Internet-based cognitive behavioural therapy for adults with tinnitus

Tinnitus remains one of the most prevalent and distressing audiological symptoms. Although specialist tinnitus services are in high demand, geographical and service constraints result in limited access to these services. Internet-based cognitive behavioural therapy (ICBT) has been developed to provide additional evidence-based tinnitus care. This article provides insights into what ICBT involves

Comments on Tao et al. (2017), “Multiple-Frequency Matching Treatment Strategy for Tinnitus”

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U.S. Media Portrayal of Hearing Loss and Hearing Aids

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How to Develop and Deliver Internet-based Audiological Interventions

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Predicting the Outcomes of Internet-Based Cognitive Behavioral Therapy for Tinnitus: Applications of Artificial Neural Network and Support Vector Machine

Purpose: Internet-based cognitive behavioral therapy (ICBT) has been found to be effective for tinnitus management, although there is limited understanding about who will benefit the most from ICBT. Traditional statistical models have largely failed to identify the nonlinear associations and hence find strong predictors of success with ICBT. This study aimed at examining the use of an artificial neural network (ANN) and support vector machine (SVM) to identify variables associated with treatment success in ICBT for tinnitus. Method: The study involved a secondary analysis of data from 228 individuals who had completed ICBT in previous intervention studies. A 13-point reduction in Tinnitus Functional Index (TFI) was defined as a successful outcome. There were 33 predictor variables, including demographic, tinnitus, hearing-related and treatment-related variables, and clinical factors (anxiety, depression, insomnia, hyperacusis, hearing disability, cognitive function, and life satisfaction). Predictive models using ANN and SVM were developed and evaluated for classification accuracy. SHapley Additive exPlanations (SHAP) analysis was used to identify the relative predictor variable importance using the best predictive model for a successful treatment outcome. Results: The best predictive model was achieved with the ANN with an average area under the receiver operating characteristic value of 0.73 ± 0.03. The SHAP analysis revealed that having a higher education level and a greater baseline tinnitus severity were the most critical factors that influence treatment outcome positively. Conclusions: Predictive models such as ANN and SVM help predict ICBT treatment outcomes and identify predictors of outcome. However, further work is needed to examine predictors that were not considered in this study as well as to improve the predictive power of these models

Dismantling Internet-Based Cognitive Behavioral Therapy for Tinnitus. The Contribution of Applied Relaxation: A Randomized Controlled Trial

Background: Internet-based cognitive behavioral therapy (ICBT) for tinnitus is an evidence-based intervention. The components of ICBT for tinnitus have, however, not been dismantled and thus the effectiveness of the different therapeutic components is unknown. It is, furthermore, not known if heterogeneous tinnitus subgroups respond differently to ICBT. Aims: This dismantling study aimed to explore the contribution of applied relaxation within ICBT for reducing tinnitus distress and comorbidities associated with tinnitus. A secondary aim was to assess whether outcomes varied for three tinnitus subgroups, namely those with significant tinnitus severity, those with low tinnitus severity, and those with significant depression. Methods: A parallel randomized controlled trial design (n = 126) was used to compare audiologist-guided applied relaxation with the full ICBT intervention. Recruitment was online and via the intervention platform. Assessments were completed at four-time points including a 2-month follow-up period. The primary outcome was tinnitus severity as measured by the Tinnitus Functional Index. Secondary outcomes were included for anxiety, depression, insomnia, negative tinnitus cognitions, health-related quality of life, hearing disability, and hyperacusis. Treatment engagement variables including the number of logins, number of modules opened, and the number of messages sent. Both an intention-to-treat analysis and completer\u27s only analysis were undertaken. Results: Engagement was low which compromised results as the full intervention was undertaken by few participants. Both the ICBT and applied relaxation resulted in large reduction of tinnitus severity (within-group effect sizes d = 0.87 and 0.68, respectively for completers only analysis), which were maintained, or further improved at follow-up. These reductions in tinnitus distress were greater for the ICBT group, with a small effect size differences (between-group d = 0.15 in favor of ICBT for completers only analysis). Tinnitus distress decreased the most at post-intervention for those with significant depression at baseline. Both ICBT and applied relaxation contributed to significant reductions on most secondary outcome measures, with no group differences, except for a greater reduction of hyperacusis in the ICBT group. Conclusion: Due to poor compliance partly attributed to the COVID-19 pandemic results were compromised. Further studies employing strategies to improve compliance and engagement are required. The intervention\u27s effectiveness increased with initial level of tinnitus distress; those with the highest scores at intake experienced the most substantial changes on the outcome measures. This may suggest tailoring of interventions according to tinnitus severity. Larger samples are needed to confirm this

Portrayal of hearing loss in YouTube videos: An exploratory cross-sectional analysis

Objective: The objective of the current study was to examine the source, content, understandability and actionability of hearing loss information on YouTube videos. Method: The study used a cross-sectional design. One hundred of the most frequently viewed YouTube videos were identified and various data were manually coded (i.e., video source, video content, popularity measures such as number of views, likes, and dislikes). In addition, the understandability and actionability of each video were evaluated using the Patient Education Materials Assessment Tool for Audiovisual Martials (PEMAT-AV) rating scale. Results: Of the 100 most viewed videos, 16 were created by consumers, 62 were professional-created, and 22 were media-based. Symptoms, causes and treatment or management of hearing loss were the most frequently discussed content categories with over 60% of all videos commenting on these areas. The overall understandability and actionability scores for the 100 videos included were 77% and 31% respectively indicating adequate understandability and poor actionability. Conclusions: The YouTube videos on hearing loss focus on a range of issues. The poor actionability of these videos was a concern as these videos may not lead to appropriate consumer actions in addressing their hearing loss. Efforts are needed to improve the quality and content of these videos to promote appropriate behavior change