Table 1 Review eligibility criteria
Study characteristic | Inclusion criteria | Exclusion criteria |
|---|---|---|
Study designs | • Randomised controlled trials (RCT) (both efficacy and effectiveness trials) • Crossover designs where data from before the cross-over are extractable to avoid the potential for a carry-over phenomenon | • Cluster randomised RCTs • Non-randomised trials • Repeated measures designs (pre- and post-intervention) unless this is for the long term outcomes after group cross- over has taken place or control conditions are no longer available • Quasi-experimental controlled trials • Case studies • Observational studies • Purely qualitative studies • Expert options • Cross-sectional studies • Trials were participants have not been randomly assigned |
Participants | All adults (aged ≥ 18 years) from both clinical and non-clinical samples (self-referred due to response from study advertisement) with acute or chronic complaints of hearing loss, tinnitus and/or vestibular disorders and meeting the Intervention studies’ eligibility criteria. Adults with significant levels of disability as defined by the individual studies’ inclusion criteria to include: - A significant global score on a multi-item questionnaire (Table 3) - Presenting with hearing loss of at least a mild degree as measured by an audiologist using pure tone audiometric testing -Significant levels of hearing loss, tinnitus and/or dizziness diagnosed by an Ear Nose and Throat consultant, audiologist or clinical psychologist following clinical examination This assumes that those with significant co-existing conditions and undertaking co-interventions (excluding hearing aid fittings) will be excluded. All ethnic and social-economic groups will be included | • Data focused on children and adolescents • Studies not defining the eligibility criteria to undertake the Internet interventions for hearing handicap, tinnitus distress and vestibular difficulties, such as tinnitus of at least 3 months duration of moderate severity as measured by a self-reported assessment measure |
Interventions | • Internet-based interventions as a structured form of self-help aimed at reducing difficulties related to hearing loss, vestibular disorders, and tinnitus • Both guided and self-guided interventions will be included • An element of blending may be involved such as introducing the intervention during a face-to-face consultation. However, the Internet-intervention part needs to be 70% or greater than the face-to-face part • There are no limitations based on the starting point of interventions or their durations • There should be a minimum of at least one Internet-intervention • Internet interventions running concurrently with hearing aid fittings will be included as this forms part of standard audiological care | • Predominantly app-based interventions • Solely computer-based programmes not accessed via the Internet (e.g. provided on disks/DVDs) • Interventions using a predominantly blended approach with 30% or more face-to-face input • Online discussion forums provided in isolation and not as part of a structured programme • Internet interventions running concurrently with additional treatments (excluding hearing aid fittings) will be excluded as the effects of the Internet intervention will not be isolated. |
Comparators | At least one comparator is required this may be either an inactive control (e.g. no treatment, standard care, waiting list control, discussion forum, information only, usual care) or active control (e.g. different variant of the same intervention, a different kind of therapy) | • No comparison (single group designs) unless this is for the long term outcomes after group cross-over has taken place or control conditions are no longer available • Comparators comparing the role of guidance using the same Internet-based intervention in both the experimental and the control groups |
Outcomes | Reporting results from a self-reported outcome measure related to the main difficulty targeted e.g. hearing loss, tinnitus, or vestibular difficulties | • Primary outcome reported not related to hearing loss, tinnitus, or vestibular difficulties • Primary outcome, not a self-reported measure |
Timings | At least two data points are required for pre and post-intervention or follow-up (e.g. baseline and 1 year post-intervention) endpoint outcomes | No post-intervention follow-up period |
Additional inclusion criteria | ||
 Language | English only |  |
 Setting | All settings including clinics, hospitals (private, public, university) and/or home-treatments in all geographic locations |  |