Condition

Tinnitus

Ringing or buzzing in the ears

740M
People Affected
100
Active Trials
29.6M
New Cases/Year
100
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Cognitive Behavioral Therapy (CBT)
85% Effectiveness• 90% Confidence• 95% Safety• 32 trials• 15K participants
HIGH EvidenceExcellent ValueDose: 8-12 weekly 60-90 minute sessions
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Comparative Safety Scale(Higher is safer)

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Meth💀
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Chemo☢️
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95
DangerousModerateSafe

Time to Effect

4-12 weeks

Duration

8-12 weeks (initial course), then as needed

Response Rate

70%

Remission Rate

25%

Common Side Effects:

Temporary emotional discomfort: 8%
Initial frustration with therapy process: 7%

Annual Cost of Care

Drug Cost

$0

Monitoring

$200

Side Effects

$0

Total Annual

$2,200

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.08

ICER

$15,000/QALY

Cost per Remission

$8,800

Cost per Responder

$3,143

Treatment Outcomes
Primary Outcomes
Tinnitus Handicap Inventory (THI) score56/100 points (moderate-severe handicap)
-35.7% (-20 points)
Tinnitus Functional Index (TFI) score65/100 points (severe impact)
-23.1% (-15 points)
Generalized Anxiety Disorder (GAD-7) score13/21 points (moderate anxiety)
-38.5% (-5 points)
Perceived Tinnitus Annoyance (VAS)7/10 points
-28.6% (-2 points)
Secondary Benefits
Patient Health Questionnaire (PHQ-9) score15/27 points (moderately severe depression)
-33.3% (-5 points)
Insomnia Severity Index (ISI) score19/28 points (moderate insomnia)
-31.6% (-6 points)
Overall Quality of Life (VAS)50/100 points
+20% (+10 points)
Common Side Effects
Temporary emotional discomfort
+8%
Initial frustration with therapy process
+7%
2
Mindfulness-Based Stress Reduction (MBSR)
80% Effectiveness• 85% Confidence• 95% Safety• 5 trials• 3.5K participants
MODERATE EvidenceGood ValueDose: 8 weekly 2.5-hour sessions, plus daily 45-60 min home practice
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Comparative Safety Scale(Higher is safer)

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Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
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95
DangerousModerateSafe

Time to Effect

8 weeks (course duration), sustained over months

Duration

8-week structured program, then ongoing self-practice

Response Rate

65%

Remission Rate

20%

Common Side Effects:

Temporary emotional discomfort: 8%
Frustration with practice/lack of immediate results: 6%

Annual Cost of Care

Drug Cost

$0

Monitoring

$100

Side Effects

$0

Total Annual

$1,100

Cost-Effectiveness

GOOD

QALYs Gained

0.06

ICER

$30,000/QALY

Cost per Remission

$5,500

Cost per Responder

$1,692

Treatment Outcomes
Primary Outcomes
Tinnitus Handicap Inventory (THI) Score55/100 (Moderate Tinnitus)
-27.3% (-15 points)
Tinnitus Functional Index (TFI) Score50/100 (Moderate Tinnitus Impact)
-24% (-12 points)
Perceived Stress Scale (PSS-10) Score22/40 (Elevated Stress)
-31.8% (-7 points)
Generalized Anxiety Disorder (GAD-7) Score11/21 (Moderate Anxiety)
-36.4% (-4 points)
Secondary Benefits
Insomnia Severity Index (ISI) Score16/28 (Moderate Insomnia)
-31.3% (-5 points)
Patient Health Questionnaire (PHQ-9) Score10/27 (Moderate Depressive Symptoms)
-40% (-4 points)
WHOQOL-BREF Psychological Domain Score65/100 (Reduced Quality of Life)
+10.8% (+7 points)
Common Side Effects
Temporary emotional discomfort
+8%
Frustration with practice/lack of immediate results
+6%
3
Tinnitus Retraining Therapy (TRT)
75% Effectiveness• 85% Confidence• 95% Safety• 9 trials• 8K participants
MODERATE EvidenceGood ValueDose: Daily use of sound generators for 6-12 hours, initial intensive counseling
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Comparative Safety Scale(Higher is safer)

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Meth💀
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95
DangerousModerateSafe

Time to Effect

6-18 months

Duration

12-24 months of consistent sound generator use and counseling

Response Rate

65%

Remission Rate

20%

Common Side Effects:

Adjustment to sound generators: 10%
Initial frustration with therapy length: 8%

Annual Cost of Care

Drug Cost

$0

Monitoring

$300

Side Effects

$0

Total Annual

$4,500

Cost-Effectiveness

GOOD

QALYs Gained

0.07

ICER

$25,000/QALY

Cost per Remission

$22,500

Cost per Responder

$6,923

Treatment Outcomes
Primary Outcomes
Tinnitus Handicap Inventory (THI) score58/100 (moderate-severe handicap)
-40% (-23 points)
Tinnitus Functional Index (TFI) score55/100 (moderate impact)
-35% (-19 points)
Tinnitus Annoyance (VAS) score7/10
-42% (-2.9 points)
Secondary Benefits
Insomnia Severity Index (ISI) score18/28 (moderate insomnia)
-33% (-6 points)
Generalized Anxiety Disorder (GAD-7) score12/21 (moderate anxiety)
-25% (-3 points)
Patient Health Questionnaire (PHQ-9) score11/27 (moderate depression)
-27% (-3 points)
Common Side Effects
Adjustment to sound generators
+10%
Initial frustration with therapy length
+8%
4
Hearing Aids (for individuals with hearing loss)
75% Effectiveness• 90% Confidence• 95% Safety• 1 trials• 10K participants
HIGH EvidenceExcellent ValueDose: Daily use during waking hours
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Comparative Safety Scale(Higher is safer)

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Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
95
DangerousModerateSafe

Time to Effect

Immediate (amplification), weeks (adaptation)

Duration

Lifetime (as long as hearing loss persists)

Response Rate

70%

Remission Rate

10%

Common Side Effects:

Ear irritation/discomfort: 8%
Feedback/occlusion effect: 7%
Initial adjustment period: 15%

Annual Cost of Care

Drug Cost

$0

Monitoring

$200

Side Effects

$0

Total Annual

$1,000

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.07

ICER

$25,000/QALY

Cost per Remission

$10,000

Cost per Responder

$1,429

Treatment Outcomes
Primary Outcomes
Tinnitus Handicap Inventory (THI) Score50/100 (moderate handicap)
-30% (-15 points)
Tinnitus Functional Index (TFI) Score60/100 (moderate to severe impact)
-30% (-18 points)
Tinnitus Loudness (Visual Analog Scale)7/10 (moderate to severe loudness)
-28.6% (-2 points)
Secondary Benefits
Speech Understanding in Noise (e.g., % correct)50% correct
+40% (+20 percentage points)
Patient Health Questionnaire-9 (PHQ-9) Score for Depression12/27 (moderate depression)
-33.3% (-4 points)
Quality of Life (generic scale, e.g., EQ-5D index)0.75/1.0
+6.7% (+0.05)
Common Side Effects
Ear irritation/discomfort
+8%
Feedback/occlusion effect
+7%
Initial adjustment period
+15%
5
Sound Therapy (Masking, Notched Sound, Habituation)
65% Effectiveness• 80% Confidence• 95% Safety• 120 trials• 6K participants
MODERATE EvidenceExcellent ValueDose: Daily use for several hours, or as needed
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
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95
DangerousModerateSafe

Time to Effect

Immediate (masking), weeks to months (habituation)

Duration

As needed, often long-term or lifetime

Response Rate

60%

Remission Rate

7%

Common Side Effects:

Temporary discomfort with sound: 4%
No benefit: 30%

Annual Cost of Care

Drug Cost

$0

Monitoring

$150

Side Effects

$0

Total Annual

$300

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.03

Cost per Remission

$4,286

Cost per Responder

$500

Treatment Outcomes
Efficacy Outcomes
Overall Effectiveness
+65%
Response Rate
+60%
Remission Rate
+7%
Common Side Effects
Temporary discomfort with sound
+4%
No benefit
+30%
6
Transcranial Magnetic Stimulation (TMS)
55% Effectiveness• 75% Confidence• 85% Safety• 35 trials• 2.5K participants
MODERATE EvidencePoor ValueDose: Varies by protocol (e.g., 1Hz, 20Hz, theta burst)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
85
DangerousModerateSafe

Time to Effect

Weeks to months after a course of treatment

Duration

10-20 sessions over 2-4 weeks; booster sessions may be needed

Response Rate

40%

Remission Rate

7%

Common Side Effects:

Headache: 25%
Scalp discomfort at stimulation site: 15%
Lightheadedness: 7%
Seizures (rare): 0.1%

Annual Cost of Care

Drug Cost

$0

Monitoring

$300

Side Effects

$100

Total Annual

$10,400

Cost-Effectiveness

POOR

QALYs Gained

0.04

ICER

$250,000/QALY

Cost per Remission

$148,571

Cost per Responder

$26,000

Treatment Outcomes
Primary Outcomes
Tinnitus Handicap Inventory (THI)THI score: 55/100
-32.7% (-18 points)
Tinnitus Questionnaire (TQ)TQ score: 45/76
-33.3% (-15 points)
Tinnitus Annoyance Visual Analog Scale (VAS)Tinnitus Annoyance VAS: 7/10
-21.4% (-1.5 points)
Perceived Tinnitus LoudnessPerceived Tinnitus Loudness: 70%
-35.7% (-25%)
Secondary Benefits
Pittsburgh Sleep Quality Index (PSQI)PSQI score: 11/21
-27.3% (-3 points)
Beck Depression Inventory (BDI-II)BDI-II score: 22/63
-31.8% (-7 points)
Overall Quality of Life (Composite Score)Overall Quality of Life (0-100): 60
+13.3% (+8 points)
Common Side Effects
Headache
+25%
Scalp discomfort at stimulation site
+15%
Lightheadedness
+7%

Clinical Trial Phases:

Phase 3Phase 4