JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Retractions in Otolaryngology Publications.","authors":"Shaun Edalati, Tony Chung, Maya Govindaraj, Daniel Kraft, David K Lerner, Anthony Del Signore, Alfred Marc Iloreta","doi":"10.1001/jamaoto.2025.0018","DOIUrl":"10.1001/jamaoto.2025.0018","url":null,"abstract":"<p><strong>Objective: </strong>To characterize trends in otolaryngology (ear, nose, and throat [ENT]) retractions, identify underlying causes, and compare retraction rates with similar specialties.</p><p><strong>Design, setting, and participants: </strong>A scoping review of retracted articles published from January 1, 1974, through December 31, 2023, was carried out. Retraction data were obtained from the Crossref/Retraction Watch database and corresponding abstracts were retrieved from PubMed. Publication data were obtained from Scopus. All retracted articles related to ENT were identified. Articles from neurosurgery and ophthalmology were similarly retrieved for comparison. Articles withdrawn for routine updates, expressions of concern, reinstatements, and corrections were excluded. The data were obtained on December 3, 2024.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes were annual retraction rate (proportion of retracted articles per total published articles) and reasons for retraction (categorized as intentional data misconduct, intentional procedural misconduct, unintentional data errors, unintentional procedural errors, or unknown). Secondary measures included time from publication to retraction and comparisons with neurosurgery and ophthalmology retraction rates.</p><p><strong>Results: </strong>Of 481 215 ENT articles, 471 (0.10%) were retracted. Retractions increased over time, peaking in 2022 with a retraction rate of 0.42%. Among retracted ENT articles, the most common reasons were intentional data misconduct (233 [49.50%]) and intentional procedural misconduct (210 [44.60%]). Articles with first authors from China accounted for the largest share (243 [51.60%]) of these retractions. Basic science head and neck cancer research represented the largest subspecialty category (161 [34.20%]). The median (IQR) time to retraction was 21.8 (10.8-55.3) months.</p><p><strong>Conclusions and relevance: </strong>This analysis found that retractions in ENT literature have increased over 5 decades, predominantly driven by intentional misconduct. These findings highlight the need for enhanced oversight, training, and editorial vigilance to maintain the integrity of ENT research and protect patient welfare.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"458-465"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing Loss and Falls: A Systematic Review and Meta-Analysis.","authors":"Brian Sheng Yep Yeo, Vanessa Yee Jueen Tan, Jia Hui Ng, Joyce Zhi'en Tang, Brenda Ling Hui Sim, Yu Ling Tay, Anupama Roy Chowdhury, Abel P David, Nicole T Jiam, Elliott D Kozin, Steven D Rauch","doi":"10.1001/jamaoto.2025.0056","DOIUrl":"10.1001/jamaoto.2025.0056","url":null,"abstract":"<p><strong>Importance: </strong>Falls constitute a significant public health concern worldwide and have been associated with increased morbidity and mortality across all ages. Identifying potentially modifiable risk factors for falls is a key public health priority. Literature surrounding the association between hearing loss (HL) and falls remains inconclusive.</p><p><strong>Objective: </strong>To conduct a systematic review and meta-analysis to comprehensively synthesize evidence surrounding the impact of HL on falls.</p><p><strong>Data sources: </strong>PubMed, Embase, and Cochrane Library from database inception through April 9, 2024.</p><p><strong>Study selection: </strong>Observational studies investigating the association between HL and falls were selected. Only studies reporting covariate-adjusted estimates were included to minimize confounding.</p><p><strong>Data extraction and synthesis: </strong>Two independent reviewers evaluated studies for eligibility, extracted data, and assessed the risk of bias of included studies. Using a random-effects model, adjusted estimates were pooled in meta-analyses. Heterogeneity was evaluated using subgroup and sensitivity analyses, and publication bias was assessed.</p><p><strong>Main outcomes and measures: </strong>The cross-sectional odds and longitudinal risk of falls among patients with HL compared with those without HL.</p><p><strong>Results: </strong>A total of 5 071 935 participants were included from 27 studies; approximately 49.2% of participants were female, and 14 studies were conducted in Asia, 7 in North America, 3 in Europe, and 3 in Oceania, represented by Australia. Patients with HL exhibited an increased cross-sectional odds of falls (odds ratio, 1.51; 95% CI, 1.37-1.67; I2 = 64%) and longitudinal risk of falls (risk ratio, 1.17; 95% CI, 1.06-1.29; I2 = 69%) than those without HL. Further stratification by self-reported or validated hearing assessments, fall reporting duration, continent, community-dwelling adults, and studies adjusting for other sensory deficits identified as fall risk factors by the World Falls Guideline did not change significance. These results remained robust to sensitivity analyses, and publication bias was absent.</p><p><strong>Conclusions and relevance: </strong>This systematic review and meta-analysis found that overall, HL may be a risk factor for falls. With a rapidly aging global population, it is crucial to acknowledge the public health concerns surrounding falls and consider if HL could be a potentially modifiable risk factor. Nonetheless, further randomized clinical trials are needed to elucidate any benefit of treating HL on fall prevention.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"485-494"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Progress and Future Directions of Immunotherapy in Head and Neck Squamous Cell Carcinoma: A Narrative Review.","authors":"Edward S Sim, Hoang C B Nguyen, Glenn J Hanna, Ravindra Uppaluri","doi":"10.1001/jamaoto.2024.5254","DOIUrl":"10.1001/jamaoto.2024.5254","url":null,"abstract":"<p><strong>Importance: </strong>For decades, the 3 therapeutic pillars for head and neck squamous cell carcinoma (HNSCC) have been radiation therapy, chemotherapy, and surgery. In recent years, a fourth pillar, immunotherapy, has shifted the existing paradigm of oncologic care by improving survival outcomes. This narrative review highlights key completed and ongoing clinical trials that have led to new therapeutic approaches and are aiming to further alter the current standard of care.</p><p><strong>Observations: </strong>Immunotherapy in HNSCC first saw success in phase 3 clinical trials with immune checkpoint inhibitors (ICIs) for programmed cell death 1 protein in patients with recurrent or metastatic (R/M) disease. However, only approximately 15% to 20% of patients with R/M HNSCC achieve durable responses. Subsequent trials aimed to broaden ICIs to the definitive or curative setting, in combination with established chemoradiation modalities. These studies have yielded disappointing results, raising concerns that concurrent administration of ICI with chemoradiation- or radiation-induced attenuation of immune responses may contribute to lack of efficacy. Therefore, recent studies have attempted to introduce ICI sequentially, either prior to standard of care surgery in the neoadjuvant setting or following definitive treatment in the adjuvant or maintenance setting. These trials have demonstrated mixed results but with promising initial results from early phase neoadjuvant trials demonstrating early signals of response. Further trials are currently underway with various combinatorial approaches in the neoadjuvant and adjuvant settings to assess response rates and survival.</p><p><strong>Conclusions and relevance: </strong>The introduction of ICIs has brought a dramatic shift in the treatment landscape of HNSCC. Completed trials have provided new hope for patients, but failures in several settings suggest that further studies based on a biologic understanding of immune responses are required to expand immunotherapeutic approaches.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"521-528"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Clinical and Tumor Factors Associated With Adjuvant Therapy for Oral Cavity Cancer.","authors":"Gabriel S Dayan, Houda Bahig, Justine Colivas, Antoine Eskander, Stephanie Johnson-Obaseki, Shamir Chandarana, John R de Almeida, Anthony C Nichols, Michael Hier, Mathieu Belzile, Andrea Avagnina, Xinyuan Hong, Marc Gaudet, T Wayne Matthews, Robert Hart, David P Goldstein, Ali Hosni, Danielle MacNeil, James Fowler, Carlos Khalil, Mark Khoury, Gregoire Morand, Khalil Sultanem, Tareck Ayad, Apostolos Christopoulos","doi":"10.1001/jamaoto.2024.5250","DOIUrl":"10.1001/jamaoto.2024.5250","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;The standard of care for patients with oral cavity squamous cell carcinoma (OCSCC) is generally primary surgical resection with or without adjuvant therapy (AT), based on pathological factors. Identifying preoperative factors that are associated with the receipt of AT may enhance treatment planning.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To identify preoperative patient and tumor factors associated with receiving AT, either radiation therapy (RT) or chemoradiation therapy (CRT), in patients with OCSCC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This cohort study, spanning January 2005 to December 2019 at 9 academic centers in Canada, was conducted as part of the Canadian Head & Neck Collaborative Research Initiative, a national network of head and neck surgical oncologists. Participants included patients with oral cavity cancer who underwent surgery. The data analysis was performed in March 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;Preoperative variables, including demographics (age, sex, smoking history, and Charlson Comorbidity Index [CCI]) and tumor characteristics (clinical T and N stage, biopsy grade, tumor size).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The main outcomes were the receipt of AT vs surgery alone; the type of AT, either RT or CRT; and the presence of a strong pathologic indicator for AT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 3980 patients, 2438 underwent surgery alone (61%) and 1542 received AT (39%). Of these, 1907 (48%) had a strong pathologic indicator for AT. The mean (SD) age was 63 (13) years, and 1498 participants (38%) were female. On multivariable analysis, factors independently associated with AT included being older than 65 years (odds ratio [OR], 0.50 [95% CI, 0.38-0.64]), CCI of 4 or higher (OR, 1.83 [95% CI, 1.26-2.65]), previous head and neck cancer (OR, 0.40 [95% CI, 0.26-0.62]), maxillary alveolus (OR, 2.16 [95% CI, 1.11-4.22]) and retromolar trigone (OR, 1.85 [95% CI, 1.04-3.29) subsites, tumor dimension (OR, 1.35 [95% CI, 1.22-1.50] per cm), increasing clinical T and N stages, and worse grade on biopsy (poorly differentiated: OR, 1.89 [95% CI, 1.25-2.84]). Among those receiving AT, poorly differentiated grade (OR, 2.40 [95% CI, 1.34-4.30]) and advanced N stage were associated with CRT rather than RT. Among patients with strong pathologic indicators for AT, factors associated with not receiving AT included age, CCI, grade, stage, and tumor dimension. The prediction model showed good discriminatory power (area under the receiver operating characteristic curve, 0.84 [95% CI, 0.82-0.86]).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;The results of this cohort study suggest that preoperative variables can help to identify patients with OCSCC who are more likely to receive AT, despite many factors not being predictable until the postoperative period. Early identification of patients at high risk may improve treatment planning and reduce delays in initiating A","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"466-475"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fusion of Middle Ear Optical Coherence Tomography and Computed Tomography.","authors":"Junzhe Wang, Floor Couvreur, Joshua D Farrell, Reshma Ghedia, Nael Shoman, David P Morris, Robert B A Adamson","doi":"10.1001/jamaoto.2025.0043","DOIUrl":"10.1001/jamaoto.2025.0043","url":null,"abstract":"<p><strong>Importance: </strong>Middle ear optical coherence tomography (OCT) imaging in patients has not previously been directly compared with a standard of care clinical 3-dimensional imaging technology, such as computed tomography (CT).</p><p><strong>Objective: </strong>To qualitatively compare the capabilities of middle ear OCT with CT in normal and pathological ears on representative slices in coregistered OCT and CT datasets.</p><p><strong>Design, setting, and participants: </strong>This case series included 3 patients and 3 ears: 1 normal middle ear, 1 ear affected by traumatic injury, and 1 ear with cholesteatoma. The ears were imaged with both OCT and high-resolution clinical temporal bone CT. Participants were drawn from the patient population of a tertiary otology clinic. CT and OCT images were aligned using rigid coregistration with manual landmark selection. Data were collected from January 2022 to April 2023, and data were analyzed from February 2022 to December 2023.</p><p><strong>Main outcomes and measures: </strong>Images were analyzed qualitatively for field of view (FOV), resolution, shadowing, artifacts, soft tissue and bony tissue contrast, and presentation of diagnostically important features.</p><p><strong>Results: </strong>In the 3 imaged ears, OCT was capable of visualizing many of the important features indicative of middle ear pathology. Compared with CT, OCT exhibited a limited FOV largely confined to the mesotympanum and subject to shadowing from bony structures. However, OCT could resolve soft tissue features that were not readily apparent in the CT images to have a higher resolution than CT and to provide excellent anatomical fidelity with CT, which allowed OCT images to be accurately coregistered with CT images.</p><p><strong>Conclusions and relevance: </strong>In this case series, while OCT was not capable of replacing CT due to its limited FOV and inability to image through thick bony tissues, it visualized signs of pathology, including some soft tissue features, that are difficult to visualize with CT. Given OCT's ability to image in real time, its compatibility with in-office imaging, and its lack of ionizing radiation, it may, despite its limitations compared with CT, be an appealing imaging modality for many applications in middle ear diagnostics.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"476-484"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Further Clarifications for Interpretation of Study of Lobectomy vs Total Thyroidectomy With Ipsilateral Lateral Neck Dissection.","authors":"Keyu Shen, Xiequn Xu","doi":"10.1001/jamaoto.2025.0158","DOIUrl":"10.1001/jamaoto.2025.0158","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"534"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"JAMA Otolaryngology-Head & Neck Surgery-The Year in Review, 2024.","authors":"Jay F Piccirillo","doi":"10.1001/jamaoto.2025.0365","DOIUrl":"10.1001/jamaoto.2025.0365","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"429-431"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost of Neoadjuvant Immunotherapy vs Up-Front Surgery in Cutaneous Squamous Cell Carcinoma: A Post Hoc Analysis of a Nonrandomized Clinical Trial.","authors":"Shannon S Wu, A Dimitrios Colevas, Luis Martinez Ramirez, Uchechukwu C Megwalu, Michelle M Chen, Aronpreet Atwell, Vasu Divi","doi":"10.1001/jamaoto.2025.0001","DOIUrl":"10.1001/jamaoto.2025.0001","url":null,"abstract":"<p><strong>Importance: </strong>There is increasing interest in use of neoadjuvant immunotherapy (NAT) in advanced cutaneous squamous cell carcinoma (cSCC) to reduce surgical morbidity and forego adjuvant therapy, while potentially improving survival outcomes.</p><p><strong>Objective: </strong>To assess the cost to Medicare of NAT compared with up-front surgery.</p><p><strong>Design, setting, and participants: </strong>This cohort study was a post hoc analysis of a phase 2 clinical trial evaluating the feasibility of neoadjuvant atezolizumab. The study was conducted from June 2021 to December 2023 at a tertiary-level academic institution among 20 patients with advanced stage II-IV cSCC.</p><p><strong>Interventions: </strong>Up to 3 doses of neoadjuvant atezolizumab, followed by surgical resection with or without adjuvant radiation therapy.</p><p><strong>Main outcomes and measures: </strong>Direct medical costs in US dollars of care received on trial were compared with baseline treatment plans of up-front surgery developed a priori from a Medicare payer perspective.</p><p><strong>Results: </strong>Of 20 patients with advanced cSCC enrolled (median [range] age, 71.5 [53-88] years; 17 male [85.0%]), most individuals had stage III (12 patients [60.0%]) or IV (5 patients [25.0%]) disease. The median (range) follow-up was 14.2 (3.5-28.7) months. Compared with $26 602.67 for up-front surgery, NAT was associated with mean overall costs of $51 561.02, or a 93.8% increase, equivalent to $24 958.36 (95% CI, $22 057.95 to $24 692.43) per patient, which was primarily associated with the drug acquisition costs of atezolizumab ($30 603.96). NAT was associated with mean cost reductions from $12 707.07 to $10 543.71 (17.0%) in surgery and $11 711.97 to $7157.32 (38.9%) in radiation across all patients compared with up-front surgery. Adjuvant radiation therapy was obviated in 5 of 17 patients not previously irradiated (29.4%), reducing costs of radiation. Mean (SD) surgical complexity was reduced from 63.81 (30.55) to 44.71 (32.49) work relative value units (wRVUs; difference, 19.10 wRVU; 95% CI, 5.00 to 33.20 wRVU). NAT was associated with 5 fewer free flaps, 4 fewer neck dissections, 5 more organ-preserving resections, and 3 conversions from inpatient to outpatient surgery.</p><p><strong>Conclusions and relevance: </strong>This study found that treatment with 3 doses of NAT was associated with an overall cost increase compared with up-front surgery, driven by drug acquisition costs, and cost reductions from less extensive surgical resections and obviated adjuvant radiation. Predictive markers for response to NAT could optimize patient selection and improve cost-effectiveness.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04710498.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"495-502"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Further Clarifications for Interpretation of Study of Lobectomy vs Total Thyroidectomy With Ipsilateral Lateral Neck Dissection.","authors":"Pierpaolo Trimboli, Gianluca Bottoni, Arnoldo Piccardo","doi":"10.1001/jamaoto.2025.0156","DOIUrl":"10.1001/jamaoto.2025.0156","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"533-534"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Guideline for Management of Tinnitus: Recommendations From the US VA/DOD Clinical Practice Guideline Work Group.","authors":"LaGuinn P Sherlock, Jennifer Ballard-Hernandez, Amy Boudin-George, Khaya Clark, Maria Colandrea, Catherine Edmonds, Catherine Kelley, Suheily Lovelace, Sally Mahmood, Idalisse Martinez, Paula Myers, Sara Pulliam, James Sall, Michele Spencer, Sarah M Theodoroff, Anthony M Tolisano, Lisa M Wayman, Tara Zaugg, Robert L Folmer","doi":"10.1001/jamaoto.2025.0052","DOIUrl":"10.1001/jamaoto.2025.0052","url":null,"abstract":"<p><strong>Importance: </strong>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.</p><p><strong>Methods and observations: </strong>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.</p><p><strong>Conclusions and relevance: </strong>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.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"513-520"},"PeriodicalIF":6.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}