关键词: European Committee for Hyperbaric Medicine Evidence Medical conditions and problems Symposium Systematic review

Mesh : Bacterial Infections / therapy Biomedical Research / standards Brain Injuries / therapy Burns / therapy Carbon Monoxide Poisoning / therapy Crush Injuries / therapy Decompression Sickness / therapy Embolism, Air / therapy Europe Evidence-Based Medicine Femur Head Necrosis / therapy Fractures, Open / therapy Hearing Loss, Sudden / therapy Humans Hyperbaric Oxygenation / methods standards Osteomyelitis / therapy Radiation Injuries / therapy Skin Transplantation Wound Healing

来  源:   DOI:10.28920/dhm47.1.24-32   PDF(Sci-hub)

Abstract:
The tenth European Consensus Conference on Hyperbaric Medicine took place in April 2016, attended by a large delegation of experts from Europe and elsewhere. The focus of the meeting was the revision of the European Committee on Hyperbaric Medicine (ECHM) list of accepted indications for hyperbaric oxygen treatment (HBOT), based on a thorough review of the best available research and evidence-based medicine (EBM). For this scope, the modified GRADE system for evidence analysis, together with the DELPHI system for consensus evaluation, were adopted. The indications for HBOT, including those promulgated by the ECHM previously, were analysed by selected experts, based on an extensive review of the literature and of the available EBM studies. The indications were divided as follows: Type 1, where HBOT is strongly indicated as a primary treatment method, as it is supported by sufficiently strong evidence; Type 2, where HBOT is suggested as it is supported by acceptable levels of evidence; Type 3, where HBOT can be considered as a possible/optional measure, but it is not yet supported by sufficiently strong evidence. For each type, three levels of evidence were considered: A, when the number of randomised controlled trials (RCTs) is considered sufficient; B, when there are some RCTs in favour of the indication and there is ample expert consensus; C, when the conditions do not allow for proper RCTs but there is ample and international expert consensus. For the first time, the conference also issued \'negative\' recommendations for those conditions where there is Type 1 evidence that HBOT is not indicated. The conference also gave consensus-agreed recommendations for the standard of practice of HBOT.
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