A gravel road leading into the distance in a calm natural setting
You may have noticed the term evidence-based practice or evidence-based treatments on other health sites and on this clinic’s site also. It’s an important term and that’s why it appears across our assessment and treatment information at the Blue Mountains Tinnitus Clinic.
In this short article, we define evidence-based and also explain evidence-based clinical guidelines as these are important to prcaticing quality care for all patients.
Three aspects of evidence-based: more than backed by research
Evidence-based doesn’t just mean there’s a study for it. The term includes specific things working together:
The best available evidence from reserach.
The experience of the clinician, including clinical expertise.
The preferences and circumstances of the patient seeking care
The second two are important.
First, the research is taken from large groups of people with a specific concern and helps to develop guidelines for health conditions.
Second, your clinician uses their experience and expertise to make a clinical decision on what will help you most.
Third, your values and preferences matter in all assessment and treatment decisions. For example, people who find certain sounds hard to tolerate, which is often defined as hyperacusis, may decide not to do loudness tolerance tests due to the stress it causes them. This is valid and important for your clinician to consider.
“Evidence-based care includes science, skill, and the individual seeking support”
What are evidence-based clinical guidelines?
Guidelines are devised by experts in an area of clinical or scientific expertise.
The panel of experts gather comprehensive research on a health condition and weigh up how robust the research is. This is then written as a set of recommendations for treatment, grading each treatment method on how strong the evidence is.
Using the GRADE system, the evidence is rated from high to low (Guyatt et al., 2008). Guidelines are useful to patients and clinicians as they tell us two things: What is recommended, and how sure the field is.
Hence, the grading system decides on:
How confident are we with this evidence?
How strongly do we recommend the treatment?
How this relates to tinnitus care
In tinnitus assessment and treatment, the strongest evidence for improving quality of life and reducing distress points to Cognitive Behavioural Therapy for tinnitus (CBT) (Zaugg et al., 2020). This is why clinical guidelines recommend it.
For you, as a patient, this means care is delivered based in science and what is most likely to help you.
Two questions worth asking for your tinnitus health pathway
What is the strength of the evidence behind the treatment I am using
Does this suit my life: my values, my symptoms, my preferences, my lifestyle needs?
At the Blue Mountains Tinnitus Clinic we welcome your questions about evidence-based care.
Your tinnitus assessment includes education about it, which is evidence-based, and carries out recommended and validated questionnaires to determine how tinnitus is impacting you and what treatment would suit you best, if needed. Your input and preferences are based on client-centred care, which is foundational to how we work with you.
References
Guyatt, G. H., Oxman, A. D., Vist, G. E., Kunz, R., Falck-Ytter, Y., Alonso-Coello, P., & Schünemann, H. J. (2008). GRADE: An emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 336(7650), 924–926. https://doi.org/10.1136/bmj.39489.470347.AD
Nilsen, P., Sundemo, D., Heintz, F., Neher, M., Nygren, J., Svedberg, P., & Petersson, L. (2024). Towards evidence-based practice 2.0: Leveraging artificial intelligence in healthcare. Frontiers in Health Services, 4, 1368030. https://doi.org/10.3389/frhs.2024.1368030
Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B., & Richardson, W. S. (1996). Evidence based medicine: What it is and what it isn't. BMJ, 312(7023), 71–72. https://doi.org/10.1136/bmj.312.7023.71
Zaugg, T. L., Thielman, E. J., Carlson, K. F., Tuepker, A., Elnitsky, C., Drummond, K. L., Schmidt, C. J., Newell, S., Kaelin, C., Choma, C., & Henry, J. A. (2020). Factors affecting the implementation of evidence-based Progressive Tinnitus Management in Department of Veterans Affairs Medical Centers. PLOS ONE, 15(12), e0242007. https://doi.org/10.1371/journal.pone.0242007
