Shetty Hemanth Narayan, Chandrashekar Sushma
JSS Institute of Speech and Hearing, Mysuru, India.
Wenlock district hospital, Mangalore, India.
Indian J Otolaryngol Head Neck Surg. 2024 Dec;76(6):5025-5034. doi: 10.1007/s12070-024-04986-0. Epub 2024 Aug 20.
To evaluate the effectiveness of Frequency Discrimination Training (FDT) programs with and without an integrated game format for treating a person with tinnitus. Searches were conducted in Medline, PubMed, Web of Science, Elsevier, Springer, Scopus, and ProQuest databases from early 2000 to 2024. FDT studies of non-randomised and randomised clinical trials that used validated tinnitus handicap index were considered. A total of six articles from non-randomised (four studies) and randomised clinical trials (two studies) met our inclusion criteria. Both types of studies were rated as good quality, as assessed by the Mixed Methods Appraisal Tool. However, the levels of evidence were generally limited by factors such as lack of blinding, failure to calculate effect sizes, and absence of follow-up assessments after the treatment period to monitor outcomes. According to the random-effects model, Frequency Discrimination Training (FDT) reduces tinnitus handicap with a medium effect size of 0.5104 (95% CI: 0.2478 to 0.7729), regardless of game integration. When considering FDT without game integration, the effect size remained medium at 0.473 (95% CI: 0.14 to 0.780). In contrast, FDT with game integration demonstrated a large effect size of 0.90 (95% CI: 0.29 to 1.50) in reducing the handicap caused by the tinnitus. A substantial effect size was observed in THI score reduction among tinnitus participants trained with FDT integrated with a game compared to those without integration.
评估有无整合游戏形式的频率辨别训练（FDT）方案对耳鸣患者的治疗效果。于2000年初至2024年在Medline、PubMed、科学网、爱思唯尔、施普林格、Scopus和ProQuest数据库中进行检索。纳入使用经过验证的耳鸣致残指数的非随机和随机临床试验的FDT研究。共有6篇来自非随机（4项研究）和随机临床试验（2项研究）的文章符合我们的纳入标准。如通过混合方法评估工具所评估，这两类研究的质量均被评为良好。然而，证据水平通常受到缺乏盲法、未计算效应量以及治疗期后未进行随访评估以监测结果等因素的限制。根据随机效应模型，无论是否整合游戏，频率辨别训练（FDT）均能降低耳鸣致残程度，效应量中等，为0.5104（95%可信区间：0.2478至0.7729）。当考虑未整合游戏的FDT时，效应量仍为中等，为0.473（95%可信区间：0.14至0.780）。相比之下，整合游戏的FDT在减轻耳鸣所致致残方面显示出较大的效应量，为0.90（95%可信区间：0.29至1.50）。与未整合游戏的FDT训练的耳鸣参与者相比，整合游戏的FDT训练的耳鸣参与者在耳鸣致残量表（THI）评分降低方面观察到显著的效应量。
