Unbound MEDLINE

A comparison of benefit and economic value between two sound therapy tinnitus management options.

Abstract

BACKGROUND
Sound therapy coupled with appropriate counseling has gained widespread acceptance in the audiological management of tinnitus. For many years, ear level sound generators (SGs) have been used to provide masking relief and to promote tinnitus habituation. More recently, an alternative treatment device was introduced, the Neuromonics Tinnitus Treatment (NTT), which employs spectrally-modified music in an acoustic desensitization approach in order to help patients overcome the disturbing consequences of tinnitus. It is unknown, however, if one treatment plan is more efficacious and cost-effective in comparison to the other. In today's economic climate, it has become critical that clinicians justify the value of tinnitus treatment devices in relation to observed benefit.
PURPOSE
To determine perceived benefit from, and economic value associated with, two forms of sound therapy, namely, SGs and NTT.
RESEARCH DESIGN
Retrospective between-subject clinical study.
STUDY SAMPLE
A sample of convenience comprised of 56 patients drawn from the Tinnitus Management Clinic at the Cleveland Clinic participated. Twenty-three patients selected SGs, and 33 patients selected NTT as their preferred sound therapy treatment option.
DATA COLLECTION AND ANALYSIS
Sound therapy benefit was quantified using the Tinnitus Handicap Inventory (THI). The questionnaire was administered before and 6 mo after initiation of tinnitus treatment. Prior to device fitting, all patients participated in a 1.5 hr group education session about tinnitus and its management. Economic value comparisons between sound therapy options were made using a cost-effectiveness analysis (CEA) and cost-utility analysis (CUA).
RESULTS
THI scores indicated a significant improvement (p < 0.001) in tinnitus reduction for both treatment types between a pre- and 6 mo postfitting interval, yet there were no differences (p > 0.05) between the treatment alternatives at baseline or 6 mo postfitting. The magnitude of improvement for both SGs and NTT was dependent on initial perceived tinnitus handicap. Based on the CEA and CUA economic analyses alone, it appears that the SGs may be the more cost-effective alternative; however, the magnitude of economic value is a function of preexisting perceived tinnitus activity limitation/participation restriction.
CONCLUSIONS
Both SGs and NTT provide significant reduction in perceived tinnitus handicap, with benefit being more pronounced for those patients having greater tinnitus problems at the beginning of therapy. Although the economic models favored the SGs over the NTT, there are several other critical factors that clinicians must take into account when recommending a specific sound therapy option. These include initial tinnitus severity complaints and a number of patient preference variables such as sound preference, listening acceptability, and lifestyle.

Links

  • Publisher Full Text
  • Authors

    Newman CW, Sandridge SA

    Institution

    Cleveland Clinic, Cleveland, OH, USA. newmanc@ccf.org

    Source

    Journal of the American Academy of Audiology 23:2 2012 Feb pg 126-38

    MeSH

    Acoustic Stimulation
    Adult
    Aged
    Cost-Benefit Analysis
    Female
    Habituation, Psychophysiologic
    Hearing Aids
    Humans
    Male
    Middle Aged
    Music
    Perceptual Masking
    Quality of Life
    Quality-Adjusted Life Years
    Questionnaires
    Retrospective Studies
    Tinnitus
    Treatment Outcome

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    22353681