Recommendation ID

What is the clinical and cost effectiveness of a combination management strategy consisting of sound therapy and tinnitus support?

Any explanatory notes
(if applicable)

Why the committee were unable to make recommendations
The evidence for combination strategies was limited, but indicated to the committee that tinnitus support alongside other management strategies was important. No recommendations on particular combinations of tinnitus management strategies were made. However, the recommendations on tinnitus support and management in this guideline specify that everyone should receive tinnitus support along with whatever strategy (for example, amplification devices and psychological therapies) has been chosen in their management plan.

The committee noted that there is limited evidence available for the use of sound therapy with tinnitus support. They made a research recommendation on the combination of sound therapy with tinnitus support.

The committee recognised that tinnitus retraining therapy (TRT) is a specific combination management strategy. They agreed that the original protocol for TRT does not allow people to be actively engaged in the development of their management plan. TRT is used in modified forms in current practice, generally in different formats to those described in the literature. In the evidence base identified in the associated evidence review, there is variation in how TRT is delivered, which makes it difficult to determine the most clinically effective form of TRT. The committee agreed that this evidence base does not reflect the TRT interventions that are typically delivered in current practice, and that a recommendation for TRT could not be made. Modified TRT, using the principles of tinnitus support, can be evaluated under the research recommendation made in the combination management strategies review.

Source guidance details

Comes from guidance
Tinnitus: assessment and management
Date issued
March 2020

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 01/03/2020