Trial of a tinnitus treatment platform based on "Personalised Sound Therapy"

Brief name: Personalised Sound Therapy. Materials: Participants cell phone, custom application (app) for Apple and Android, calibrated Bluetooth bone conduction headphones, Bluetooth neck worn stereo speaker, clinician dashboard software. The app has three different modes – passive listening (Relief, Relax & Retraining), active listening (game-based treatment) and counselling. The control app is a popular self-help tinnitus app that lacks the personalisation of the treatment app. The participants will be asked to use for a minimum of 2 hours per day for 12 weeks. The instructions per participant will vary as part of a goal setting and needs assessment process. Participants requiring "relief" may use "relief" sounds often until some control over tinnitus is achieved, those for whom relaxation was an important goal may use when stress, and so on. Relief sounds have high interaction with tinnitus creating masking (an example is white noise) while relaxation sounds have positive emotion affect associated with calm situations (an example is a gentle waterfall). The exact sounds are selected from a library of sounds according to participant preference. Retraining sounds are more complex nature sounds with multiple sounds that participants are instructed to focus attention on, enabling retraining of attention away from tinnitus. A training program is provided in which a variety of different 'everyday' sounds at different frequencies that participants are trained to attend to, and respond, feedback is provided on correct/incorrect identification. This aims to motivate the participant to complete listening tasks. The number of hours and type of sound/counselling will be personalised to these needs. The general recommendations for an average anticipated participant is the following: "to use relief sounds in morning, relaxation sounds in afternoon (as needed) and training – for 30 mins between 10:00-14:00 h and 16:00-22:00 h (a total of 1 hr per day). Depending on needs and preferences recommendations may change during the trial, but with 2 hrs minimum target. Compliance will be measured through the cloud based interface with the app that creates a catalog of use. Further monitoring will be completed by the researcher at assessment times through email and sms text messages. The app is a currently only available for study participants. The outcome of this trial will determine, to some extent, if and how the app will be made more widely available. The patient undergoes a clinic-based psychoacoustic and psychometric hearing and tinnitus assessment The clinician assesses and record the patient’s condition and set treatment goals and priorities. A customised profile is established using the clinician dashboard and fitting algorithms according to the patients’ needs and tinnitus assessment. The frequency response of relief sounds are tailored to the individuals minimum masking levels, and the perceived position in space is modified to the most effective position relative to where the tinnitus is heard. Recommendations and selection of sounds available on the app are chosen based on personal preference. Using the clinician dashboard, the treatment modules are customised in the manner described and uploaded to the patient’s smartphone.