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Placebo effect in tinnitus management.

L G Duckert, T S Rees

    Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
    |December 1, 1984
    PubMed
    Summary
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    Placebo effects significantly impact tinnitus treatment studies. Even when expecting lidocaine, 40% of tinnitus patients reported changes after a saline placebo injection, highlighting trial design flaws.

    Area of Science:

    • Otolaryngology
    • Clinical Psychology
    • Pharmacology

    Background:

    • Tinnitus therapies like masking devices and lidocaine show promise.
    • Previous tinnitus studies often used single-blind protocols, potentially introducing bias.
    • The placebo effect's influence on tinnitus treatment outcomes requires further investigation.

    Purpose of the Study:

    • To assess the magnitude of the placebo effect in tinnitus clinical trials.
    • To evaluate patient responses to a perceived lidocaine treatment versus actual placebo.

    Main Methods:

    • Twenty tinnitus patients from a prior double-blind lidocaine study were re-contacted.
    • Patients were informed they would receive a lidocaine test dose.
    • A placebo saline injection was administered instead of lidocaine.

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    Main Results:

    • Forty percent of patients reported a change in their tinnitus perception post-injection.
    • This suggests a substantial placebo response in tinnitus patients.
    • The study highlights potential overestimation of treatment efficacy in uncontrolled trials.

    Conclusions:

    • Clinical trials for tinnitus treatments are susceptible to placebo effects.
    • Uncontrolled studies may yield inflated success rates due to psychological factors.
    • Methodological rigor, including robust blinding, is crucial for accurate tinnitus research.