Tinnitus, characterized by a constant ringing or buzzing in the ear, is a significant burden for approximately 740 million people worldwide. The condition is not considered curable—however, there are several treatment options available that can help manage or alleviate the symptoms. Until now, it was unclear whether it is more effective to use a single treatment method or to combine several approaches simultaneously, such as wearing a hearing aid while undergoing behavioral therapy.
Overall, combination treatments led to a slightly greater reduction in the burden of tinnitus
As part of the UNITI (Unification of Treatments and Interventions for Tinnitus Patients) research project (opens in a new window), researchers led by PD Dr. Stefan Schoisswohl (opens in a new window) (University of Regensburg) conducted a study involving 461 patients at five clinical sites across Europe to investigate the effects of single and combination treatments over a twelve-week period. They compared four established therapeutic approaches: cognitive behavioral therapy, hearing aids, app-based structured counseling, and app-based sound therapy. The study results showed that, in principle, all therapeutic approaches are effective: Nearly all participants experienced an improvement in symptoms within twelve weeks—regardless of which treatment they received. However, patients who received a combination of two different methods fared slightly better. Instead of the expected synergy effect, a compensation effect occurred: If one method was already very effective—cognitive behavioral therapy and hearing aids in particular showed the best results here—it offset the effects of a less effective therapy. This is particularly significant for everyday clinical practice, where it is often unclear which therapy is most suitable, as combining different approaches can increase the likelihood of therapeutic success.
A key factor in the study’s success: Prof. Dr. Schobel’s software architecture
A key factor in conducting such complex, multicenter studies across various European countries is a technologically sophisticated software architecture that meets the relevant requirements and implements them technically. This software architecture in the UNITI research project was largely conceived and technically implemented by Prof. Dr. rer. nat. Johannes Schobel, Research Professor in the field of “Digital Medicine and Care” and Director of the DigiHealth Institute at HNU. It guided the study process for individual participants using predefined modules, collected clinical parameters across various European centers, provided digital therapy and coaching modules for integration into the treatment plan, and simultaneously contributed to the standardization of data collection throughout the entire study period.
About the study
Schoisswohl, S., Basso, L., Simoes, J. et al. Single versus combination treatment in tinnitus: an international, multicentre, parallel-arm, superiority, randomised controlled trial. Nat Commun 16, 10510 (2025). https://doi.org/10.1038/s41467-025-66165-1
Contact
Prof. Dr. Johannes Schobel
