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      Incidence Rates of Clinically Significant Tinnitus: 10-Year Trend From a Cohort Study in England

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          Abstract

          Objective:

          To investigate the incidence of tinnitus that burdens the health service in England.

          Design:

          This was an observational study of 4.7 million residents of England under 85 years of age who were at risk for developing clinically significant tinnitus (sigT). SigT was defined by a discharge from hospital with a primary diagnosis of tinnitus, or a primary care recording of tinnitus with subsequent related medical follow-up within 28 days. The database used was the Clinical Practice Research Datalink and individual records were linked to additional data from the Hospital Episode Statistics. The observational period was from January 1, 2002 to December 31, 2011. Age-, gender-, and calendar year-specific incidence rates for and cumulative incidences of sigT were estimated and a projection of new cases of sigT between 2012 and 2021 was performed.

          Results:

          There were 14,303 incident cases of sigT identified among 26.5 million person-years of observation. The incidence rate was 5.4 new cases of sigT per 10,000 person-years (95% confidence interval: 5.3 to 5.5). The incidence rate did not depend on gender but increased with age, peaking at 11.4 per 10,000 in the age group 60 to 69 years. The annual incidence rate of sigT increased from 4.5 per 10,000 person-years in 2002 to 6.6 per 10,000 person-years in 2011. The 10-year cumulative incidence of sigT was 58.4 cases (95% confidence interval: 57.4 to 59.4) per 10,000 residents. Nearly 324,000 new cases of sigT are expected to occur in England between 2012 and 2021.

          Conclusions:

          Tinnitus presents a burden to the health care system that has been rising in recent years. Population-based studies provide crucial underpinning evidence; highlighting the need for further research to address issues around effective diagnosis and clinical management of this heterogeneous condition.

          Abstract

          This study used national clinical data from the general English population to estimate the incidence of “clinically significant” tinnitus (sigT), defined as tinnitus of sufficient concern to warrant seeking medical medical assistance. The annual incidence rate of sigT was 6.6 per 10,000 person-years, corresponding to 31,000 new cases in England in 2012. The incidence rate increased with age from 0.3 for those under 10 years to 12.7 per 10,000 person-years in those ages 60-69. Nearly 324,000 new cases of sigT are predicted to occur between 2012 and 2021. These findings demonstrate the considerable burden of sigT at a population level.

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          Most cited references21

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          Hearing in middle age: a population snapshot of 40- to 69-year olds in the United Kingdom.

          To report population-based prevalence of hearing impairment based on speech recognition in noise testing in a large and inclusive sample of U.K. adults aged 40 to 69 years. The present study is the first to report such data. Prevalence of tinnitus and use of hearing aids is also reported. The research was conducted using the UK Biobank resource. The better-ear unaided speech reception threshold was measured adaptively using the Digit Triplet Test (n = 164,770). Self-report data on tinnitus, hearing aid use, noise exposure, as well as demographic variables were collected. Overall, 10.7% of adults (95% confidence interval [CI] 10.5-10.9%) had significant hearing impairment. Prevalence of tinnitus was 16.9% (95%CI 16.6-17.1%) and hearing aid use was 2.0% (95%CI 1.9-2.1%). Odds of hearing impairment increased with age, with a history of work- and music-related noise exposure, for lower socioeconomic background and for ethnic minority backgrounds. Males were at no higher risk of hearing impairment than females. Around 1 in 10 adults aged 40 to 69 years have substantial hearing impairment. The reasons for excess risk of hearing impairment particularly for those from low socioeconomic and ethnic minority backgrounds require identification, as this represents a serious health inequality. The underuse of hearing aids has altered little since the 1980s, and is a major cause for concern.
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            The prevalence of tinnitus and the relationship with neuroticism in a middle-aged UK population.

            Previous research has suggested that a substantial proportion of the population are severely affected by tinnitus, however recent population data are lacking. Furthermore, there is growing evidence that the perception of severity is closely related to personality factors such as neuroticism. In a subset (N=172,621) of a large population sample of >500,000 adults aged 40 to 69years, (from the UK Biobank dataset) we calculated the prevalence of tinnitus and that which is perceived as bothersome, and examined the association between tinnitus and a putative predisposing personality factor, neuroticism. Participants were recruited through National Health Service registers and aimed to be inclusive and as representative of the UK population as possible. The assessment included subjective questions concerning hearing and tinnitus. Neuroticism was self-rated on 13 questions from the Eysenck Personality Inventory. Associations between neuroticism and tinnitus were tested with logistic regression analyses. Prevalence of tinnitus was significantly higher for males, and increased with age, doubling between the youngest and oldest age groups (males 13% and 26%; females 9% and 19% respectively). Of those with tinnitus, females were more likely to report bothersome tinnitus. Neuroticism was associated with current tinnitus and bothersome tinnitus, with the items: 'loneliness', 'mood swings', 'worrier/anxious' and 'miserableness', as the strongest associations of bothersome tinnitus. Neuroticism was identified as a novel association with tinnitus. Individuals with tinnitus and higher levels of neuroticism are more likely to experience bothersome tinnitus, possibly as a reflection of greater sensitivity to intrusive experiences. © 2013. Published by Elsevier Inc. All rights reserved.
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              Prevalence and characteristics of tinnitus in older adults: the Blue Mountains Hearing Study.

              There have been few recent estimates of the prevalence of tinnitus from large population-based samples of older persons. Our study aimed to assess the prevalence and characteristics of prolonged tinnitus in a representative sample of 2015 adults aged 55-99 years, residing in the Blue Mountains, west of Sydney, Australia, during 1997-99. All participants underwent a detailed hearing examination by an audiologist, including comprehensive questions about hearing. After age adjustment, subjects reporting tinnitus had significantly worse hearing at both lower and higher frequencies (p < 0.001). This difference was more marked in younger than in older subjects (p < 0.05). Overall, 602 subjects (30.3%) reported having experienced tinnitus, with 48% reporting symptoms in both ears. Tinnitus had been present for at least 6 years in 50% of cases, and most (55%) reported a gradual onset. Despite tinnitus being described as mildly to extremely annoying by 67%, only 37% had sought professional help, and only 6% had received any treatment.
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                Author and article information

                Journal
                Ear Hear
                Ear Hear
                AUD
                Ear and Hearing
                Williams And Wilkins
                0196-0202
                1538-4667
                May 2015
                27 April 2015
                : 36
                : 3
                : e69-e75
                Affiliations
                [1 ]Institute for Epidemiology, Statistics and Informatics GmbH, Frankfurt, Germany; [2 ]Colchester Hospital University NHS Foundation Trust, Colchester, Essex, United Kingdom; [3 ]National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit, University of Nottingham, Nottingham, United Kingdom; and [4 ]Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
                Author notes
                Address for correspondence: Carlos Martinez, Institute for Epidemiology, Statistics and Informatics GmbH, Im Dinkelfeld 32, 60388 Frankfurt, Germany. E-mail: carlos.martinez@ 123456pharmaepi.com
                Article
                00011
                10.1097/AUD.0000000000000121
                4415963
                25470370
                89c51bc1-eb39-4b38-91b4-a6f8fafd5deb
                Copyright © 2014 Wolters Kluwer Health, Inc. All rights reserved.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 29 April 2014
                : 30 September 2014
                Categories
                Brief Report
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                clinically significant tinnitus,incidence rates,time trend

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