Evaluation & the health professions
-
There is a desire among many tinnitus researchers and clinicians for greater standardization in the assessment and management of tinnitus. In their commentary on the complexity of tinnitus, Hoare et al. have highlighted the need for strong evidence-based protocols. ⋯ While I agree with the bulk of their commentary there are a few areas where I will offer a counter view. In particular I will address their view that only high-level evidence has a place in forming practice guidelines for tinnitus.
-
Tinnitus is a heterogeneous disorder that causes significant impairment in many patients. Treatment is elusive and there is a need for more comprehensive guidelines for diagnosis and management of tinnitus. However, different standardization approaches should be differentiated according to their specific purpose. ⋯ Therefore, medical diagnosis is necessarily the first step in tinnitus management. Treatment guidelines should not be restricted to recommendations that are supported by high-level evidence. They should also contain treatment recommendations that have shown clinically highly relevant effects in case series of specific tinnitus subgroups.