The HyperbaricLink Evidence Index
The HyperbaricLink Evidence Index provides you with a handy reference to the state of clinical evidence on hyperbaric
oxygen therapy (HBOT) for many diseases and conditions.
The more you know about the clinical evidence, the better you can participate in your healthcare, work with your
physician, and help advance evidence-based hyperbaric medical research.
For some off-label indications the medical literature strongly supports further research and investigational use of
hyperbaric oxygen therapy. For others the clinical evidence is weak (scant) or totally lacking (none).
The Evidence Index can help you be a more informed patient, but it can’t take the place of proper medical consultation.
Talk to your doctor before you begin hyperbaric oxygen therapy, and use the information you find here to ask more informed
HyperbaricLink Evidence Index scoring is based solely on our reading and interpretation of the medical literature. We
distinguish six categories of clinical evidence:
Approved — HBOT indicated and widely reimbursed. Only FDA-cleared and UHMS-approved clinical
indications earn this rating.
Learn more about FDA clearance and UHMS approval »
Compelling — Strong body of evidence supporting evidence-based practice. A select few
off-label indications for hyperbaric oxygen therapy merit such interest and encouragement.
Promising — Repeatedly favorable results urging further study. Hyperbaric oxygen therapy
has demonstrated real promise for just a handful off-label diseases and conditions.
Scant — Early or mixed results with lingering questions. We find scant evidence for the
majority of off-label indications for hyperbaric oxygen therapy.
None — Unfavorable results or no published evidence. HyperbaricLink is unlikely to publish
pages on diseases and conditions for which there is no published evidence on HBOT.
Disproved — Strong evidence against using hyperbaric oxygen therapy. Null findings in the
hyperbaric medical literature have not yet eliminated any diseases or conditions from further clinical investigation.
We look at a broad range of medical literature in scoring our Evidence Index, but we don’t give every paper equal weight.
Some studies are better designed and conducted than others.
Some clinical investigators and healthcare institutions are more influential than others.
Some medical journals are more highly regarded than others.
The most reliable clinical findings spring from large, prospective, randomized controlled trials (RCTs) published in
major peer-reviewed journals. The US Food and Drug Administration (FDA) and Undersea and Hyperbaric Medical Society (UHMS)
require RCT evidence for the approval of new clinical indications for hyperbaric oxygen therapy.
The RCT is the gold standard, but not the only standard, for evidence-based medicine (EBM). Randomized controlled trials are
expensive to conduct and take years to complete. In the absence of gold standard RCT evidence, published findings from
well-designed animal research or smaller human clinical trials may persuade some responsible physicians to adopt new
Strong evidence grows stronger as other scientists replicate, refine, and cite the original findings in new published studies.
Weak evidence grows weaker as peers expose weaknesses in study design, data analysis, and professional biases or conflicts
Of course the state of scientific evidence may change instantly, with the publication of a single paper. So our Evidence Index
rating may change the moment we find a new study that meets our criteria. We keep especially alert for findings that refute
previous studies and for papers retracted by their authors or journals.
As a rule HyperbaricLink only recognizes papers listed in
and clinical trials posted on
You can review the medical literature we consulted by following the links to the Sources on our individual diseases and
conditions pages. The links we provide in Clinical Resources will also take you to a wealth of relevant information.
HyperbaricLink offers a white paper on Evidence-Based Hyperbaric Oxygen Therapy. There we more fully explain how we read and
evaluate scholarly articles in the medical literature and popular stories in the mainstream health media.
Request a copy by e-mail