1 Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.
2 Department of Vision and Hearing Sciences, Faculty of Science and Engineering, Anglia Ruskin University, Cambridge, UK.
Trends Hear. 2019 Jan-Dec;23:2331216519851749. doi: 10.1177/2331216519851749.
Internet-based interventions have been developed to improve access to audiovestibular health care. This review aimed to identify outcomes of Internet interventions for adults with hearing loss, tinnitus, and vestibular disorders. Electronic databases and manual searches were performed to identify studies meeting eligibility for inclusion. Fifteen studies (1,811 participants) met the inclusion criteria, with nine studies targeting tinnitus distress, five considering hearing loss, and one for vestibular difficulties. Only the tinnitus and hearing loss Internet intervention studies were eligible for data synthesis. Internet-based interventions for hearing loss were diverse. Overall, they showed no significant effects, although a statistically significant moderate effect ( = 0.59) was found after removing the study with the highest risk of bias (as a result of high attrition). Most Internet-based interventions for tinnitus provided cognitive behavioural therapy. They yielded statistically significant mean effect sizes for reducing tinnitus distress compared with both inactive ( = 0.59) and active controls ( = 0.32). Significant effects were also present for the secondary outcomes of anxiety, depression, insomnia, and quality of life (combined effect = 0.28). Only Internet-based interventions for tinnitus evaluated the 1-year postintervention effects indicated that results were maintained long term ( = 0.45). Scientific study quality was appraised using the Grading of Recommendations Assessment, Development and Evaluation approach and found to vary from very low to moderate. This review indicates the potential of Internet interventions for tinnitus to provide evidence-based accessible care. There is a need for additional high-quality evidence before conclusive results can be established regarding the effects of audiovestibular Internet interventions.
互联网干预措施已经被开发出来，以改善听觉和前庭健康护理的可及性。本综述旨在确定针对听力损失、耳鸣和前庭障碍成年人的互联网干预措施的结果。通过电子数据库和手动搜索，确定了符合纳入标准的研究。15 项研究（1811 名参与者）符合纳入标准，其中 9 项针对耳鸣困扰，5 项考虑听力损失，1 项针对前庭困难。只有耳鸣和听力损失互联网干预研究有资格进行数据综合。听力损失的互联网干预措施多种多样。总体而言，它们没有显著效果，尽管在去除风险最高的研究后（由于高脱落率），发现了一个具有统计学意义的中等效果（ = 0.59）。大多数针对耳鸣的互联网干预措施提供认知行为疗法。与非活动对照（ = 0.59）和积极对照（ = 0.32）相比，它们在降低耳鸣困扰方面产生了具有统计学意义的平均效应量。焦虑、抑郁、失眠和生活质量（综合效应量 = 0.28）的次要结果也存在显著效果。只有针对耳鸣的互联网干预措施评估了 1 年的干预后效果，表明结果可以长期维持（ = 0.45）。使用推荐评估、制定和评价方法评估科学研究质量，发现从极低到中等不等。本综述表明，针对耳鸣的互联网干预措施有可能提供基于证据的可及性护理。在确定视听互联网干预措施的效果方面，需要更多的高质量证据。
