September 23, 2019

VA treatment should be based on evidence, not political pressure

By Kayla M. Williams

Last week, lawmakers introduced legislation that would require the VA to make hyperbaric oxygen therapy (HBOT) available to any veteran with post-traumatic stress disorder (PTSD) and extend its use among veterans with traumatic brain injuries (TBI). This builds upon a previous expansion of its off-label use at VA for veterans who have not shown clinical improvement, similar legislation passed by multiple states, and attention from VA’s COVER Commission.

All this is happening without evidence that HBOT actually works to treat either PTSD or mild TBI.

Study after study after study after study after study has failed to show any evidence that HBOT improves symptoms of PTSD or mild TBI more than sham treatments. It does have legitimate medical uses, such as treating decompression sickness among divers, but for-profit treatment centers make unsupported claims that it can treat multiple other diseases.

This doesn’t mean no veterans showed any improvement over a course of HBOT sessions — which should not be surprising. Clinical trials compare the effectiveness of real drugs to fake ones to tease out how much of any improvements (or side effects) are caused by the medication itself compared to the placebo effect. The passage of time alone can also ease some symptoms: 85 percent of those who experience a mild TBI, also known as a concussion, fully recover within a matter of months; for many, symptoms of PTSD can fluctuate in response to external stimuli. So it’s inevitable that there are compelling anecdotes out there from folks who saw improvements after trying HBOT — but that isn’t the same as proof.

Read the full article in The Hill.

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