style="line-height:normal">'''<span style="font-size:12.0pt">Mean memory quotient (0 to 100)</span>'''</span> | ||
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| + | | style="width:4.0cm; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="151" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal"><span style="font-size:12.0pt">Two weeks</span></span></p> | ||
| + | | style="width:70.85pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="94" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal"><span style="font-size:12.0pt">78</span></span></p> | ||
| + | | style="width:70.9pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="95" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal"><span style="font-size:12.0pt">73</span></span></p> | ||
| + | | style="width:68.3pt; border-top:none; border-left:none; border-bottom:solid windowtext 1.0pt; border-right:solid windowtext 1.0pt" width="91" | <p align="center" style="margin-bottom:.0001pt; text-align:center; padding:0cm 5.4pt 0cm 5.4pt"><span style="line-height:normal"><span style="font-size:12.0pt">NS</span></span></p> | ||
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| + | <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. Complex outcome measures not presented with clarity.</span> | ||
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| + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">2. This study also tested normobaric oxygen against placebo in a further two arms (not reported here).</span> | ||
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| + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">3. There were eight significant differences in 101 F tests across the four groups.</span> | ||
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| + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">4. There was an 'acclimatisation period' of seven days, during which 38 patients were withdrawn and replaced by others. It is not clear what effect this may have had on the outcome.</span> | ||
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| + | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">5. Authors mention repeated assessment up to 8 weeks but have not given supporting results in this paper.</span> | ||
<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Expiry date:''' June 2020</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''Expiry date:''' June 2020</span> | ||
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<span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''References:''' 1. Raskin A, Gershon S, Crook T, Sathananthan G, Ferris S. The effects of hyperbaric and normobaric oxygen on cognitive impairment in the elderly. Archives of General Psychiatry 1978; 35:50-56.</span> | <span style="font-family: Arial,Helvetica,sans-serif; font-size: 120%;">'''References:''' 1. Raskin A, Gershon S, Crook T, Sathananthan G, Ferris S. The effects of hyperbaric and normobaric oxygen on cognitive impairment in the elderly. Archives of General Psychiatry 1978; 35:50-56.</span> | ||
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| − | <span style="color: #7c00ff; display: block; font-size: 22.1px; text-align: center;">[[ | + | <span style="color: #7c00ff; display: block; font-size: 22.1px; text-align: center;">[[Neuro_-_miscellaneous|BACK]]</span> |
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Latest revision as of 01:39, 13 May 2021
There was no improvement in memory, behaviour or psychometric testing with hyperbaric oxygen therapy in patients with cognitive impairment of the elderly.
Clinical Bottom Line:
1. No evidence of a benefit from hyperbaric oxygen therapy in memory function or psychometric performance in cognitive impairment of the elderly.
Appraised by: Mike Bennett, Dept of Diving and Hyperbaric Medicine, Prince of Wales Hospital Sydney; Tuesday, 9 March 1999
Clinical Scenario: A 75 year old patient with cognitive impairment related to age.
hree-part Question: In patients with a diagnosis of cognitive impairment of the elderly, does the application of hyperbaric oxygen compared to normobaric oxygen or air, result in any demonstrable improvement in intellectual ability or memory? Search Terms: Hyperbaric oxygenation, dementia
The Study: Double-blind randomised controlled trial without intention-to-treat. Ambulatory patients aged 60 to 85 years who tested to a minimum on an age-related adult intelligence scale vocabulary sub-test (to allow completion of outcome measures) and had a demonstrated deficit of 1 standard deviation or more on 3 out of 5 sub-tests of memory.
Control group (N = 22; 20 analysed): 10% oxygen at 2.3ATA for 90 minutes twice daily for 15 days.
Experimental group (N = 27; 20 analysed): 100% oxygen at 2.5ATA for 90 minutes twice daily for 15 days.
The Evidence:
Non-Event Outcomes |
Time to outcome |
Air group |
HBO group |
P-value |
|
Recall of faces scale (undefined) |
Two weeks |
3.29 |
3.93 |
NS |
|
Mean memory quotient (0 to 100) |
Two weeks |
78 |
73 |
NS |
Comments:
1. Complex outcome measures not presented with clarity.
2. This study also tested normobaric oxygen against placebo in a further two arms (not reported here).
3. There were eight significant differences in 101 F tests across the four groups.
4. There was an 'acclimatisation period' of seven days, during which 38 patients were withdrawn and replaced by others. It is not clear what effect this may have had on the outcome.
5. Authors mention repeated assessment up to 8 weeks but have not given supporting results in this paper.
Expiry date: June 2020
References: 1. Raskin A, Gershon S, Crook T, Sathananthan G, Ferris S. The effects of hyperbaric and normobaric oxygen on cognitive impairment in the elderly. Archives of General Psychiatry 1978; 35:50-56.
