Hi,
I don't really want to get drawn into the same debate again... but here I am!
I'm not sure that most of the research money does get spent on CBT, etc. I don't think there are as many CBT trials as is widely perceived and secondly they're cheap, so don't take up a huge amount of funding. In our recent research review, Dr Schlee presents the breakdown of the papers included on the recent Frontiers tinnitus topic (see below). Source:
https://www.tinnitus.org.uk/2018-at...tus-heterogeneity-echoes-from-the-social-buzz
To directly quote the article assessing the breakdown;
"The majority of the articles published addressed aspects of tinnitus treatment (n=25; 35%, Figure 1). The majority of these were related to sound therapy treatments and cochlear implants (20% and 16% respectively). Studies investigating co-occurring conditions were also high in number (14%). Neuronal mechanisms, assessment methods and animal models accounted for nearly 10% each. Three articles addressed the effects of combined therapies, such as Cognitive Behavior Therapy (CBT) coupled with repetitive Transcranial Magnetic Stimulation (rTMS). The remainder concerned a wide range of novel treatment approaches such as Acoustic Coordinated Reset Neuromodulation®, electric stimulation, neurofeedback, physical therapy, rTMS, and vagus nerve stimulation."
One of my theories about why CBT, etc trials are more noticeable is because they are easy to understand and therefore easy for mainstream media to disseminate. Basic science (e.g. Will Sedley's research) is harder to understand, therefore harder to disseminate and in a way less of a story as it doesn't lead to a treatment available 'now'.
Another factor is many drugs trials are never written up so we never publically know the results.
Project Idea: that could easily be done to prove or disprove my hypothesis and one that could easily be done by the Tinnitus Talk community is to categorise and count the number (and value?) of research projects (maybe using the cure map to categorise) and see where they all fit. Would give the evidence for a great campaigning platform if what you find is that the research is skewed to any particular area - including CBT. Would need to think carefully about the methodology (happy to discuss this further) for doing so but may well give the evidence - or demonstrate that there's not as many CBT trials as thought. Either way it's a win, either there are a lot of CBT trials and you have the evidence to back this, or there isn't and can be reassured that the field is much more diverse than that.
I understand the cynicism towards the CBT trials, I have my own cynicism of some regions of tinnitus research too (which I'll keep to myself)!
@Steve and
@Hazel's points here are entirely valid. We need to encourage more researchers from all disciplines to engage in tinnitus research, we need to be an open and welcoming community that supports them - as well as supporting and respecting those that have given their careers and time to work in an area that is much undervalued and under researched. If it looks as though that doesn't happen, it is easy for talented researchers to look to other fields that are more supportive.
This doesn't exclude constructive criticism - but I believe any criticism needs to be that. An evidence based view that there is too much CBT research and the tinnitus research community needs to reprioritise would be just that IMO. Build the case! Happy to help.