title: Systematic review and meta-analyses of randomized controlled trials examining tinnitus management.
abstract: OBJECTIVE
  To evaluate the existing level of evidence for tinnitus management strategies identified in the UK Department of Health's Good Practice Guideline.
  
  
  METHODS
  Systematic review of peer-reviewed literature and meta-analyses.
  
  
  METHODS
  Searches were conducted in PubMed, Cambridge Scientific Abstracts, Web of Science, and EMBASE (earliest to August 2010), supplemented by hand searches in October 2010. Only randomized controlled trials that used validated questionnaire measures of symptoms (i.e., measures of tinnitus distress, anxiety, depression) were included.
  
  
  RESULTS
  Twenty-eight randomized controlled trials met our inclusion criteria, most of which provide moderate levels of evidence for the effects they reported. Levels of evidence were generally limited by the lack of blinding, lack of power calculations, and incomplete data reporting in these studies. Only studies examining cognitive behavioral therapy were numerous and similar enough to perform meta-analysis, from which the efficacy of cognitive behavioral therapy (moderate effect size) appears to be reasonably established. Antidepressants were the only drug class to show any evidence of potential benefit.
  
  
  CONCLUSIONS
  The efficacy of most interventions for tinnitus benefit remains to be demonstrated conclusively. In particular, high-level assessment of the benefit derived from those interventions most commonly used in practice, namely hearing aids, maskers, and tinnitus retraining therapy needs to be performed.
authors.affiliation: National Institute for Health Research National Biomedical Research Unit in Hearing, Nottingham, United Kingdom. derek.hoare@nottingham.ac.uk
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Hoare
authors.forename: Victoria L
authors.initials: VL
authors.lastname: Kowalkowski
authors.forename: Sujin
authors.initials: S
authors.lastname: Kang
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Hall
mesh_terms: D000223:Adaptation, Psychological; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy; D003376:Counseling / Q000379:methods; D018450:Disease Progression; D005260:Female; D006310:Hearing Aids; D006801:Humans; D008297:Male; D011788:Quality of Life; D012064:Relaxation Therapy / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D014012:Tinnitus / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome