Question · asked by 1 review

Hyperbaric oxygen therapy plus standard care (surgery, antibiotics, oral rinse) vs Standard care alone (surgery, antibiotics, oral rinse): Healing of osteonecrosis - improvement ('healed' or 'improved' vs 'unchanged' or 'worse')

Population
People with BRONJ (mean age ~66 years; most treated with bisphosphonates for cancer (multiple myeloma, breast cancer) or osteoporosis)
Intervention
Hyperbaric oxygen therapy plus standard care (surgery, antibiotics, oral rinse)
Comparison
Standard care alone (surgery, antibiotics, oral rinse)
Outcome
Healing of osteonecrosis - improvement ('healed' or 'improved' vs 'unchanged' or 'worse')

Hyperbaric oxygen therapy plus standard care (surgery, antibiotics,… showed no clear difference in healing of osteonecrosis - improvement ('healed' or 'improved' vs… compared with standard care alone (surgery, antibiotics, oral rinse); GRADE not reported.

What each review found

Include earlier review versions
No studies found 0 · 0%GRADE not reported 4 · 80%Very low 1 · 20%Low 0 · 0%Moderate 0 · 0%High 0 · 0%
FindingEffectStudiesGRADE certainty
Hyperbaric oxygen therapy plus standard care (surgery, antibiotics, oral rinse) vs Standard care alone (surgery, antibiotics, oral rinse)
Healing of osteonecrosis - improvement ('healed' or 'improved' vs 'unchanged' or 'worse') · People with BRONJ (mean age ~66 years; most treated with bisphosphonates for cancer (multiple myeloma, breast cancer)… · 18 months
Hyperbaric oxygen therapy plus standard care (surgery, antibiotics,… showed no clear difference in healing of osteonecrosis - improvement ('healed' or 'improved' vs… compared with standard care alone (surgery, antibiotics, oral rinse); GRADE not reported.
Interventions for treating bisphosphonate‐related osteonecrosis of the jaw (BRONJ) (2016) · Cochrane All outcomes
RR 1.75 [0.51, 5.98]1 study · 18 participantsGRADE not reported
Hyperbaric oxygen therapy plus standard care (surgery, antibiotics, oral rinse) vs Standard care alone (surgery, antibiotics, oral rinse)
Healing of osteonecrosis - improvement ('healed' or 'improved' vs 'unchanged' or 'worse') · People with BRONJ (mean age ~66 years; most treated with bisphosphonates for cancer (multiple myeloma, breast cancer)… · Last contact
Hyperbaric oxygen therapy plus standard care (surgery, antibiotics,… showed no clear difference in healing of osteonecrosis - improvement ('healed' or 'improved' vs… compared with standard care alone (surgery, antibiotics, oral rinse); GRADE not reported.
Interventions for treating bisphosphonate‐related osteonecrosis of the jaw (BRONJ) (2016) · Cochrane All outcomes
RR 1.78 [0.97, 3.28]1 study · 46 participantsGRADE not reported
Hyperbaric oxygen therapy plus standard care (surgery, antibiotics, oral rinse) vs Standard care alone (surgery, antibiotics, oral rinse)
Healing of osteonecrosis - improvement ('healed' or 'improved' vs 'unchanged' or 'worse') · People with BRONJ (mean age ~66 years; most treated with bisphosphonates for cancer (multiple myeloma, breast cancer)… · 3 months
It is very uncertain whether hyperbaric oxygen therapy plus standard care (surgery, antibiotics,… changes healing of osteonecrosis - improvement ('healed' or 'improved' vs… compared with standard care alone (surgery, antibiotics, oral rinse) (very low certainty).
Interventions for treating bisphosphonate‐related osteonecrosis of the jaw (BRONJ) (2016) · Cochrane All outcomes
RR 1.94 [1.01, 3.74]1 study · 45 participantsVery low
Hyperbaric oxygen therapy plus standard care (surgery, antibiotics, oral rinse) vs Standard care alone (surgery, antibiotics, oral rinse)
Healing of osteonecrosis - improvement ('healed' or 'improved' vs 'unchanged' or 'worse') · People with BRONJ (mean age ~66 years; most treated with bisphosphonates for cancer (multiple myeloma, breast cancer)… · 6 months
Hyperbaric oxygen therapy plus standard care (surgery, antibiotics,… showed no clear difference in healing of osteonecrosis - improvement ('healed' or 'improved' vs… compared with standard care alone (surgery, antibiotics, oral rinse); GRADE not reported.
Interventions for treating bisphosphonate‐related osteonecrosis of the jaw (BRONJ) (2016) · Cochrane All outcomes
RR 1.31 [0.78, 2.22]1 study · 40 participantsGRADE not reported
Hyperbaric oxygen therapy plus standard care (surgery, antibiotics, oral rinse) vs Standard care alone (surgery, antibiotics, oral rinse)
Healing of osteonecrosis - improvement ('healed' or 'improved' vs 'unchanged' or 'worse') · People with BRONJ (mean age ~66 years; most treated with bisphosphonates for cancer (multiple myeloma, breast cancer)… · 12 months
Hyperbaric oxygen therapy plus standard care (surgery, antibiotics,… showed no clear difference in healing of osteonecrosis - improvement ('healed' or 'improved' vs… compared with standard care alone (surgery, antibiotics, oral rinse); GRADE not reported.
Interventions for treating bisphosphonate‐related osteonecrosis of the jaw (BRONJ) (2016) · Cochrane All outcomes
RR 1.65 [0.75, 3.64]1 study · 24 participantsGRADE not reported

Findings are shown side by side, never pooled across reviews.

The reviews

ReviewSearched up toIncluded studiesAMSTAR 2
Interventions for treating bisphosphonate‐related osteonecrosis of the jaw (BRONJ)
2016 · Cochrane All outcomes
2015-12Not listedNot assessed
How reviews are matched to this question

Reviews word the same question differently. Four decision models (TypeSafe's Jev, Liquid AI's d1-ultra, SubQ Snap and Baseten's Elephant) judged each wording of the population, intervention, comparator and outcome against the others; two wordings count as the same when at least three of them agree and none clearly disagrees, and findings count as this question only when all four elements match. Timing, setting and subgroup never split a question: they are shown on each finding.