Consistent with the Committee on Publication Ethics guidelines, we the above authors are initiating a partial retraction and correction of our paper: Mathieu D, Marroni A, Kot J: Tenth European Consensus Conference on Hyperbaric Medicine: recommendations for accepted and non-accepted clinical indications and practice of hyperbaric oxygen treatment. Diving Hyperb Med. 2017 Mar;47(1):24-32.
We wish to make the following statement: "Regardless of the strict process of editing and proof-reading of tables included in the above-mentioned publication, we received some comments from readers which showed us that imperfect layout of Table 1 and incorrect layout of Table 2 changed significantly the conclusions which could be drawn from them.
Table 1. Consensus-based and GRADE scaling for recommendations .
| Strength of recommendation (consensus-based) | Level of evidence (based on GRADE system) |
| Level 1 = Strong recommendation = "We recommend…" | Grade A = High level of evidence |
| The course of action is considered appropriate by the | The true effect lies close to our estimate of the effect. |
| large majority of experts with no major dissension. The | |
| panel is confident that the desirable effects of adherence | |
| to the recommendation outweigh the undesirable effects. | |
| Level 2 = Weak recommendation = "We suggest…" | Grade B = Moderate level of evidence |
| The course of action is considered appropriate by the | The true effect is likely to be close to our estimate of |
| majority of experts but some degree of dissension exists | the effect, but there is a possibility that it is substantially |
| amongst the panel. The desirable effects of adherence to the | different. |
| recommendation probably outweigh the undesirable effects. | |
| Level 3 = Neutral recommendation = "It would be | Grade C = Low level of evidence |
| reasonable…" | The true effect may be substantially different from our |
| The course of action could be considered appropriate in | estimate of the effect |
| the right context. | |
| No recommendation | Grade D = Very low level of evidence |
| No agreement was reached by the group of experts. | Our estimate of the effect is just a guess, and it is very |
| likely that the true effect is substantially different from our | |
| estimate of the effect. |
Table 2. Recommendations on the indications accepted for HBOT .
| Condition | Level of evidence | Agreement level | |
| B | C | ||
| Type 1 | |||
| CO poisoning | X | Strong agreement | |
| Open fractures with crush injury | X | Strong agreement | |
| Prevention of osteoradionecrosis after | X | Strong agreement | |
| dental extraction | |||
| Osteoradionecrosis (mandible) | X | Strong agreement | |
| Soft tissue radionecrosis (cystitis, proctitis) | X | Strong agreement | |
| Decompression illness | X | Strong agreement | |
| Gas embolism | X | Strong agreement | |
| Anaerobic or mixed bacterial infections | X | Strong agreement | |
| Sudden deafness | X | Strong agreement | |
| Type 2 | |||
| Diabetic foot lesions | X | Strong agreeement | |
| Femoral head necrosis | X | Strong agreeement | |
| Compromised skin grafts and musculo- | X | Strong agreeement | |
| cutaneous flaps | |||
| Central retinal artery occlusion (CRAO) | X | Strong agreement | |
| Crush Injury without fracture | X | Agreement | |
| Osteoradionecrosis (bones other than mandible) | X | Agreement | |
| Radio-induced lesions of soft tissues | X | Agreement | |
| (other than cystitis and proctitis) | |||
| Surgery and implant in irradiated tissue | X | Agreement | |
| (preventive treatment) | |||
| Ischaemic ulcers | X | Agreement | |
| Refractory chronic osteomyelitis | X | Agreement | |
| Burns, 2nd degree more than 20% BSA | X | Agreement | |
| Pneumatosis cystoides intestinalis | X | Agreement | |
| Neuroblastoma, stage IV | X | Agreement | |
| Type 3 | |||
| Brain injury (acute and chronic TBI, chronic stroke, | X | Agreement | |
| post anoxic encephalopathy) in highly selected patients | |||
| Radio-induced lesions of larynx | X | Agreement | |
| Radio-induced lesions of the CNS | X | Agreement | |
| Limb replantation | X | Agreement | |
| Selected non-healing wounds secondary | X | Agreement | |
| to systemic processes | |||
| Sickle cell disease | X | Agreement | |
| Interstitial cystitis | X | Agreement | |
Table 1 described the relation between strength of recommendations given by the Jury of the Consensus Conference and the level of evidence based on the GRADE system. There should be a clear and straight relation showing that Level 1 "strong recommendation" should be based on GRADE A "high level of evidence (LOE)", Level 2 "weak recommendation" should be based on GRADE B "moderate LOE", Level 3 "neutral recommendation" should be based on GRADE C "low LOE" and finally no recommendation should be given when only GRADE D "very low LOE" are present. Note that there is no change to the content of the table, but only visual representation of this relationship.
Table 2 has been incorrectly printed. In fact, there is no GRADE A LOE. All X marks placed in the column A should be moved to the right, to GRADE B LOE. In the same way, all X marks placed in the column B should be moved to the right, to GRADE C LOE. We voluntarily retract these tables from the above-mentioned publication, expressing our regret for the situation."
The corrected Tables 1 and 2 are published below and have been corrected in the pdf version of the March 2017 issue on the society websites.
Contributor Information
D Mathieu, European Committee for Hyperbaric Medicine; Critical Care Department, Medical University and Hospital of Lille, France.
A Marroni, European Committee for Hyperbaric Medicine; DAN Europe Research Division, Roseto degli Abruzzi, Italy.
J Kot, European Committee for Hyperbaric Medicine.
