Research Activities, October 2013
More research needed on treating tinnitus
Comparative Effectiveness Research
Among pharmacological/food supplements, medical/surgical treatments, sound treatments/technologies, and psychological/behavioral treatments for tinnitus (ringing in the ears), there is low strength of evidence indicating that cognitive behavioral therapy improves tinnitus-specific quality of life compared with controls.
That's the conclusion of a research review by AHRQ's Effective Healthcare Program. It found that sertraline was the one pharmacological intervention with consistently significant effects on multiple outcomes in a clinical trial, such as reducing loudness, improving global quality of life, and alleviating severity. However, for pharmacological interventions overall, the strength of evidence is low that neurotransmitter drugs improve subjective loudness compared with placebo in patients with tinnitus.
The strength of evidence is insufficient for all other pharmacological interventions and outcomes, including sleep disturbance, tinnitus-specific quality of life, anxiety, etc. In addition, there is not enough evidence to suggest that medical or sound technology interventions improve outcomes relative to controls.
Future research investigating the effectiveness of treatments for tinnitus should focus on improving collection of adverse effects, calculating sample size, and specifying doses for interventions. Furthermore, additional research is needed to investigate measures used to assess patients for management needs and the identification of prognostic factors.
To put this research in perspective, tinnitus is fairly common, with an estimated 16 percent of the American population (50 million people) experiencing it and up to 16 million seeking medical help; two million people with tinnitus are unable to lead a normal life. The prevalence of tinnitus increases with age and noise exposure. A variety of conditions and experiences can lead to tinnitus, but the exact physiology is still unknown.
These findings are available in the research review, Evaluation and Treatment of Tinnitus: A Comparative Effectiveness Review at http://go.usa.gov/DXsW.