Simoes Jorge, Neff Patrick, Schoisswohl Stefan, Bulla Jan, Schecklmann Martin, Harrison Steve, Vesala Markku, Langguth Berthold, Schlee Winfried
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland.
Front Public Health. 2019 Jun 25;7:157. doi: 10.3389/fpubh.2019.00157. eCollection 2019.
Chronic tinnitus is a condition estimated to affect 10-15% of the population. No treatment has shown efficacy in randomized clinical trials to reliably and effectively suppress the phantom perceptions, and little is known why patients react differently to the same treatments. Tinnitus heterogeneity may play a central role in treatment response, but no study has tried to capture tinnitus heterogeneity in terms of treatment response. To test if the individualized treatment response can be predicted using personal, tinnitus, and treatment characteristics. A survey conducted by the web platform Tinnitus Hub collected data of 5017 tinnitus bearers. The participants reported which treatments they tried and the outcome of the given treatment. Demographic and tinnitus characteristics, alongside with treatment duration were used as predictors of treatment outcomes in both an univariate as well as a multivariate regression setup. First, simple linear regressions were used with each of the 13 predictors on all of 25 treatment outcomes to predict how much variance could be explained by each predictor individually. Then, all 13 predictors were added together in the elastic net regression to predict treatment outcomes. Individual predictors from the linear regression models explained on average 2% of the variance of treatment outcome. "Duration of treatment" was the predictor that explained, on average, most of the variance, 6.8%. When combining all the predictors in the elastic net, the model could explain on average 16% of the deviance of treatment outcomes. By demonstrating that different aspects predict response to various treatments, our results support the notion that tinnitus heterogeneity influences the observed variability in treatment response. Moreover, the data suggest the potential of personalized tinnitus treatment based on demographic and clinical characteristics.
据估计,慢性耳鸣影响着10%至15%的人群。在随机临床试验中,尚无治疗方法能有效可靠地抑制这种幻听,而且对于患者对相同治疗反应不同的原因知之甚少。耳鸣的异质性可能在治疗反应中起核心作用,但尚无研究试图从治疗反应的角度捕捉耳鸣的异质性。为了测试是否可以使用个人、耳鸣和治疗特征来预测个体化的治疗反应。由网络平台耳鸣中心进行的一项调查收集了5017名耳鸣患者的数据。参与者报告了他们尝试过的治疗方法以及给定治疗的结果。在单变量和多变量回归设置中,人口统计学和耳鸣特征以及治疗持续时间被用作治疗结果的预测因素。首先,对25种治疗结果中的每一种,使用13个预测因素中的每一个进行简单线性回归,以预测每个预测因素单独可以解释多少方差。然后,将所有13个预测因素添加到弹性网络回归中以预测治疗结果。线性回归模型中的各个预测因素平均解释了治疗结果方差的2%。“治疗持续时间”是平均解释方差最多的预测因素,为6.8%。当在弹性网络中组合所有预测因素时,该模型平均可以解释治疗结果偏差的16%。通过证明不同方面可预测对各种治疗的反应,我们的结果支持耳鸣异质性影响观察到的治疗反应变异性这一观点。此外,数据表明基于人口统计学和临床特征进行个性化耳鸣治疗的潜力。