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The key challenges facing researchers investigating the debilitating hearing condition tinnitus have been identified.
It is hoped that identifying the top 10 ‘unanswered questions’ for tinnitus will prove a catalyst for further research and will focus future studies on the main priorities, leading to tangible benefits for patients.
It comes as part of an initiative led by the
British Tinnitus Association and the National Institute for
Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, which involves researchers from The University of Nottingham.
Professor Deb Hall, the Director of the NIHR Nottingham Hearing Biomedical Research Unit and University of Nottingham academic, said: “The outcomes from this project provide a much needed boost to tinnitus research because they identify specific questions for scientists to address that will bring about real patient benefit.”
David Stockdale, Chief Executive of the British Tinnitus Association said: “I am delighted with the top 10 research uncertainties that have been selected. They represent a clear focus for future research as well as really capturing the questions that are important for patients and clinicians alike.”
The top 10 research uncertainties were:
1. What management strategies are more effective than a usual model of audiological care in improving outcomes for people with tinnitus?
2. Is Cognitive Behaviour Therapy (CBT), delivered by audiology professionals, effective for people with tinnitus? Here comparisons might be with usual audiological care or CBT delivered by a psychologist.
3. What management strategies are more effective for improving tinnitus-related insomnia than a usual model of care?
4. Do any of the various available complementary therapies provide improved outcome for people with tinnitus compared with a usual model of care?
5. What type of digital hearing aid or amplification strategy provides the most effective tinnitus relief?
6. What is the optimal set of guidelines for assessing children with tinnitus?
7. How can tinnitus be effectively managed in people who are deaf or who have a profound hearing loss?
8. Are there different types of tinnitus and can they be explained by different mechanisms in the ear or brain?
9. What is the link between tinnitus and hyperacusis (over-sensitivity to sounds)?
10. Which medications have proven to be effective in tinnitus management compared with placebo?
Troublesome condition
Not an illness or disease, tinnitus is a term that describes the sensation of hearing a noise in the absence of an external sound. The noise can have virtually any quality. Ringing, whistling, and buzzing are common, but more complex sounds may also be reported. Troublesome tinnitus can be very distressing for the affected individual, and issues may arise with sleep, concentration and mood. However, in many cases, subtle changes in people’s environment can address these issues, and improve quality of life.
The work looking into the main research uncertainties for tinnitus has been produced by the James Lind Alliance (JLA) Tinnitus Priority Setting Partnership (PSP), a non-profit making initiative established in 2004 which brings patients, carers and clinicians together to identify and prioritise the top 10 unanswered questions about the effects of treatments that they agree are the most important.
Working with the JLA, the process of choosing the uncertainties began in September 2011, with patients and clinicians submitting the questions that they would like to see researched. More than 2,500 questions were subsequently posed. A pooling and filtering process then took place removing anything previously researched leaving 386 questions. This long list was refined to 170 by removing those questions selected by only one or two people. These were then distributed within the tinnitus community so that patients and clinicians could choose their top 10. A shortlist was produced from these responses and discussed at a meeting in London on 16 July 2012 where both patients and clinicians finally agreed on the top 10.
Research recommendations
The tinnitus uncertainties, will now appear on the UK Database of Uncertainties about the Effects of Treatments (UK DUETs). UK DUETs publishes treatment uncertainties from patients, carers, clinicians, and from research recommendations, covering a wide variety of health problems.
The final 10 tinnitus treatments uncertainties will be launched at the British Society of Audiology (BSA) Conference on 5-7 September 2012.
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