Episode 6: Clinical Guidelines for Tinnitus — Status Quo or Way Forward?

[Tinnitus Talk]

Hi everybody!

We're not gonna lie, this was the toughest episode yet to publish. It was recorded way back in March, when @Hazel was in Milan for an ESIT meeting and had the chance to sit down with Rilana Cima and Derek Hoare, two of the co-authors of the European Clinical Practice Guidelines for Tinnitus, which were published earlier this year. But… there was no suitable room for recording, and Hazel only had one microphone with her – a good one, but for three people it did not yield the audio quality we strive for. @Markku worked tirelessly to improve the audio, but his standards are high and weren't met. We went back and forth many times on "to publish or not to publish." In the end, we decided that content is more important and did not want to keep this episode from our audience, so here you go!

As a special token of appreciation to our Patreon supporters, we will soon make this episode available exclusively to them as a video! We plan to release more exclusive content to our supporters in future.

The content should certainly be interesting enough for a listen, and perhaps even somewhat contentious. It's disheartening to learn that there is such a scarcity of evidence for nearly all the tinnitus treatments currently on the market. So, what can one really offer patients? Not much yet, it seems… But still, it's useful to have such a comprehensive overview of the status quo, and this is what Clinical Guidelines are for.

Clinical Guidelines are recommendations for healthcare professionals on how to diagnose and treat a medical condition, based on currently available evidence. What is the current state of evidence in favour or against tinnitus treatments on the market? Which treatments have been thoroughly tested and which require more testing? What should doctors and patients learn from this? And how should this inform new tinnitus research? These are all questions answered in this episode!

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Listen on:

• Tinnitus Talk Podcast (incl. timestamps and transcript)
  
• SoundCloud
  
• iTunes
  
• Spotify

We welcome any discussion, but please keep the following in mind when commenting:

• Off-topic comments, i.e. not directly responding to the content of the podcast, will be removed. So please do listen before commenting!
• While we welcome constructive criticism on ideas or policies, we do not tolerate direct attacks on individuals.

Tinnitus Talk would like to thank Derek and Rilana for taking the time to speak to us.

This episode was produced, as usual, by @Markku, @Jack Straw and @Hazel. Do you want to join our team as well? Let us know!

Don't forget to:

• Send Ideas and Suggestions for Future Podcast Episodes

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[evastrm]

Great interview and appreciate the trouble you guys go through getting these interviews to us. Very well done!

Can someone give me a brief comparison between the European and US guidelines for tinnitus? Which do you think is better?

It is disheartening to hear what a mess the health system is when it comes to tinnitus.

 

[Hazel]

Great interview and appreciate the trouble you guys go through getting these interviews to us. Very well done!

Thanks, we really appreciate the feedback!

Can someone give me a brief comparison between the European and US guidelines for tinnitus? Which do you think is better?

From what I understand they're pretty comparable. The main difference is that the US one was released in 2014, and I don't know whether it's really been updated since then, so the EU one is just more up-to-date.

It is disheartening to hear what a mess the health system is when it comes to tinnitus.

It wasn't our most upbeat episode in that regard, but this is the truth unfortunately.

 

[Rafalek73]

Is there a chance that these interviews could be provided in written form?
Not everyone speaks English by ear.

 

[Hazel]

Is there a chance that these interviews could be provided in written form?
Not everyone speaks English by ear.

Hi there! Yes, we do in fact provide a transcript You can find it on the episode page by clicking the CC button to the right-hand side of the player:

This is also an opportunity for me to highlight the amazing work of our volunteer @Liz Windsor who creates these transcriptions. It costs her about 15h per episode, very painstaking work!!!

 

[Rafalek73]

Thank you @Hazel for your answer and than @Liz Windsor for great job

 

[Liz Windsor]

Happy to be of assistance! It's nice to know the transcripts are being read out there in Tinnitus World.

 

[Hazel]

By the way folks, I wrote a blog post inspired by this episode, which you can find here.

Basically, we're advocating for much more thorough testing of existing and new treatments and higher quality data on treatment efficacy.

It's just not acceptable that there's hardly any evidence for most of the treatments currently on the market. We need to know what works and what doesn't!

 

[Stan M]

Here are the guidelines I found on the internet.

American

https://www.ata.org/sites/default/files/Otolaryngology Head and Neck Surgery-2014.pdf

European

https://www.researchgate.net/public...tinnitus_diagnostics_assessment_and_treatment

 

[Halsy]

It is disheartening to hear what a mess the health system is when it comes to tinnitus.

That's where people need to get active and get political. I plan to get meetings with our federal and provincial ministers of health sometime in the new year as Canada has an upcoming election this October and we'll have to see the shakeout for that first.

After that I'd like to get a national and provincial strategy and official policies in place for dealing with and treating tinnitus patients. It damn near killed me. Like far too many here you're stumbling around in the dark, clueless, in pain, afraid. You're going to see professionals who basically shrug and don't know what to do. When I first went to ER they referred me to cardiologist for Christ's sake. Had they a policy in place it probably would have mitigated most of the problem from the outset - get them to an ENT or Neurotologist within 24 hours, get them on some benzos and tricyclic antidepressants immediately, have a hotline or something.

For something that is supposed to be a pretty common condition governments need to do better in addressing it. Not only that but once they can quantify the data and look at the economics of it - loss of GDP, tax revenue, tax costs for medical treatment, disability, et al. then they can start pressuring the private sector to act and incentivize them to fine a "cure".

Organizations like the ATA or Canadian Hearing Society are doing bupkis here so it's time to get grassroots.

 

[Hazel]

That's where people need to get active and get political. I plan to get meetings with our federal and provincial ministers of health sometime in the new year as Canada has an upcoming election this October and we'll have to see the shakeout for that first.

After that I'd like to get a national and provincial strategy and official policies in place for dealing with and treating tinnitus patients. It damn near killed me. Like far too many here you're stumbling around in the dark, clueless, in pain, afraid. You're going to see professionals who basically shrug and don't know what to do. When I first went to ER they referred me to cardiologist for Christ's sake. Had they a policy in place it probably would have mitigated most of the problem from the outset - get them to an ENT or Neurotologist within 24 hours, get them on some benzos and tricyclic antidepressants immediately, have a hotline or something.

For something that is supposed to be a pretty common condition governments need to do better in addressing it. Not only that but once they can quantify the data and look at the economics of it - loss of GDP, tax revenue, tax costs for medical treatment, disability, et al. then they can start pressuring the private sector to act and incentivize them to fine a "cure".

Organizations like the ATA or Canadian Hearing Society are doing bupkis here so it's time to get grassroots.

Totally agree. Would you mind outlining your ideas in this thread? We're trying to get a discussion going on political lobbying/activism, which will hopefully lead to a concrete project.