Tinnitus is a frequent disorder that causes significant morbidity and treatment is elusive. A large variety of different treatment options have been proposed and from most of them some patients benefit. However, a particular treatment that helps one patient may fail in others. This suggests that there are different forms of tinnitus which differ in their pathophysiology and their response to specific treatments. Therefore, it is a major challenge for tinnitus treatment to identify the most promising therapy for a specific patient. A major step forward would be, if therapeutic decisions can be based on valid predictors for a possible positive treatment response in an individual patient. So far, such predictors are missing largely and the search for predictors is hampered by the fact, that most treatment studies in tinnitus patients enrolled only small patient samples and interstudy-comparability is limited because of varying methods of tinnitus assessment and different outcome parameters.
Therefore, performing clinical trials according to standardized methodology and pooling the data in one international database will facilitate both clinical subtypisation of different form of tinnitus, and identification of promising treatments for different types of tinnitus.
The TRI database project is the first international collaboration of specialized tinnitus clinics following this approach. At present, 19 centers from 11 countries participate in the project. Since the start of the project in summer 2008, almost 3000 tinnitus patients worldwide have been documented according to the TRI Consensus using an standardized Case Report Form (CRF) and have been followed up while undergoing more than 40 different treatment strategies.
The goals of the TRI database:
- Subtyping of different forms of tinnitus, based on their specific symptoms and/or their response to treatment modalities (e.g. by cluster analysis)
- Identifying predictors for treatment response to specific treatments
- Assessment of treatment outcome for specific treatments using a modular approach
- Identification of candidate clinical characteristics for delineating neurobiologically distinct forms of tinnitus
- Explanation of discrepant results of different studies (e.g. by the possibility to identify differences between the study populations)
- Collection of epidemiological data
- Cross validation of different assessment instruments in different languages
- Development of an individualized treatment algorithm for every single patient based on the individual diagnostic profile
- Delineation of subgroups with similar characteristics and generating data about discriminative power of diagnostic procedures
The TRI database project is open to everyone, who is willing to collect data according to the TRI consensus on data collection.