Rademaker Maaike M, Essers Brigitte A B, Stokroos Robert J, Smit Adriana L, Stegeman Inge
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.
University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands.
Front Neurol. 2021 May 25;12:668880. doi: 10.3389/fneur.2021.668880. eCollection 2021.
The therapeutic rationale varies among tinnitus therapies. A recent study identified which outcome measures should be used for different types of interventions. What patients consider the most important outcome measure in tinnitus therapy is unclear. To study the preference of the tinnitus patient for different outcome measures in tinnitus therapy. A discrete choice experiment was conducted. Participants were provided with two alternatives per choice set (nine choice sets total). Each choice-set consisted of four attributes (tinnitus loudness, tinnitus acceptance, quality of sleep and concentration). With a difference in one of three levels (increased, similar or decreased after treatment) between the alternatives. Results were analyzed with a mixed logit model. Preference heterogeneity was explored with covariates, correlating attributes and a latent class analysis. One hundred and twenty-seven participants took part. In the mixed logit models we found that the choice for a tinnitus therapy was significantly affected by all levels of the outcomes, except for a similar level in concentration and tinnitus acceptance. Tinnitus loudness was considered the most important outcome measure relative to the other attributes. Preference heterogeneity was not explained by correlating attributes. The latent class analysis identified two classes. The first class was similar to the mixed logit analysis, except for a non-significance of similar quality of sleep and tinnitus acceptance. The second class showed a statistical significant preference only for increased tinnitus acceptance and similar quality of sleep. Based on this study, tinnitus patients consider loudness the most important outcome measure. However, there is a variance in preference as indicated by the latent class analysis. This study underlines the importance of research into tinnitus heterogeneity. Next, this study highlights the need for research into tinnitus therapies that focus on diminishing tinnitus loudness.
耳鸣疗法的治疗原理各不相同。最近的一项研究确定了不同类型干预措施应使用哪些结果指标。目前尚不清楚患者认为耳鸣治疗中最重要的结果指标是什么。为了研究耳鸣患者对耳鸣治疗中不同结果指标的偏好,开展了一项离散选择实验。每个选择集为参与者提供两个备选方案(共九个选择集)。每个选择集由四个属性组成(耳鸣响度、对耳鸣的接受度、睡眠质量和注意力)。备选方案之间在三个水平之一(治疗后增加、相似或降低)上存在差异。结果采用混合逻辑模型进行分析。通过协变量、相关属性和潜在类别分析来探讨偏好异质性。127名参与者参与了研究。在混合逻辑模型中,我们发现除了注意力和对耳鸣接受度处于相似水平外,耳鸣治疗的选择受所有结果水平的显著影响。相对于其他属性,耳鸣响度被认为是最重要的结果指标。相关属性无法解释偏好异质性。潜在类别分析确定了两类。第一类与混合逻辑分析相似,只是睡眠质量和对耳鸣接受度处于相似水平时不显著。第二类仅对耳鸣接受度增加和睡眠质量相似表现出统计学上的显著偏好。基于这项研究,耳鸣患者认为响度是最重要的结果指标。然而,潜在类别分析表明存在偏好差异。这项研究强调了耳鸣异质性研究的重要性。其次,这项研究突出了针对降低耳鸣响度的耳鸣疗法进行研究的必要性。