Abstract
Objectives/HypothesisTo evaluate the existing level of evidence for tinnitus management strategies identified in the UK Department of Health's Good Practice Guideline.Study DesignSystematic review of peer-reviewed literature and meta-analyses.MethodsSearches were conducted in PubMed, Cambridge Scientific s, Web of Science, and EMBASE (earliest to August 2010), supplemented by hand searches in October 2010. Only randomized controlled trials that used validated questionnaire measures of symptoms (i.e., measures of tinnitus distress, anxiety, depression) were included.ResultsTwenty-eight randomized controlled trials met our inclusion criteria, most of which provide moderate levels of evidence for the effects they reported. Levels of evidence were generally limited by the lack of blinding, lack of power calculations, and incomplete data reporting in these studies. Only studies examining cognitive behavioral therapy were numerous and similar enough to perform meta-analysis, from which the efficacy of cognitive behavioral therapy (moderate effect size) appears to be reasonably established. Antidepressants were the only drug class to show any evidence of potential benefit.ConclusionsThe efficacy of most interventions for tinnitus benefit remains to be demonstrated conclusively. In particular, high-level assessment of the benefit derived from those interventions most commonly used in practice, namely hearing aids, maskers, and tinnitus retraining therapy needs to be performed.
Highlights
IntroductionThe ‘‘phantom’’ auditory experience of tinnitus affects 10% to 15% of people in the United Kingdom
The ‘‘phantom’’ auditory experience of tinnitus affects 10% to 15% of people in the United Kingdom.1 It is most clearly associated with noise exposure and ageing and can present with comorbid sleep disturbance, hearing difficulty, social withdrawal, and negative emotional reactions such as anxiety and depression.2,3 a majority of tinnitus patients are male and present with some form of hearing loss and higher-frequency steeply sloping hearing loss in particular, there is no typical characteristic history or level of distress of the help-seeking tinnitus patient.4In the United Kingdom, the Department of Health issued a Good Practice Guide (GPG) for the commissioning of tinnitus services and for the clinical assessmentFrom the National Institute for Health Research NationalBiomedical Research Unit in Hearing
Levels of evidence were generally limited by the lack of blinding, lack of power calculations, and incomplete data reporting in these studies
Summary
The ‘‘phantom’’ auditory experience of tinnitus affects 10% to 15% of people in the United Kingdom.. The ‘‘phantom’’ auditory experience of tinnitus affects 10% to 15% of people in the United Kingdom.1 It is most clearly associated with noise exposure and ageing and can present with comorbid sleep disturbance, hearing difficulty, social withdrawal, and negative emotional reactions such as anxiety and depression.. In the United Kingdom, the Department of Health issued a Good Practice Guide (GPG) for the commissioning of tinnitus services and for the clinical assessment. From the National Institute for Health Research National. A. H .), Nottingham; School of Clinical Sciences (D.J.H., V.L.K., S.K., D.A.H.), The
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