VA/DoD Clinical Practice Guideline for Tinnitus
U.S. Department of Veterans Affairs. (2024).
Washington, D.C.: U.S. Department of Veterans Affairs, (Version 1.0), Available from: https://www.healthquality.va.gov/guidelines/CD/tinnitus/.
<div>This clinical practice guideline provides recommendations on best evidence-based practices on assessment and care options for adults, 18 years and older, with bothersome tinnitus.</div>
U.S. Department of Veterans Affairs/U.S. Department of Defense Tinnitus Clinical Practice Guideline Work Group
<div>For monitoring the effectiveness of tinnitus management,</div>
<div>
<ul>
<li>validated subjective outcome measures are suggested (e.g., Tinnitus Functional Index, Tinnitus Handicap Inventory; Weak For); and</li>
<li>psychoacoustic measures are <span style="text-decoration: underline;">not</span> suggested (e.g., minimum masking level, loudness matching; Weak Against).</li>
</ul>
</div>
<div>Educational counseling is suggested to reduce the functional impact of tinnitus (Weak For). Web-based or app-based educational self-management tools and computer-based educational games or training programs lack evidence for recommendation (Neither For Nor Against).</div>
<div>For adults with hearing loss and tinnitus,</div>
<div>
<ul>
<li>hearing aids are suggested for tinnitus management (Weak For);</li>
<li>contralateral routing of signal/sound (CROS) hearing aids lack evidence for recommendation (Neither For Nor Against);</li>
<li>implantable bone conduction devices (BCD) lack evidence for recommendation (Neither For Nor Against); </li>
<li>cochlear implantation (CI) is suggested for adults who meet candidacy requirements (Weak For); and</li>
<li>CI is suggested over BCD or CROS for adults with single-sided deafness who meet candidacy requirements (Weak For).</li>
</ul>
</div>
<div>Therapeutic use of sound for tinnitus self-care is suggested (Weak For). Other sound-based interventions lack evidence for recommendation including</div>
<ul>
<li>auditory cognitive training for the reduction of tinnitus distress (e.g., frequency discrimination training, auditory attention training; Neither For Nor Against); and</li>
<li>sound therapy with altered music to reduce the impact of tinnitus (e.g., notched music therapy, spectrally altered music; Neither For Nor Against).</li>
</ul>
<div>A multidisciplinary team is suggested for interventions combining sound-based treatments and behavioral interventions (e.g., Cognitive Behavioral Therapy; Weak For). The authors suggest that audiologists direct tinnitus education (Weak For).</div>
