HBOT Therapy

HBOT Research and
Evidence Library

The Evidence Base

Built on Peer-Reviewed Research

Hyperbaric oxygen therapy is supported by more than fifty years of peer-reviewed clinical research, with thousands of published studies across the spectrum of recognized indications. The strength of evidence varies by condition: for the 9 OHIP-covered conditions Evolve treats, the evidence is robust enough that OHIP funds the therapy in Ontario (delayed radiation tissue injury and ISSNHL have particularly strong supporting literature). For off-label indications we offer, the evidence is suggestive but still evolving (post-concussion syndrome, long COVID).

At Evolve, we treat the difference between “strong evidence” and “emerging evidence” honestly. Our condition pages tell you which is which.

Authoritative Sources

What We Work From

UHMS Indications Manual

The Undersea and Hyperbaric Medical Society Indications Manual (Moon RE ed., 14th edition, 2019) is the primary clinical reference in North American hyperbaric medicine. It defines the recognized indications, summarizes the evidence base for each, and sets out protocol recommendations. We use it as the working clinical reference across all Evolve locations.

Cochrane systematic reviews

Several Cochrane reviews specifically address HBOT for the conditions we treat, providing the most rigorous available synthesis of randomized trial evidence:

  • Kranke P et al. — Hyperbaric oxygen therapy for chronic wounds (Cochrane 2015)
  • Bennett MH et al. — Hyperbaric oxygen for idiopathic sudden sensorineural hearing loss and tinnitus (Cochrane 2012)
  • Bennett MH et al. — Hyperbaric oxygen therapy for late radiation tissue injury (Cochrane 2016)

European Consensus Conference on Hyperbaric Medicine

Mathieu D, Marroni A, Kot J. Tenth European Consensus Conference on Hyperbaric Medicine. Diving and Hyperbaric Medicine. 2017;47(1):24–32. Provides European consensus recommendations on accepted and non-accepted indications and practice standards.

CPSO and Ontario Health

Ontario’s coverage framework for HBOT is set out in OHIP funding policy. Evolve is OHIP-approved and treats 9 of the funded conditions across our outpatient clinic network; acute hyperbaric emergencies are managed at tertiary acute-care hyperbaric services.

By Condition

Evidence at a Glance

The detailed evidence summary for each condition lives on its condition page. Use the links below to navigate.

Radiation tissue damage

Idiopathic sudden sensorineural hearing loss

Diabetic lower extremity wounds & chronic non-healing wounds

Failed (compromised) skin grafts and flaps

Thermal burns

Chronic refractory osteomyelitis

Avascular necrosis (osteonecrosis)

Crohn’s disease (perianal fistulas, adjunctive)

Medical review

Dr. Vik Agarwal MD CCFP FRCPC CAQ-HP — President, Evolve Medical Group

Dr. Seema Agarwal MD CCFP CAQ-HP — Chief Medical Officer, Evolve Hyperbarics

Last reviewed: May 2026 · Next: May 2027

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