Considered judgement on quality of evidence

Key question:

Does HBOT improve symptoms in children with Autism?

1. Volume of evidence

Evidence table ref:

Comment here on any issues concerning the quantity of evidence available on this topic and its methodological quality.
The only issue on the evidence is the financial motivation for this study to be a success. The author makes a living off of the HBOT chambers and thus would benefit him greatly to have HBOT as a top treatment for Autism. 2. Applicability

Comment here on the extent to which the evidence is directly applicable to the NHS in Scotland.
Treatments for difficult diseases are a benefit for all worldwide. Any relevant evidence is applicable to allow people to learn about therapies. 3. Generalisability

Comment here on how reasonable it is to generalise from the results of the studies used as evidence to the target population for this guideline.
It is quite reasonable to gereralise the results as evidence. Other than the possible conflict, the study appears well done. 4. Consistency

Comment here on the degree of consistency demonstrated by the available of evidence. Where there are conflicting results, indicate how the group formed a judgement as to the overall direction of the evidence
The results made sense. There were no conflicting results found.

5. Clinical impact

Comment here on the potential clinical impact that the intervention in question might have e.g. size of patient population; magnitude of effect; relative benefit over other management options; resource implications; balance of risk and benefit.
This intervention is huge. It is a hope given to parents and children to have more functional lives by eliminating symptoms of autism. Perhaps it can offer more of an idea on how, biochemically, autism occurs and through that to determine what is the ultimate cause of it. 6. Other factors

Indicate here any other factors that you took into account when assessing the evidence base.
I took into account conflicts of interest as well as the amounts of participants and

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side effects.

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7. Evidence statement

Please summarise the development group's synthesis of the evidence relating to this key question, taking all the above factors into account, and indicate the evidence level which applies.

Evidence level

Different scales were used in order to track the development and progress of results. These included a physician clinical global impression scale, parental clinical global impression scale, abherent behavior checklist, and autism treatment evaluation checklist

1b

8. Recommendation

What recommendation(s) does the guideline development group draw from this evidence? Please indicate the grade of recommendation(s) and any dissenting opinion within the group.

Grade of recommendation

Level B

Further studies are needed by other investigators to confirm these findings; we are aware of several other planned or ongoing studies of hyperbaric treatment in children with autism.

At least fair scientific evidence suggests that the benefits of the clinical service outweighs the potential risks. Clinicians should discuss the service with eligible patients.

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