A commentary on the complexity of tinnitus management: clinical guidelines provide a path through the fog.
ABSTRACT There is a desire among many tinnitus researchers and clinicians for greater standardization in the assessment and management of tinnitus. In their commentary on the complexity of tinnitus, Hoare et al. have highlighted the need for strong evidence-based protocols. The authors make many valid and important conclusions as to the current state of clinical guidelines; they identify clear gaps in evidence and limited consensus as to clinical practice. While I agree with the bulk of their commentary there are a few areas where I will offer a counter view. In particular I will address their view that only high-level evidence has a place in forming practice guidelines for tinnitus.
- SourceAvailable from: Eman KhedrKlinische Neurophysiologie 03/2014; 45:32. DOI:10.1055/s-0034-1371186 · 0.33 Impact Factor
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ABSTRACT: Background: Tinnitus can have a devastating impact on the quality of life of the sufferer. Although the mechanisms underpinning tinnitus remain uncertain, hearing loss is often associated with its onset, and hearing aids are among the most commonly used tools for its management. Purpose: To conduct a scoping review to explore the role of hearing aids in tinnitus management. Research Design: Scoping review based on the six-stage framework of Arksey and O'Malley (2005). Study Sample: Relevant studies were identified using various databases (Scopus, Google Scholar, SpringerLink, and PubMed) and hand searching of journals and a reference list of articles. Out of 277 shortlisted articles, 29 studies (18 research studies and 11 reviews) were chosen for charting of data based on their abstracts. Data Collection and Analysis: Tinnitus assessment measures used in studies were recorded along with changes in their scores. Measures used in studies included the Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), Tinnitus Severity Index (TSI), Tinnitus Reaction Questionnaire (TRQ), German version of Tinnitus Questionnaire (TQ), Beck Depression Inventory (BDI), and visual analogue scale (VAS) of tinnitus intensity. Where possible Cohen's d effect size statistic was calculated. Results: Although the quality of evidence for hearing aids' effect on tinnitus is not strong, the weight of evidence (17 research studies for, 1 against) suggests merit in using hearing aids for tinnitus management. Conclusions: The majority of studies reviewed support the use of hearing aids for tinnitus management. Clinicians should feel reassured that some evidence shows support for the use of hearing aids for treating tinnitus, but there is still a need for stronger methodology and randomized control trials.Journal of the American Academy of Audiology 09/2013; 24(8):747-762. DOI:10.3766/jaaa.24.8.11 · 1.59 Impact Factor