Prediction of treatment outcome in patients suffering from chronic tinnitus - from individual characteristics to early and long-term change.

Female Humans Prospective Studies Surveys and Questionnaires Tinnitus / diagnosis Treatment Outcome
Chronic tinnitus Lasso Outcome prediction Therapy

Journal

Journal of psychosomatic research
ISSN: 1879-1360
Titre abrégé: J Psychosom Res
Pays: England
ID NLM: 0376333

Informations de publication

Date de publication:
06 2022
Historique:
received: 31 03 2021
revised: 07 01 2022
accepted: 19 03 2022
pubmed: 28 3 2022
medline: 1 6 2022
entrez: 27 3 2022
Statut: ppublish

Résumé

Despite the availability of successful treatment approaches for chronic tinnitus, it has proven difficult to predict who profits from treatment and it is still an open question if it is possible at all. We tried to overcome methodological shortcomings and to predict treatment outcome indicated by questionnaires measuring tinnitus distress. This is an observational, prospective cohort study. Lasso and post-selection inference methods were used to predict treatment outcome in patients suffering from chronic tinnitus (N = 747). Patients were treated for five consecutive days in an interdisciplinary setting according to guidelines. Early change, i.e. a positive response after the screening day, as well as change due to treatment was predicted by several psychopathological variables, but also tinnitus-related factors. Female gender as an example was a predictor for change due to treatment. In general, therapy success both for early change and change due to treatment cannot be predicted satisfactorily as indicated by a high mean cross-validation error (for early change: 9.83, for change due to treatment: 14.40). Analyzing sub-groups separated by tinnitus severity to reduce heterogeneity did not improve the situation and for patients with high tinnitus severity no predictors at all could be reported (cross-validated error: 11.62 for the low quartile, 13.38 for the low-medium quartile, and 15.61 for the medium-high quartile). Several psychopathological and tinnitus-related variables predicted early and long-term change. Nevertheless, also overcoming methodological shortcomings to predict treatment success did not lead to satisfactory results, but rather emphasizes the high heterogeneity of chronic tinnitus.

Sections du résumé

BACKGROUND AND OBJECTIVE
Despite the availability of successful treatment approaches for chronic tinnitus, it has proven difficult to predict who profits from treatment and it is still an open question if it is possible at all. We tried to overcome methodological shortcomings and to predict treatment outcome indicated by questionnaires measuring tinnitus distress.
METHODS
This is an observational, prospective cohort study. Lasso and post-selection inference methods were used to predict treatment outcome in patients suffering from chronic tinnitus (N = 747). Patients were treated for five consecutive days in an interdisciplinary setting according to guidelines.
RESULTS
Early change, i.e. a positive response after the screening day, as well as change due to treatment was predicted by several psychopathological variables, but also tinnitus-related factors. Female gender as an example was a predictor for change due to treatment. In general, therapy success both for early change and change due to treatment cannot be predicted satisfactorily as indicated by a high mean cross-validation error (for early change: 9.83, for change due to treatment: 14.40). Analyzing sub-groups separated by tinnitus severity to reduce heterogeneity did not improve the situation and for patients with high tinnitus severity no predictors at all could be reported (cross-validated error: 11.62 for the low quartile, 13.38 for the low-medium quartile, and 15.61 for the medium-high quartile).
CONCLUSION
Several psychopathological and tinnitus-related variables predicted early and long-term change. Nevertheless, also overcoming methodological shortcomings to predict treatment success did not lead to satisfactory results, but rather emphasizes the high heterogeneity of chronic tinnitus.

Identifiants

DOI: 10.1016/j.jpsychores.2022.110794 PMID: 35339906
pubmed: 35339906
pii: S0022-3999(22)00079-4
doi: 10.1016/j.jpsychores.2022.110794
pii:
doi:

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

110794

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

Auteurs

Daniela Ivansic (D)

Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.

Julia Palm (J)

Institute of Medical Statistics, Computer and Data Sciences, Jena University Hospital, Friedrich Schiller University, Jena, Germany.

Christo Pantev (C)

Institute of Biomagnetism and Biosignalanalysis, University of Muenster, Münster, Germany.

Petra Brüggemann (P)

Tinnitus Center, Charité Universitätsmedizin Berlin, Berlin, Germany.

Birgit Mazurek (B)

Tinnitus Center, Charité Universitätsmedizin Berlin, Berlin, Germany.

Orlando Guntinas-Lichius (O)

Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.

Christian Dobel (C)

Department of Otorhinolaryngology, Jena University Hospital, Friedrich Schiller University, Jena, Germany. Electronic address: christian.dobel@med.uni-jena.de.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Prediction of treatment outcome in patients...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Prediction of treatment outcome in patients...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › Prediction of treatment outcome in patients...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Troubles sensitifs › Troubles de l'audition › Acouphène › Prediction of treatment outcome in patients...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Prediction of treatment outcome in patients...