• Open Access

Systematic review and meta-analyses of randomized controlled trials examining tinnitus management§

Authors

  • Derek J. Hoare PhD,

    Corresponding author
    1. National Institute for Health Research National Biomedical Research Unit in Hearing, Nottingham
    2. School of Clinical Sciences, The University of Nottingham, Nottingham
    • NIHR National Biomedical Research Unit in Hearing, Ropewalk House, 113 The Ropewalk, Nottingham, UK NG1 5DU
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  • Victoria L. Kowalkowski BA,

    1. National Institute for Health Research National Biomedical Research Unit in Hearing, Nottingham
    2. School of Clinical Sciences, The University of Nottingham, Nottingham
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  • Sujin Kang MA,

    1. National Institute for Health Research National Biomedical Research Unit in Hearing, Nottingham
    2. School of Clinical Sciences, The University of Nottingham, Nottingham
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  • Deborah A. Hall PhD

    1. Division of Psychology, School of Social Sciences, Nottingham Trent University, Nottingham, United Kingdom
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  • The National Biomedical Research Unit in Hearing is funded by the UK National Institute for Health Research. The authors are funded by the UK National Institute for Health Research.

  • The authors have no other funding, financial relationships, or conflicts of interest to disclose.

  • §

    Re-use of this article is permitted in accordance with the Terms and Conditions set out at http://wileyonlinelibrary.com/onlineopen#OnlineOpen_Terms

Abstract

Objectives/Hypothesis:

To evaluate the existing level of evidence for tinnitus management strategies identified in the UK Department of Health's Good Practice Guideline.

Study Design:

Systematic review of peer-reviewed literature and meta-analyses.

Methods:

Searches were conducted in PubMed, Cambridge Scientific Abstracts, 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.

Results:

Twenty-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.

Conclusions:

The 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.

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