Clinical Practice Guideline for Management of Tinnitus: Recommendations From the US VA/DOD Clinical Practice Guideline Work Group

Importance: The most recent US clinical practice guideline (CPG) for tinnitus was published in 2014. The US Department of Veterans Affairs (VA)/US Department of Defense Tinnitus Clinical Practice Guideline Work Group recently completed a new guideline. The work group consisted of experts across disciplines who were supported by the VA Office of Quality and Patient Safety and the Defense Health Agency Clinical Quality Improvement Program. This article summarizes the first VA/US Department of Defense CPG for tinnitus management. Methods and Observations: The guideline was based on a systematic review of clinical and epidemiological evidence. Rigorous methods determined the strength of the recommendations. Developed by a panel of multidisciplinary experts, it provides a clear explanation of the logical associations between various care options and health outcomes while rating the quality of the evidence and strength of the recommendations for 20 questions focused on evaluating and managing care for adults with bothersome tinnitus. The guideline provides an evidence-based framework for evaluating and managing care for adults with bothersome tinnitus. Conclusions and Relevance: The CPG offers patients with tinnitus and clinicians an overview of evidence-based education and self-management, care options, and recommended outcome measures to monitor effectiveness and potentially improve patient health and well-being. Findings of a lack of sufficient evidence resulted from evaluating the quality of the body of evidence and emphasize the gaps in knowledge that need further study. Addressing these gaps may enable a comprehensive evaluation of the potential benefits and limitations of various tinnitus care options, ultimately improving patient care and clinical practice.