Winfried Schlee

University of Regensburg | UR · Department of Psychiatry and Psychotherapy

Phantom perceptions like tinnitus occur without any identifiable environmental or bodily source. The mechanisms and key drivers behind tinnitus are poorly understood. The dominant framework, suggesting that tinnitus results from neural hyperactivity in the auditory pathway following hearing damage, has been difficult to investigate in humans and ha...

Background: Somatic tinnitus (ST) is a type of tinnitus that is influenced by changes in somatosensory input from the cervical spine or temporomandibular area. Although traditional physiotherapy has been shown to reduce ST symptoms, in-clinic treatment is not always available, and adherence to home exercise programs is often low. This study aims to...

This perspective article explores how process mining can extract clinical insights from mobile health data and complement data-driven techniques like machine learning. Despite technological advances, challenges such as selection bias and the complex dynamics of health data require advanced approaches. Process mining focuses on analyzing temporal pr...

Background: Somatic tinnitus (ST) is a type of tinnitus that is influenced by changes in somatosensory input from the cervical spine or temporomandibular area. Although traditional physiotherapy has been shown to reduce ST symptoms, in-clinic treatment is not always available, and adherence to home exercise programs is often low. This study aims to...

In the era of burgeoning high-dimensional data, particularly in fields likemedicine, where data collection is increasing, the need for effective feature selectionin machine learning is paramount. Feature selection helps mitigate challengessuch as noise and irrelevant information, leading to a deeper understanding ofresults and improved predictive c...

Current clinical decision support systems (DSS) are trained and validated on observational data from the target clinic. This is problematic for treatments validated in a randomized clinical trial (RCT), but not yet introduced in any clinic. In this work, we report on a method for training and validating the DSS using the RCT data. The key challenge...

Background: Despite the high frequency of tinnitus and its impact on wellbeing, little is known about its economic burden and no data to our knowledge are available on out-of-pocket (OOP) expenses. Methods: In 2022 a survey was conducted on OOP costs of tinnitus. We enrolled 679 participants with slight, moderate and severe tinnitus in Italy, Unite...

Phantom perceptions like tinnitus occur without any identifiable environmental orbodily source. The mechanisms and key drivers behind tinnitus are poorly understood. The dominant framework, suggesting that tinnitus results from neural hyperactivity in the auditory pathway following hearing damage, has been difficult to investigate in humans and has...

BACKGROUND Tinnitus is the perception of sound without an external auditive stimulus and can be a severe burden for affected patients. Cognitive Behavioral Therapy (CBT) is recommended by medical guidelines and effectively improves tinnitus related distress and anxiety. OBJECTIVE The study investigated the outcome of a 9 months smartphone-based CB...

Tinnitus, the perception of sound without a corresponding external sound source, and tinnitus disorder, which is tinnitus with associated suffering, present a multifaceted clinical challenge due to its heterogeneity and its incompletely understood pathophysiology and especially due to the limited therapeutic options. In this narrative review, we gi...

In this chapter, we give an outlook about future research strategies for the tinnitus field. The core question of every scientist, researcher, research team, or research organization is: what do you need to be successful? A literature research reveals characteristics such as multidisciplinarity, open-mindedness, spatial proximity, distributed respo...

We conducted an umbrella review of the scientific literature followed by a systematic review to comprehensively collect existing evidence on global prevalence from national or regional representative samples of tinnitus. The present chapter shows selected results from a comprehensive recently published systematic review and meta-analysis (Jarach et...

It is a hallmark of modern medicine that it claims to be evidence based. This means that clinical decisions are based on research findings. Standardized algorithms have been developed to translate research findings into clinical recommendation. These involve a systematic review of the literature together with meta-analytic aggregation of research f...

Modern mobile devices are mainstream and ubiquitous devices. The widespread adoption of mobile devices has resulted in surge of mobile applications (apps) hosted on marketplaces (app stores) of several mobile platforms. Besides other benefits, these apps are also applied in healthcare-related and medical use, for instance, in case of tinnitus, wher...

Background: Tinnitus is associated with a variety of etiologies, phenotypes, and underlying pathophysiological mechanisms, and available treatments have limited efficacy. A combination of treatments, addressing various aspects of tinnitus, might provide a viable and superior treatment strategy. Methods: In this multicenter, parallel-arm, randomized...

Background and Objective Tinnitus would benefit from an objective biomarker. The goal of this study is to identify plasma biomarkers of constant and chronic tinnitus among selected circulating inflammatory proteins. Methods A case–control retrospective study on 548 cases with constant tinnitus and 548 matched controls from the Swedish Tinnitus Out...

Objectives. The study aimed to assess the relationship of tinnitus with hyperacusis with cognitive impairment as indicated by the Montreal Cognitive Assessment (MoCA) tool.Methods. This multicenter cross-sectional study included individuals with chronic tinnitus from the “Unification of Treatments and Interventions for Tinnitus Patients” (UNITI) da...

Tinnitus, the phantom perception of sounds, generates distress and anxiety in those affected. Cognitive behavioral treatment approaches reproducibly help patients in managing chronic tinnitus. This study systematically evaluated the usefulness of a tinnitus app (with areas of attention and relaxation, mindfulness, acceptance, self-efficacy), which...

Background Tinnitus is a leading cause of disease burden globally. Several therapeutic strategies are recommended in guidelines for the reduction of tinnitus distress; however, little is known about the potentially increased effectiveness of a combination of treatments and personalized treatments for each tinnitus patient. Methods Within the Unifi...

Clinical records frequently include assessments of the characteristics of patients, which may include the completion of various questionnaires. These questionnaires provide a variety of perspectives on a patient’s current state of well-being. Not only is it critical to capture the heterogeneity given by these perspectives, but there is also a growi...

Tinnitus is a highly prevalent condition, affecting more than 1 in 7 adults in the EU and causing negative effects on sufferers’ quality of life. In this study, we utilised data collected within the “UNITI” project, the largest EU tinnitus-related research programme. Initially, we extracted characteristics from both auditory brainstem response (ABR...

Mobile applications have gained popularity in healthcare in recent years. These applications are an increasingly important pillar of public health care, as they open up new possibilities for data collection and can lead to new insights into various diseases and disorders thanks to modern data analysis approaches. In this context, Ecological Momenta...

With mHealth apps, data can be recorded in real life, which makes them useful, for example, as an accompanying tool in treatments. However, such datasets, especially those based on apps with usage on a voluntary basis, are often affected by fluctuating engagement and by high user dropout rates. This makes it difficult to exploit the data using mach...

Evidence-based medicine (EBM) is generally accepted as the gold standard for high-quality medicine and, thus, for managing patients with tinnitus. EBM integrates the best available scientific information with clinical experience and patient values to guide decision-making about clinical management. To help health care providers and clinicians, the...

Recently, the use of mobile technologies in ecological momentary assessments (EMAs) and interventions has made it easier to collect data suitable for intraindividual variability studies in the medical field. Nevertheless, especially when self-reports are used during the data collection process, there are difficulties in balancing data quality and t...

The WHO estimated that 430 million people worldwide suffer from moderate-to-severe hearing loss [...]

At the beginning of the COVID-19 pandemic, with a lack of knowledge about the novel virus and a lack of widely available tests, getting first feedback about being infected was not easy. To support all citizens in this respect, we developed the mobile health app Corona Check. Based on a self-reported questionnaire about symptoms and contact history,...

Recent advances in technology and societal changes have increased the amount of patient data that is being collected remotely, outside of hospitals. As technology enables the ability to collect Ecological Momentary Assessments (EMAs) of patient symptoms remotely, personalised predictors have become especially relevant in the field of medicine. Howe...

Tinnitus affects a considerable part of the population and develops into a severe disorder in some sufferers. App-based interventions are able to provide low-threshold, cost-effective, and location-independent care for tinnitus patients. Therefore, we developed a smartphone app combining structured counseling with sound therapy and conducted a pilo...

The advent of chatbots (also called conversational agents) has been recognized to support various treatment procedures in the medical and psychological fields. Chatbots may be particularly useful before and after medical procedures when patients are at home. For example, while being in the preparation phase of a colonoscopy, a chatbot might answer...

Tinnitus is a condition associated with a continuous noise in the ears or head and can arise from many different medical disorders. The perception of tinnitus can vary within and between days. In the recent years, Ecological Momentary Assessments of tinnitus have been used to investigate these tinnitus variations during the daily life of the patien...

Optimization of dietary intake is an essential component in the multidimensional effort to prevent and manage chronic disease. Recently, demand has increased for nutrition-focused management strategies for chronic tinnitus. The primary aim of this study was to evaluate 10 dietary items for their association with changes in subjective tinnitus sever...

Aims/Hypothesis Identifying risk factors for tinnitus could facilitate not only the recommendations for prevention measures, but also identifying potential pathways for new interventions. This study reports the first comprehensive systematic review of analytical observational studies able to provide information about causality (i.e., case–control a...

Background Tinnitus is a leading cause of disease burden globally. Several therapeutic strategies are recommended in guidelines for the reduction of tinnitus distress; however, little is known about the potential increased effectiveness of a combination of treatments and personalized treatments for each tinnitus patient. Methods Within the Unifica...

Clinical records frequently include assessments of the characteristics of patients, which may include the completion of various questionnaires. These questionnaires provide a variety of perspectives on a patient's current state of well-being. Not only is it critical to capture the heterogeneity given by these perspectives, but there is also a growi...

Background and aim COVID-19 is a respiratory disease caused by the new coronavirus SARS-CoV-2, for which the first cases were reported in China, by December 2019. The spectrum of clinical presentations is wide, ranging from asymptomatic cases to a severe acute respiratory syndrome, sometimes with multiple systems involvement. Viral infections, incl...

Previous studies have shown a high prevalence of sleep disturbances in tinnitus patients. However , no study has yet evaluated subjective sleep satisfaction. The present study aimed to investigate associations of self-reported sleep satisfaction with sociodemographic factors, tinnitus-related distress, depression, and self-reported quality of life....

Importance: To date, no systematic review has taken a meta-analytic approach to estimating the prevalence and incidence of tinnitus in the general population. Objective: To provide frequency estimates of tinnitus worldwide. Data sources: An umbrella review followed by a traditional systematic review was performed by searching PubMed-MEDLINE an...

Recently the use of mobile technologies in Ecological Momentary Assessments (EMA) and Interventions (EMI) has made it easier to collect data suitable for intra-individual variability studies in the medical field. Nevertheless, especially when self-reports are used during the data collection process, there are difficulties in balancing data quality...

Tinnitus is an auditory phantom perception without external sound stimuli. This chronic perception can severely affect quality of life. Because tinnitus symptoms are highly heterogeneous, multimodal data analyses are increasingly used to gain new insights. MHealth data sources, with their particular focus on country- and season-specific differences...

Tinnitus is the perception of sound when no actual external noise is present. Tinnitus is highly prevalent, with more than 1 in 7 adults in the EU having tinnitus, and it causes negative effects on quality of life for many individuals. However, there is currently no cure for tinnitus and its pathophysiology and genesis are unknown. Auditory evoked...

Tinnitus is the conscious perception of a phantom sound in absence of an external or internal stimulus. More than 1 in 7 adults in the EU experience tinnitus and for a large proportion of them tinnitus is an intrusive, persistent, and disabling condition, which impairs their life quality. Therefore, tinnitus is posed as a major global burden, which...

Background: The COVID-19 symptom monitoring apps provide direct feedback to users about the suspected risk of infection with SARS-CoV-2 and advice on how to proceed to prevent the spread of the virus. We have developed the CoronaCheck mobile health platform, the first free app that provides easy access to valid information about the risk of infect...

Tinnitus treatment, diagnosis and management across Europe varies significantly. The lack of national clinical guidelines for tinnitus management in most European countries and the absence of a common language across all disciplines involved is reflected in the diversification of healthcare practices. Interprofessional Training for Tinnitus Researc...

Background Tinnitus is a heterogeneous condition which may be associated with moderate to severe disability, but the reasons why only a subset of individuals is burdened by the condition are not fully clear. Ecological momentary assessment (EMA) allows a better understanding of tinnitus by capturing the fluctuations of tinnitus symptoms, such as di...

Background Tinnitus is a highly prevalent symptom, affecting 10–15% of the adult population. Tinnitus influenced by alterations in somatosensory afference from the neck or jaw is referred to as somatic tinnitus (ST). ST is known to respond positively to physiotherapy treatment; however, it is challenging to motivate patients to systematically perfo...

The European School for Interdisciplinary Tinnitus Research (ESIT) is an EU-funded doctoral training network. ESIT is a consortium of 12 universities, over 30 commercial and not‐for‐profit organizations, and 15 PhD students providing cutting-edge education across 10 European countries to develop highly knowledgeable and innovative experts in the fi...

Background: Somatosensory or somatic tinnitus (ST) is a type of tinnitus where changes in somatosensory afference from the cervical spine or temporomandibular area alter the tinnitus perception. Very recently, the diagnostic value of a set of 16 diagnostic criteria for ST was determined. The next step in the development of easily applicable diagno...

Tinnitus is an auditory phantom perception in the ears or head in the absence of a corresponding external stimulus. There is currently no effective treatment available that reliably reduces tinnitus. Educational counseling is a treatment approach that aims to educate patients and inform them about possible coping strategies. For this feasibility st...

Background Chronic tinnitus is a clinically multidimensional phenomenon that entails audiological, psychological and somatosensory components. Previous research has demonstrated age and female gender as potential risk factors, although studies to this regard are heterogeneous. Moreover, whilst recent research has begun to identify clinical “phenoty...

Background Tinnitus is a heterogeneous condition associated with moderate to severe disability, but the reasons why only a subset of individuals is burdened by the condition are not fully clear. Ecological momentary assessment (EMA) allows a better understanding of tinnitus by allowing individualized models and by capturing the fluctuations of tinn...

Tinnitus is an auditory phantom perception in the ears or head in the absence of a corresponding external stimulus. There is currently no effective treatment available that reliably reduces tinnitus. Educative counseling is a treatment approach that aims to educate patients and inform them about possible coping strategies. For this feasability stud...

Background Chronic tinnitus is an increasing worldwide health concern, causing a significant burden to the health care system each year. The COVID-19 pandemic has seen a further increase in reported cases. For people with tinnitus, symptoms are exacerbated because of social isolation and the elevated levels of anxiety and depression caused by quara...

Recent digitization technologies empower mHealth users to conveniently record their Ecological Momentary Assessments (EMA) through web applications, smartphones, and wearable devices. These recordings can help clinicians understand how the users’ condition changes, but appropriate learning and visualization mechanisms are required for this purpose....

Background Tinnitus represents a relatively common condition in the global population accompanied by various comorbidities and severe burden in many cases. Nevertheless, there is currently no general treatment or cure, presumable due to the heterogeneity of tinnitus with its wide variety of etiologies and tinnitus phenotypes. Hence, most treatment...

Background Tinnitus prevalence studies report large variability across countries that might be due to inconsistent research methods. Our study aimed to report a single Pan-European estimate for tinnitus prevalence and investigate the effect of individual and country-level characteristics on prevalence. We explored the relationships of healthcare re...

Tinnitus is attributed by the perception of a sound without any physical source causing the symptom. Symptom profiles of tinnitus patients are characterized by a large heterogeneity, which is a major obstacle in developing general treatments for this chronic disorder. As tinnitus patients often report severe constraints in their daily life, the lac...

Tinnitus is the perception of a phantom sound and the individual's reaction to it. Although much progress has been made, tinnitus remains an unresolved scientific and clinical issue, affecting more than 10% of the general population and having a high prevalence and socioeconomic burden. Clinical decision support systems (CDSS) are used to assist cl...