title: A Bayesian perspective on tinnitus pitch matching.
abstract: OBJECTIVE
  New tinnitus therapies are being developed and marketed that target the patient's tinnitus frequency. This frequency is estimated clinically by pitch matching, which has the patient identify the pure tone that is closest to the perceived tinnitus frequency. Though widely used, pitch matching is heavily criticized as unreliable, and the degree of reliability varies among patients. At the very least, it is recommended that multiple pitch matches be used to identify the patient's tinnitus frequency. Even so, it is not clear how many pitch matches to collect, how they should be combined, or how doing so will enhance the audiologist's certainty about the true tinnitus frequency. In this article, we describe a simple Bayesian method of sequentially combining pitch matches until acceptable precision is achieved and illustrate the method in 10 patients with chronic tinnitus.
  
  
  METHODS
  Subjects were recruited from previous study participants and support group attendees at the National Center for Rehabilitative Auditory Research. Thirty tinnitus pitch matches were elicited from 10 patients with chronic, monotonal tinnitus.
  
  
  RESULTS
  A Bayesian sequential analysis yielded estimated tinnitus frequencies for 7 patients that were within one-quarter octave of their true value with 90% certainty. Between four and twenty pitch matches were required to achieve acceptable results in these seven patients.
  
  
  CONCLUSIONS
  Despite criticism, pitch matching is widely used to estimate tinnitus frequency. We address reliability concerns with a Bayesian sequential analysis to jointly estimate tinnitus frequency and reliability. The method is easily applied.
authors.affiliation: 1VA RR&D National Center for Rehabilitative Auditory Research, VA Medical Center, Portland, Oregon, USA; 2Health Science Center, Louisiana State University, New Orleans, Louisiana, USA; and 3Department of Otolaryngology/Head and Neck Surgery, Oregon Health and Science University (OHSU), Portland, Oregon, USA.
authors.forename: Garnett P
authors.initials: GP
authors.lastname: McMillan
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Thielman
authors.forename: Krystyn
authors.initials: K
authors.lastname: Wypych
authors.forename: James A
authors.initials: JA
authors.lastname: Henry
mesh_terms: D000328:Adult; D000368:Aged; D001299:Audiometry; D001499:Bayes Theorem; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010897:Pitch Discrimination; D015203:Reproducibility of Results; D014012:Tinnitus / Q000503:physiopathology* / Q000534:rehabilitation