NIHR National Biomedical Research Unit in Hearing, School of Clinical Sciences, The University of Nottingham, Nottingham, UK.
J Eval Clin Pract. 2012 Apr;18(2):326-34. doi: 10.1111/j.1365-2753.2010.01566.x. Epub 2010 Nov 19.
RATIONALE, AIM AND OBJECTIVE: In 2009, the UK Department of Health formalized recommended National Health Service practices for the management of tinnitus from primary care onwards. It is timely therefore to evaluate the perceived practicality, utility and impact of those guidelines in the context of current practice.
We surveyed current practice by posting a 36-item questionnaire to all audiology and hearing therapy staff that we were able to identify as being involved in tinnitus patient care in England.
In total, 138 out of 351 clinicians responded (39% response rate). The findings indicate a consensus opinion that management should be tailored to individual symptom profiles but that there is little standardization of assessment procedures or tools in use.
While the lack of standardized practice might provide flexibility to meet local demand, it has drawbacks. It makes it difficult to ascertain key standards of best practice, it complicates the process of clinical audit, it implies unequal patient access to care, and it limits the implementation of translational research outcomes. We recommend that core elements of practice should be standardized, including use of a validated tinnitus questionnaires and an agreed pathway for decision making to better understand the rationale for management strategies offered.
背景、目的和目标：2009 年，英国卫生部正式规定了国民保健制度从初级保健开始管理耳鸣的推荐做法。因此，及时评估这些指南在当前实践中的实用性、实用性和影响非常重要。
我们通过向我们能够确定的参与英格兰耳鸣患者护理的所有听力学和听力治疗人员发送一份 36 项问卷来调查当前的做法。
共有 351 名临床医生中的 138 名（39%的回复率）做出了回应。调查结果表明，一种共识意见认为，管理应该根据个人的症状特征进行定制，但评估程序或使用的工具几乎没有标准化。
虽然缺乏标准化的实践可能提供了满足当地需求的灵活性，但也有缺点。这使得确定最佳实践的关键标准变得困难，使临床审计过程复杂化，意味着患者获得护理的机会不平等，限制了转化研究结果的实施。我们建议应标准化核心实践要素，包括使用经过验证的耳鸣问卷和达成的决策途径，以更好地了解所提供管理策略的基本原理。
