Non-invasive treatments improve patient outcomes in chronic tinnitus: a systematic review and network meta-analysis

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY Brazilian Journal of Otorhinolaryngology Pub Date : 2024-05-02 DOI:10.1016/j.bjorl.2024.101438

Tingting Lu , Qingxin Wang , Ziyan Gu , Zefang Li , Zhaojun Yan

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Abstract

Objective

To investigate the relative effectiveness of various Non-Invasive Treatment Techniques (NITs) in chronic tinnitus management.

Methods

We searched PubMed, Embase and Cochrane Library databases from the time of data construction to December 31, 2022. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, NITs were evaluated, including Aacceptance and commitment therapy (A), Cognitive behavioral therapy (C), Sound therapy (S), Transcranial magnetic stimulation (T), Electrical stimulation therapy (E), Virtual reality therapy (V), tinnitus Retraining therapy (R), general psychotherapy (D), and Placebo (P). The outcome indicators included the Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), Hospital Anxiety and Depression Scale-anxiety-Depression (HADS-D), Insomnia Severity Index (ISI), Visual Analogue Scales-Loudness (VAS-L), and Visual Analogue Scales-Distress (VAS-D). Statistical analysis was performed using Stata 14.0 for NMA.

Results

This systematic review and meta-analysis included 22 randomized controlled trials comprising 2,354 patients. The treatment effects varied on each scale. For THI, S (86.9%) was the most effective, whereas P (6.5%) was the worst. For TQ, C (89.5%) was the most effective, whereas D (25.4%) was the worst. For HADS-D, A (82.4%) was the most effective, whereas D (9.47%) was the worst. For ISI, A (83.2%) was the most effective, whereas R (20.6%) was the worst. For VAS-L, S (73.5%) was the most effective, whereas E (18.9%) was the worst. For VAS-D, C (84.7%) was the most effective, whereas P (18.1%) was the worst.

Conclusions

The combination of acoustics and cognitive behavioral therapy may be an effectively treat patients with chronic tinnitus.

Level of evidence

How common is the problem? Level 2.

Is this diagnostic or monitoring test accurate? (Diagnosis) Level 1.

What will happen if we do not add a therapy? (Prognosis) Level 1.

Does this intervention help? (Treatment Benefits) Level 1.

What are the COMMON harms? (Treatment Harms) Level 1.

What are the RARE harms? (Treatment Harms) Level 1.

Is this (early detection) test worthwhile? (Screening) Level 1I.

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非侵入性疗法改善慢性耳鸣患者的疗效：系统综述和网络荟萃分析

方法我们检索了从数据构建到 2022 年 12 月 31 日的 PubMed、Embase 和 Cochrane 图书馆数据库。根据《系统综述和荟萃分析首选报告项目》指南，评估的非侵入性疗法包括接受和承诺疗法（A）、认知行为疗法（C）、声音疗法（S）、经颅磁刺激疗法（T）、电刺激疗法（E）、虚拟现实疗法（V）、耳鸣再训练疗法（R）、一般心理疗法（D）和安慰剂（P）。结果指标包括耳鸣障碍量表（THI）、耳鸣问卷（TQ）、医院焦虑和抑郁量表-焦虑-抑郁（HADS-D）、失眠严重程度指数（ISI）、视觉模拟量表-响度（VAS-L）和视觉模拟量表-压力（VAS-D）。统计分析使用 Stata 14.0 for NMA 进行。结果这项系统综述和荟萃分析包括 22 项随机对照试验，共有 2354 名患者参加。每个量表的治疗效果各不相同。对于 THI，S（86.9%）最有效，而 P（6.5%）最差。对于 TQ，C（89.5%）最有效，而 D（25.4%）最差。对于 HADS-D，A（82.4%）最有效，而 D（9.47%）最差。对于 ISI，A（83.2%）最有效，而 R（20.6%）最差。对于 VAS-L，S（73.5%）最有效，而 E（18.9%）最差。对于 VAS-D，C（84.7%）最有效，而 P（18.1%）最差。结论声学疗法和认知行为疗法相结合可能会有效治疗慢性耳鸣患者。2级。该诊断或监测测试准确吗？(诊断) 1级.如果我们不增加一种疗法，会发生什么情况？(预后） 1级.这种干预有帮助吗？(治疗的益处）1级1.常见的危害是什么？治疗的危害）1级1.罕见的危害是什么？治疗的危害）1级1.这种（早期检测）试验值得吗？(筛查） 1级I.

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来源期刊

Brazilian Journal of Otorhinolaryngology OTORHINOLARYNGOLOGY-

CiteScore

3.00

自引率

0.00%

发文量

205

审稿时长

4-8 weeks

期刊介绍： Brazilian Journal of Otorhinolaryngology publishes original contributions in otolaryngology and the associated areas (cranio-maxillo-facial surgery and phoniatrics). The aim of this journal is the national and international divulgation of the scientific production interesting to the otolaryngology, as well as the discussion, in editorials, of subjects of scientific, academic and professional relevance. The Brazilian Journal of Otorhinolaryngology is born from the Revista Brasileira de Otorrinolaringologia, of which it is the English version, created and indexed by MEDLINE in 2005. It is the official scientific publication of the Brazilian Association of Otolaryngology and Cervicofacial Surgery. Its abbreviated title is Braz J Otorhinolaryngol., which should be used in bibliographies, footnotes and bibliographical references and strips.