Research: JACKSON and colleagues,

Listed in Issue 139

Abstract

JACKSON and colleagues, Northern College of Acupuncture, York, UK, have carried out a series of trials of acupuncture for tinnitus.

Background

The aim of the study was to explore patient perceived benefits of acupuncture for tinnitus.

Methodology

In a series of controlled n=1 trials, with two phases A and B, 6 patients with tinnitus were enlisted. Patients received a course of 10 acupuncture treatments over a 2-week period. Daily Diary entries related to the four tinnitus symptoms (loudness of tinnitus; pitch of tinnitus; waking hours affected with tinnitus; quality of sleep) were recorded by patients for 14 days pre-treatment (phase A) and 14 days post-treatment (phase B). Secondary outcomes were the Tinnitus Handicap Inventory (THI) and Measure Your Medical Outcome Profile (MYMOP). A hierarchical Bayesian model was used to combine the results from the individual patients to obtain estimates of the population and individual patient treatment effects, incorporating random variations at both levels (between patients and within patient).

Results

For the symptoms of loudness and pitch, there were variable treatment effects between patients, with a trend for the median overall reduction for loudness of -2.49 and for pitch -1.39. For the other two symptoms, the waking hours affected and quality of sleep, patients’ responses were more consistent, with amore credible overall median reduction for affected waking hours of -2.76 and for quality of sleep -2.72. The THI and MYMOP measures showed a trend of improvement after treatment.

Conclusion

The n=1 trial methodology, with an AB design and Bayesian analysis, can be considered of value in exploring treatment effects for small numbers of patients receiving individualised treatments, as is common within complementary medicine. When the treatment effects from 6 patients were synthesized, the results of this study suggest that acupuncture may have a beneficial role in the treatment of tinnitus.

References

Jackson A, MacPherson H, Hahn S. Acupuncture for tinnitus: a series of six n = 1 controlled trials. Complementary Therapies in Medicine 14 (1): 39-46, Mar 2006.

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