Hyperbaric Oxygen Therapy - Hyperbaric Chamber Information ...

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© Commonwealth of Australia 2001 ISSN (Print) 1443-7120 ISSN (Online) 1443-7139 This work is copyright. Apart from any use as permitted under the Copyright Act 1968 no part may be reproduced by any process without written permission from AusInfo. Requests and inquiries concerning reproduction and rights should be directed to the Manager, Legislative Services, AusInfo, GPO Box 1920, Canberra, ACT, 2601. Electronic copies of the report can be obtained from the Medicare Service Advisory Committee’s Internet site at: http://www.health.gov.au/haf/msac Hard copies of the report can be obtained from: The Secretary Medicare Services Advisory Committee Department of Health and Aged Care Mail Drop 107 GPO Box 9848 Canberra ACT 2601 Enquiries about the content of the report should be directed to the above address. The Medicare Services Advisory Committee is an independent committee which has been established to provide advice to the Commonwealth Minister for Health and Aged Care on the strength of evidence available on new and existing medical technologies and procedures in terms of their safety, effectiveness and cost-effectiveness. This advice will help to inform Government decisions about which medical services should attract funding under Medicare. This report was prepared by the Medicare Services Advisory Committee (MSAC) with the assistance of Dr Elmer Villanueva, Dr Renea Johnston, Ms Ornella Clavisi, Ms Elizabeth Burrows, Ms Vivienne Bernath, Ms Meera Rajendran, Mr Jason Wasiak, Dr Paul Fennessy and Associate Professor Jeremy Anderson, Centre for Clinical Effectiveness, Monash Institute of Public Health, Monash University and Mr Anthony Harris and Ms Karen Yong, Health Economics Unit, Monash University. The report was endorsed by the Commonwealth Minister for Health and Aged Care on 9 February 2001.
Contents Executive summary..................................................................................................x Introduction ............................................................................................................ 1 Background ............................................................................................................2 <strong>Hyperbaric</strong> oxygen therapy.............................................................................................2 The procedure ..................................................................................................................2 Intended purpose.............................................................................................................3 Clinical need......................................................................................................................4 Existing procedures and comparators ..........................................................................4 Marketing status of the device .......................................................................................5 Current reimbursement arrangement............................................................................5 Approach to assessment...........................................................................................8 Review of literature..........................................................................................................8 Expert advice..................................................................................................................13 Results of assessment............................................................................................. 14 Is it safe?..........................................................................................................................14 Is it effective?..................................................................................................................19 Thermal burns ................................................................................................................19 Diabetic wounds ............................................................................................................23 Non-diabetic wounds ....................................................................................................32 Necrotising soft tissue infections.................................................................................32 Necrotising fasciitis........................................................................................................35 Fournier’s gangrene .......................................................................................................38 Osteomyelitis ..................................................................................................................39 Osteoradionecrosis ........................................................................................................39 Skin graft survival...........................................................................................................41 Multiple sclerosis............................................................................................................43 Cardiovascular disease conditions ...............................................................................43 Acute myocardial infarction .........................................................................................43 Cerebrovascular disease ................................................................................................46 Peripheral obstructive arterial disease.........................................................................49 Soft tissue injuries ..........................................................................................................49 Cluster and migraine headaches...................................................................................51 Facial paralysis ................................................................................................................56 Sudden deafness and acoustic trauma.........................................................................57 Cancer..............................................................................................................................61 Carbon monoxide poisoning........................................................................................77 Necrotising arachnidism ...............................................................................................78 Actinomycosis ................................................................................................................78 <strong>Hyperbaric</strong> oxygen therapy iii
Page 1: Hyperbaric Oxygen Therapy November
Page 5 and 6: Tables Table 1 Measures of disease
Page 7 and 8: Table 45 Functional neurologic scor
Page 9 and 10: Figures Figure 1. Outline of search
Page 11 and 12: Effectiveness Published guidelines
Page 13 and 14: evidence that exposure to HBO may b
Page 15 and 16: No available evidence No evidence w
Page 17 and 18: Introduction The Medicare Services
Page 19 and 20: Multiplace chambers can accommodate
Page 21 and 22: Marketing status of the device The
Page 23 and 24: Table 3 1998 - 1999 self-reported d
Page 25 and 26: Table 6 retrieval. Indication-speci
Page 27 and 28: Phase of Search Initial Search Ful
Page 29 and 30: Conduct of meta-analysis When the d
Page 31 and 32: early as 1995. The guidelines - kno
Page 33 and 34: Table 10 Minimum staff qualificatio
Page 35 and 36: Is it effective? The review assesse
Page 37 and 38: Table 14 Patient criteria of includ
Page 39 and 40: offered ample details. The remainin
Page 41 and 42: characteristics compared to the tre
Page 43 and 44: Assessment of heterogeneity All the
Page 45 and 46: Odds ratio 10 1 0.1 0.01 A sensitiv
Page 47 and 48: Wound healing Two of the five ident
Page 49 and 50: Studies of necrotising soft tissue
Page 51 and 52: Summary Table 25 Survival in patien
Page 53 and 54:
Table 29 Therapeutic protocols used
Page 55 and 56:
Osteomyelitis The study by Esterhai
Page 57 and 58:
Summary The HBO group showed a stat
Page 59 and 60:
Summary These results are difficult
Page 61 and 62:
outcomes or that decreased the risk
Page 63 and 64:
Anderson et al 80 recruited non-pre
Page 65 and 66:
Summary The collected evidence exam
Page 67 and 68:
Table 46 Major outcomes following t
Page 69 and 70:
Page 71 and 72:
Table 53 Patient criteria of includ
Page 73 and 74:
Thirty-seven subjects (comparison g
Page 75 and 76:
whose hearing loss was not secondar
Page 77 and 78:
tinnitus (6 versus 3 subjects). Non
Page 79 and 80:
assume that all participants knew o
Page 81 and 82:
Page 83 and 84:
Table 65 Descriptive characteristic
Page 85 and 86:
Page 87 and 88:
These contrasted with the conclusio
Page 89 and 90:
Table 73 Patient criteria of includ
Page 91 and 92:
Summary There are conflicting resul
Page 93 and 94:
Summary separate and previously-stu
Page 95 and 96:
need to insulate patients from outs
Page 97 and 98:
Reactive effects A reactive effect
Page 99 and 100:
Cost of major amputation The hospit
Page 101 and 102:
Sensitivity analysis Table 79 shows
Page 103 and 104:
Table 80 Estimation of incremental
Page 105 and 106:
Sensitivity analysis Table 83 shows
Page 107 and 108:
Conclusions Safety Potential risks
Page 109 and 110:
Recommendations MSAC recommended th
Page 111 and 112:
Appendix B Supporting committee Sup
Page 113 and 114:
Appendix C Studies included in this
Page 115 and 116:
Necrotising soft tissue infections:
Page 117 and 118:
Soft tissue injuries: crush injurie
Page 119 and 120:
Cancer: cervix First Author and Yea
Page 121 and 122:
Appendix D Studies excluded in this
Page 123 and 124:
2. Shandling AH, Ellestad MH, Hart
Page 125 and 126:
5. Woo TCS, Joseph D, Oxer H. Hyper
Page 127 and 128:
22. Kunkler PB, Boulis-Wassif S, Sh
Page 129 and 130:
45. Wiernik G, Perrins D. The radio
Page 131 and 132:
Appendix E Calculation of monoplace
Page 133 and 134:
Hence, the total operating costs of
Page 135 and 136:
Appendix G Reviews received from ot
Page 137 and 138:
Sechrist Industries -- Hyperbaric O
Page 139 and 140:
References 1. Hampson N. Hyperbaric
Page 141 and 142:
31. L'Abbe K, Detsky A, O'Rourke K.
Page 143 and 144:
61. Perrins DJ. Influence of hyperb
Page 145 and 146:
89. DiSabato F, Giacovazzo M, Crist
Page 147:
117.Plenk HP. Hyperbaric radiation
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