Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.
Vision and Hearing Sciences Research Group, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, UK.
Int J Clin Pract. 2021 Oct;75(10):e14684. doi: 10.1111/ijcp.14684. Epub 2021 Aug 6.
Meaningfully grouping individuals with tinnitus who share a common characteristics (ie, subgrouping, phenotyping) may help tailor interventions to certain tinnitus subgroups and hence reduce outcome variability. The purpose of this study was to test if the presence of tinnitus subgroups are discernible based on hearing-related comorbidities, and to identify predictors of tinnitus severity for each subgroup identified.
An exploratory cross-sectional study was used. The study was nested within an online survey distributed worldwide to investigate tinnitus experiences during the COVID-19 pandemic. The main outcome measure was the tinnitus Handicap Inventory- Screening Version.
From the 3400 respondents, 2980 were eligible adults with tinnitus with an average age of 58 years (SD = 14.7) and 49% (n = 1457) being female. A three-cluster solution identified distinct subgroups, namely, those with tinnitus-only (n = 1306; 44%), those presenting with tinnitus, hyperacusis, hearing loss and/or misophonia (n = 795; 27%), and those with tinnitus and hearing loss (n = 879; 29%). Those with tinnitus and hyperacusis reported the highest tinnitus severity (M = 20.3; SD = 10.5) and those with tinnitus and no hearing loss had the lowest tinnitus severity (M = 15.7; SD = 10.4). Younger age and the presence of mental health problems predicted greater tinnitus severity for all groups (β ≤ -0.1, P ≤ .016).
Further exploration of these potential subtypes are needed in both further research and clinical practice by initially triaging tinnitus patients prior to their clinical appointments based on the presence of hearing-related comorbidities. Unique management pathways and interventions could be tailored for each tinnitus subgroup.
将具有共同特征(即亚组、表型)的耳鸣患者进行有意义的分组,可能有助于针对特定的耳鸣亚组进行干预,从而减少结果的变异性。本研究的目的是测试是否可以根据与听力相关的合并症来识别耳鸣亚组的存在,并确定为每个识别出的亚组确定耳鸣严重程度的预测因素。
采用探索性横断面研究。该研究嵌套在一项全球范围内在线调查中,旨在调查 COVID-19 大流行期间的耳鸣体验。主要结局测量指标是耳鸣残疾量表-筛查版。
在 3400 名应答者中,有 2980 名符合条件的成年耳鸣患者,平均年龄为 58 岁(标准差=14.7),49%(n=1457)为女性。三聚类解决方案确定了三个不同的亚组,即仅耳鸣组(n=1306;44%)、同时伴有耳鸣、听觉过敏、听力损失和/或恐声症组(n=795;27%)和伴有耳鸣和听力损失组(n=879;29%)。伴有耳鸣和听觉过敏的患者报告的耳鸣严重程度最高(M=20.3;SD=10.5),而伴有耳鸣且无听力损失的患者报告的耳鸣严重程度最低(M=15.7;SD=10.4)。年龄较小和存在心理健康问题预测所有组的耳鸣严重程度更高(β≤-0.1,P≤.016)。
在进一步的研究和临床实践中,需要进一步探索这些潜在的亚组,在患者的临床预约前,根据与听力相关的合并症,对耳鸣患者进行初步分诊。可以为每个耳鸣亚组定制独特的管理途径和干预措施。