The tinnitus decision aid: a step closer to shared decision making.

Tinnitus is a highly prevalent condition that affects 10 to 15 percent of adults, with three to five percent finding it distressing (Tinnitus Handbook, 2000). The care of tinnitus has traditionally been determined by clinicians for their patients (BMC Med Inform Decis Mak. 2012 Jul 12;12:70). To help shape the decisions clinicians make when managing patients with tinnitus, a set of clinical practice guidelines was developed (Otolaryngol Head Neck Surg. 2014 Oct;151(4):533). These guidelines provide information on the average population merits of different interventions and summarize available evidence on treatments, among others. But these guidelines have significant limitations (BMJ 2016;353:i2452). They tell us about findings that relate to patients like ours but not to our patient. A frequently overlooked aspect of evidence-based health care is that it is an integration of clinical experience, best evidence, and patient values and preferences. However, the last point is often overlooked. Guidelines should remind us to also connect and share information with our patients, but they tend not to.