Reevaluating the Use of Sound Therapy for Tinnitus Management: Perspectives on Relevant Systematic Reviews

Area of Science:

• Audiology
• Evidence-based medicine
• Clinical practice guidelines

Background:

• Tinnitus is a common condition significantly impacting health and quality of life.
• Current clinical practice guidelines (CPGs) for tinnitus are not consistently implemented.
• Patients often lack access to evidence-based tinnitus treatments.

Purpose of the Study:

• To clarify the evidence supporting sound therapy for tinnitus.
• To advocate for the inclusion of sound therapy in future tinnitus CPGs.

Main Methods:

• Review of recent, high-quality systematic reviews on tinnitus interventions.
• Analysis of the risk of bias (RoB) assessments for sound therapy trials.
• Critique of strict inclusion criteria used in systematic reviews.

Main Results:

• Systematic reviews often rate sound therapy trials as high risk of bias, excluding them from analyses.
• Cognitive behavioral therapy is frequently identified as the only effective intervention, though with low strength of evidence.
• Decades of evidence supporting sound therapy's clinical effectiveness may be obscured by current review methodologies.

Conclusions:

• Strict adherence to contemporary risk of bias criteria may exclude effective interventions like sound therapy.
• Current review practices risk preventing patients from receiving beneficial sound therapy for tinnitus.
• Re-evaluation of evidence assessment is needed to ensure sound therapy is considered in tinnitus CPGs.