The use of patient-report measures and intervention strategies for children and adolescents with chronic tinnitus: a scoping review

Chronic tinnitus during childhood/adolescence can be associated with impaired quality of life. Guidelines for managing paediatric tinnitus recommend assessment and interventions are often based upon the experiences and opinions of guideline committee members. To examine patient response tools used for the assessment and management of childhood tinnitus and how interventions had been evaluated. A structured scoping review (i) identifying and critically appraising patient response measures (PRMs) assessing tinnitus in children/adolescents, and (ii) critically appraising evidence supporting reported interventions. Original papers written in English, involving paediatric participants ≤19 years, reporting (i) application of established PRMs to assess the experience of chronic tinnitus or (ii) application and evaluation of tinnitus interventions were included. Papers written in English, identifying, or assessing the experience of chronic tinnitus (>3 months) as a primary complaint during childhood/adolescence in participants ≤19 years of age using a PRM and studies evaluating the application of non-pharmaceutical interventions for tinnitus in children/adolescents. Six studies involving the assessment of tinnitus during childhood/adolescence using a PRM were identified and evaluated. Three established (previously named, described, and published) PRMs were applied of which none were developed specifically for children/adolescents. Three behavioural tinnitus interventions and three combination intervention strategies (coupling of psychological intervention with sound enrichment) had been applied to and evaluated within paediatric populations. Although clinicians are seeing children/adolescents with tinnitus, they are evaluating and managing children’s distress without appropriate PRMs, and little evidence exists to support clinical interventions.

儿童及青少年时期的慢性耳鸣（chronic tinnitus）可能与生活质量受损相关。当前儿童耳鸣（paediatric tinnitus）管理指南中推荐的评估与干预措施，通常仅基于指南制定委员会成员的经验与主观意见。本研究旨在考察用于儿童耳鸣评估与管理的患者反应测量工具（patient response measures, PRMs），并探析各类干预措施的评估方式。本研究采用结构化范围综述（structured scoping review）方法，其一为识别并批判性评价用于评估儿童/青少年耳鸣的患者反应测量工具；其二为批判性评价支撑现有干预措施的相关证据。
本研究纳入以英语撰写的原创论文，研究对象为19岁及以下的儿童青少年参与者，且需满足以下任一条件：(i) 采用已验证的患者反应测量工具评估慢性耳鸣相关体验；或(ii) 开展耳鸣干预措施的应用与评估研究。具体纳入标准还包括：以英语撰写，针对19岁及以下儿童青少年群体，以慢性耳鸣（持续时长超过3个月）作为首要主诉，且采用患者反应测量工具对其耳鸣体验进行识别或评估的论文；以及针对儿童青少年耳鸣的非药物干预（non-pharmaceutical interventions）措施应用开展评估的研究。
最终共识别并纳入6项采用患者反应测量工具评估儿童/青少年耳鸣的研究。研究中共采用了3种已被验证（此前已有命名、描述与发表记录）的患者反应测量工具，但无一为儿童/青少年群体专门开发。另有3种行为类耳鸣干预方案，以及3种联合干预策略（即心理干预联合声音强化疗法（sound enrichment））被应用于儿童青少年群体并得到评估。尽管临床医师已接诊过不少伴耳鸣症状的儿童及青少年，但目前临床医师在评估与处理患儿耳鸣相关痛苦时，尚未配备合适的患者反应测量工具，且支撑相关临床干预措施的研究证据也较为匮乏。