Scoping a suite of priority reviews in tinnitus

Tinnitus involves the perception of sound in the absence of an external source. It is a major problem that affects 10% to 30% of adults. About 20% of these people experience bothersome tinnitus and it negatively affects their quality of life. Problems associated with tinnitus include sleep disturbance, hearing difficulties, difficulties with concentration, social isolation, anxiety, depression and emotional difficulties such as irritation or stress. 

To identify tinnitus treatments that are a priority for new or updated Cochrane Reviews a team from the National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre conducted a systematic scoping exercise. Specifically, the objective of the exercise was to scope and catalogue 1) the existing evidence for the effectiveness of tinnitus interventions, and 2) which tinnitus interventions are a priority for inclusion in future systematic (particularly Cochrane) reviews. The Cochrane ENT Information Specialist conducted searches for randomised controlled trials (RCTs) of tinnitus treatment interventions. The interventions were prioritised for systematic review according to a set of pre-defined primary and secondary criteria. 

Our searches identified 365 new RCTs (i.e. not yet included in a Cochrane Review). Based on our pre-defined priority criteria, we concluded that there were three high-priority Cochrane Reviews: 1) sound therapy using amplification devices and/or sound generators, 2) betahistine and 3) cognitive behavioural therapy (which was already in progress). Further priorities were: 1) Gingko biloba, 2) anxiolytics, 3) hypnotics, 4) antiepileptics and 5) neuromodulation. Three of the priority reviews (sound therapy, betahistine and cognitive behavioural therapy) have been conducted and published and a further two priority reviews (neuromodulation and Ginkgo biloba) are in progress.

The final scoping report (PDF)