{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T22:13:39Z","timestamp":1773526419580,"version":"3.50.1"},"reference-count":91,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T00:00:00Z","timestamp":1765238400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sonormed GmbH"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiology Research"],"abstract":"<jats:p>Background\/Objectives: Subjective tinnitus, defined as the perception of sound without an external source, is a common and often debilitating condition. In the absence of pharmacotherapy, disease management guidelines recommend counseling interventions to alleviate tinnitus-related distress and improve patient outcome. This study evaluated the benefit of guideline-compliant counseling provided by \u201cMeine Tinnitus App\u201d, a smartphone-based application, for the treatment of subjective tinnitus. Methods: A randomized controlled study was conducted in 204 patients with confirmed chronic subjective tinnitus enrolled at 33 ear, nose and throat (ENT) practices in Germany. Tinnitus improvement was evaluated after 10 weeks of intervention (digital counseling in addition to standard care vs. standard care only). The primary endpoint was the change in tinnitus-related distress (measured by the Mini-TQ-12 validated questionnaire). The secondary endpoint was the change in tinnitus-associated daily burden and coping difficulties (measured by the validated BVB-2000 questionnaire). Treatment effects for the primary and secondary endpoints were represented by the estimated marginal means (EMMs). Results: Patients of the intervention group showed a significant reduction in tinnitus-related distress (EMM [95% CI]: 4.5 [3.3\u20135.8]; p &lt; 0.001) and a significant improvement in tinnitus-associated daily burden and coping difficulties (EMM [95% CI]: 0.5 [0.2\u20130.7]; p &lt; 0.001) compared to patients of the control group, with large to moderate effect sizes (Hedges\u2019 g between 1.1. and 0.5). These positive treatment effects were confirmed by responder and sensitivity analyses. Additionally, patients with high vs. low app usage showed a greater improvement in treatment effect for both endpoints (p &lt; 0.05), further supporting the health benefits of digital counseling. Conclusions: This study demonstrated the efficacy of tinnitus counseling provided by \u201cMeine Tinnitus App\u201d to alleviate tinnitus-related distress, daily burden, and coping difficulties in patients with subjective tinnitus (German Clinical Trials Register DRKS00025379).<\/jats:p>","DOI":"10.3390\/audiolres15060173","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T14:49:01Z","timestamp":1765291741000},"page":"173","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Digital Tinnitus Counseling in Clinical Practice: A Multicenter Randomized Controlled Trial"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7142-2807","authenticated-orcid":false,"given":"Petra","family":"Brueggemann","sequence":"first","affiliation":[{"name":"Tinnitus Center, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gernot G.","family":"Supp","sequence":"additional","affiliation":[{"name":"Delta Science SL, 38632 Arona, Santa Cruz de Tenerife, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1676-1774","authenticated-orcid":false,"given":"Paul","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Statistical Consulting for Science and Research, 13086 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9587-6632","authenticated-orcid":false,"given":"Birgit","family":"Mazurek","sequence":"additional","affiliation":[{"name":"Tinnitus Center, Charit\u00e9\u2013Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/0168-0102(90)90031-9","article-title":"Phantom Auditory Perception (Tinnitus): Mechanisms of Generation and Perception","volume":"8","author":"Jastreboff","year":"1990","journal-title":"Neurosci. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1001\/jamaoto.2016.1700","article-title":"Prevalence, Severity, Exposures, and Treatment Patterns of Tinnitus in the United States","volume":"142","author":"Bhatt","year":"2016","journal-title":"JAMA Otolaryngol.-Head Neck Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1056\/NEJMra013395","article-title":"Tinnitus","volume":"347","author":"Lockwood","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.amjmed.2010.02.015","article-title":"Prevalence and Characteristics of Tinnitus among US Adults","volume":"123","author":"Shargorodsky","year":"2010","journal-title":"Am. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/s00106-019-0633-7","article-title":"A Multidisciplinary European Guideline for Tinnitus: Diagnostics, Assessment, and Treatment","volume":"67","author":"Cima","year":"2019","journal-title":"HNO"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1016\/S0140-6736(13)60142-7","article-title":"Tinnitus","volume":"382","author":"Baguley","year":"2013","journal-title":"Lancet"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S0030-6665(02)00160-3","article-title":"Classification and Epidemiology of Tinnitus","volume":"36","author":"Heller","year":"2003","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_8","first-page":"219","article-title":"Chronic Tinnitus: Diagnosis and Treatment (01.04.2022)","volume":"119","author":"Mazurek","year":"2022","journal-title":"Dtsch. \u00c4rztebl."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100250","DOI":"10.1016\/j.lanepe.2021.100250","article-title":"Tinnitus Prevalence in Europe: A Multi-Country Cross-Sectional Population Study","volume":"12","author":"Biswas","year":"2022","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1097\/AUD.0b013e31825069e8","article-title":"Generational Differences in the Reporting of Tinnitus","volume":"33","author":"Nondahl","year":"2012","journal-title":"Ear Hear."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/S0030-6665(02)00168-8","article-title":"Depression and Tinnitus","volume":"36","author":"Dobie","year":"2003","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1002\/lary.26107","article-title":"Relationships between Tinnitus and the Prevalence of Anxiety and Depression","volume":"127","author":"Bhatt","year":"2017","journal-title":"Laryngoscope"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1038\/s43856-024-00678-6","article-title":"A Retrospective Two-Center Cohort Study of the Bidirectional Relationship between Depression and Tinnitus-Related Distress","volume":"4","author":"Lukas","year":"2024","journal-title":"Commun. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1017\/S0022215100131676","article-title":"Is Central Hyperacusis a Symptom of 5-Hydroxytryptamine (5-HT) Dysfunction?","volume":"109","author":"Marriage","year":"1995","journal-title":"J. Laryngol. Otol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0378-5955(00)00093-9","article-title":"A Review of Evidence in Support of a Role for 5-HT in the Perception of Tinnitus","volume":"145","author":"Simpson","year":"2000","journal-title":"Hear. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1177\/014556130408300211","article-title":"SSRI Use by Tinnitus Patients: Interactions between Depression and Tinnitus Severity","volume":"83","author":"Folmer","year":"2004","journal-title":"Ear Nose Throat J."},{"key":"ref_17","first-page":"663","article-title":"Tinnitus: Diagnosis and Management","volume":"103","author":"Dalrymple","year":"2021","journal-title":"Am. Fam. Physician"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1097\/MOO.0000000000000185","article-title":"Treatment of Tinnitus","volume":"23","author":"Langguth","year":"2015","journal-title":"Curr. Opin. Otolaryngol.-Head Neck Surg."},{"key":"ref_19","first-page":"Doc04","article-title":"Evidence and Evidence Gaps in Tinnitus Therapy","volume":"15","author":"Hesse","year":"2016","journal-title":"GMS Curr. Top. Otorhinolaryngol. Head Neck Surg."},{"key":"ref_20","unstructured":"Esmaili, A.A., and Renton, J. (2025, February 21). Tinnitus. Available online: https:\/\/www1.racgp.org.au\/ajgp\/2018\/april\/tinnitus."},{"key":"ref_21","first-page":"CD012614","article-title":"Cognitive Behavioural Therapy for Tinnitus","volume":"1","author":"Fuller","year":"2020","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1002\/lary.21825","article-title":"Systematic Review and Meta-Analyses of Randomized Controlled Trials Examining Tinnitus Management","volume":"121","author":"Hoare","year":"2011","journal-title":"Laryngoscope"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Schecklmann, M., Weber, F.C., Lehner, A., Langguth, B., and Schoisswohl, S. (2023). Cognitive Behavioral Group Therapy for Chronic Tinnitus in a German Tertiary Clinical Real-World Setting. Int. J. Environ. Res. Public Health, 20.","DOI":"10.3390\/ijerph20064982"},{"key":"ref_24","unstructured":"DGHNO-KHC (2025, March 10). AWMF Nr. 017\/064, S3-Leitlinie Chronischer Tinnitus [Guideline for Chronic Tinnitus]. Available online: https:\/\/register.awmf.org\/de\/leitlinien\/detail\/017-064."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Fuller, T.E., Haider, H.F., Kikidis, D., Lapira, A., Mazurek, B., Norena, A., Rabau, S., Lardinois, R., Cederroth, C.R., and Edvall, N.K. (2017). Different Teams, Same Conclusions? A Systematic Review of Existing Clinical Guidelines for the Assessment and Treatment of Tinnitus in Adults. Front. Psychol., 8.","DOI":"10.3389\/fpsyg.2017.00206"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.jpsychores.2012.05.002","article-title":"Methodological Aspects of Clinical Trials in Tinnitus: A Proposal for an International Standard","volume":"73","author":"Landgrebe","year":"2012","journal-title":"J. Psychosom. Res."},{"key":"ref_27","unstructured":"(2025, February 21). Overview|Tinnitus: Assessment and Management|Guidance|NICE. Available online: https:\/\/www.nice.org.uk\/guidance\/ng155."},{"key":"ref_28","first-page":"S1","article-title":"Clinical Practice Guideline: Tinnitus","volume":"151","author":"Tunkel","year":"2014","journal-title":"Otolaryngol.-Head Neck Surg. Off. J. Am. Acad. Otolaryngol.-Head Neck Surg."},{"key":"ref_29","unstructured":"(2025, February 21). Tinnitus (2024)-VA\/DOD Clinical Practice Guidelines, Available online: https:\/\/www.healthquality.va.gov\/guidelines\/CD\/tinnitus\/index.asp."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"M\u00f8ller, A.R., Langguth, B., De Ridder, D., and Kleinjung, T. (2011). Counseling and Psycho-Education for Tinnitus Management. Textbook of Tinnitus, Springer.","DOI":"10.1007\/978-1-60761-145-5"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"389","DOI":"10.3390\/audiolres13030034","article-title":"Tinnitus Education for Audiologists Is a Ship at Sea: Is It Coming or Going?","volume":"13","author":"Fagelson","year":"2023","journal-title":"Audiol. Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1097\/AUD.0000000000000363","article-title":"Psychological Therapy for People with Tinnitus: A Scoping Review of Treatment Components","volume":"38","author":"Thompson","year":"2017","journal-title":"Ear Hear."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1097\/AUD.0b013e3181888f83","article-title":"The Additive Effect of Co-Occurring Anxiety and Depression on Health Status, Quality of Life and Coping Strategies in Help-Seeking Tinnitus Sufferers","volume":"29","author":"Bartels","year":"2008","journal-title":"Ear Hear."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1007\/s00103-023-03805-1","article-title":"Apps for tinnitus? A systematic review on quality, intervention components, and behavior change techniques","volume":"67","author":"Rinn","year":"2024","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e10353","DOI":"10.2196\/10353","article-title":"Mobile Apps for Management of Tinnitus: Users\u2019 Survey, Quality Assessment, and Content Analysis","volume":"7","author":"Sereda","year":"2019","journal-title":"JMIR mHealth uHealth"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e21767","DOI":"10.2196\/21767","article-title":"Smartphone and Mobile Health Apps for Tinnitus: Systematic Identification, Analysis, and Assessment","volume":"8","author":"Mehdi","year":"2020","journal-title":"JMIR mHealth uHealth"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Mehdi, M., Riha, C., Neff, P., Dode, A., Pryss, R., Schlee, W., Reichert, M., and Hauck, F.J. (2020). Smartphone Apps in the Context of Tinnitus: Systematic Review. Sensors, 20.","DOI":"10.3390\/s20061725"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Mehdi, M., Dode, A., Pryss, R., Schlee, W., Reichert, M., and Hauck, F.J. (2020). Contemporary Review of Smartphone Apps for Tinnitus Management and Treatment. Brain Sci., 10.","DOI":"10.20944\/preprints202009.0620.v1"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Bardy, F., Jacquemin, L., Wong, C.L., Maslin, M.R.D., Purdy, S.C., and Thai-Van, H. (2024). Delivery of Internet-Based Cognitive Behavioral Therapy Combined with Human-Delivered Telepsychology in Tinnitus Sufferers through a Chatbot-Based Mobile App. Front. Audiol. Otol., 1.","DOI":"10.3389\/fauot.2023.1302215"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1001\/jamaoto.2018.2238","article-title":"Effectiveness of Guided Internet-Based Cognitive Behavioral Therapy vs Face-to-Face Clinical Care for Treatment of Tinnitus: A Randomized Clinical Trial","volume":"144","author":"Beukes","year":"2018","journal-title":"JAMA Otolaryngol.-Head Neck Surg."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Engelke, M., Sim\u00f5es, J., Vogel, C., Schoisswohl, S., Schecklmann, M., W\u00f6lflick, S., Pryss, R., Probst, T., Langguth, B., and Schlee, W. (2023). Pilot Study of a Smartphone-Based Tinnitus Therapy Using Structured Counseling and Sound Therapy: A Multiple-Baseline Design with Ecological Momentary Assessment. PLoS Digit. Health, 2.","DOI":"10.1371\/journal.pdig.0000183"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Lee, S., Jin, T.-J., Lee, D., and Jin, I.-K. (2024). Effectiveness of Computer-Mediated Educational Counseling for Tinnitus Relief: A Randomized Controlled Trial. Brain Sci., 14.","DOI":"10.3390\/brainsci14070629"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Schlee, W., Neff, P., Simoes, J., Langguth, B., Schoisswohl, S., Steinberger, H., Norman, M., Spiliopoulou, M., Schobel, J., and Hannemann, R. (2022). Smartphone-Guided Educational Counseling and Self-Help for Chronic Tinnitus. J. Clin. Med., 11.","DOI":"10.20944\/preprints202201.0469.v1"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"e59575","DOI":"10.2196\/59575","article-title":"Continuous Improvement of Chronic Tinnitus Through a 9-Month Smartphone-Based Cognitive Behavioral Therapy: Randomized Controlled Trial","volume":"27","author":"Walter","year":"2025","journal-title":"J. Med. Internet Res."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Walter, U., Pennig, S., Kottmann, T., Bleckmann, L., R\u00f6schmann-Doose, K., and Schlee, W. (2023). Randomized Controlled Trial of a Smartphone-Based Cognitive Behavioral Therapy for Chronic Tinnitus. PLoS Digit. Health, 2.","DOI":"10.1371\/journal.pdig.0000337"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1026\/1616-3443\/a000224","article-title":"Direkte Ver\u00e4nderungsmessung in Der Psychotherapie [Direct Measurement of Change in Psychotherapy]","volume":"42","author":"Willutzki","year":"2013","journal-title":"Z. Klin. Psychol. Psychother."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Geue, K., Strau\u00df, B., and Br\u00e4hler, E. (2016). BVB-2000. Bochumer Ver\u00e4nderungsbogen-2000 [Bochum Change Questionnaire-2000]. Diagnostische Verfahren in der Psychotherapie, Hogrefe. 3. \u00fcberarbeitete und erweiterte Auflage.","DOI":"10.1026\/02700-000"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1007\/s00106-023-01365-z","article-title":"Itemanalyse der Kurzformen des Tinnitusfragebogens: Mini-TF-12 und Mini-TF-15 [Analysis of items on the short forms of the tinnitus questionnaire: Mini-TQ-12 and Mini-TQ-15]","volume":"71","author":"Brueggemann","year":"2023","journal-title":"HNO"},{"key":"ref_49","first-page":"340","article-title":"Psychometric Data for the Reliability and Validity of the Mini Tinnitus Questionnaire Turkish Version (TQ 12-T)","volume":"10","author":"Aksoy","year":"2020","journal-title":"ENT Updat."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1159\/000054832","article-title":"Qualit\u00e4tsmanagement in Der Therapie Des Chronischen Tinnitus","volume":"10","author":"Goebel","year":"2000","journal-title":"Oto-Rhino-Laryngol. Nova"},{"key":"ref_51","first-page":"31","article-title":"Validation of the Mini-TQ in a Dutch-Speaking Population: A Rapid Assessment for Tinnitus-Related Distress","volume":"7","author":"Vanneste","year":"2011","journal-title":"B-ENT"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1080\/14992020400050077","article-title":"Rapid Assessment of Tinnitus-Related Psychological Distress Using the Mini-TQ","volume":"43","author":"Hiller","year":"2004","journal-title":"Int. J. Audiol."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Biesinger, E., and Iro, H. (2005). Der Schweregrad des Tinnitus [Severity Grading of Tinnitus]. Tinnitus, Springer.","DOI":"10.1007\/3-540-27491-X"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/S0079-6123(07)66050-6","article-title":"Consensus for Tinnitus Patient Assessment and Treatment Outcome Measurement: Tinnitus Research Initiative Meeting, Regensburg, July 2006","volume":"166","author":"Langguth","year":"2007","journal-title":"Prog. Brain Res."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1044\/2014_AJA-13-0014","article-title":"Development and Validation of the Tinnitus Primary Function Questionnaire","volume":"23","author":"Tyler","year":"2014","journal-title":"Am. J. Audiol."},{"key":"ref_56","first-page":"166","article-title":"Tinnitus-Fragebogen (TF) [The Tinnitus Questionnaire (TQ)]. Results of a multicenter study with the Tinnitus Questionnaire, a standard instrument for grading the degree of tinnitus","volume":"42","author":"Goebel","year":"1994","journal-title":"HNO"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/j.2044-8260.1988.tb00778.x","article-title":"Cognitive Variables in Tinnitus Annoyance","volume":"27","author":"Hallam","year":"1988","journal-title":"Br. J. Clin. Psychol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/1477-7525-10-128","article-title":"Tinnitus Assessment by Means of Standardized Self-Report Questionnaires: Psychometric Properties of the Tinnitus Questionnaire (TQ), the Tinnitus Handicap Inventory (THI), and Their Short Versions in an International and Multi-Lingual Sample","volume":"10","author":"Zeman","year":"2012","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1186\/1477-7525-10-79","article-title":"Linking the Tinnitus Questionnaire and the Subjective Clinical Global Impression: Which Differences Are Clinically Important?","volume":"10","author":"Adamchic","year":"2012","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"107796","DOI":"10.1016\/j.heares.2019.107796","article-title":"Sensitivity to Change and Convergent Validity of the Tinnitus Functional Index (TFI) and the Tinnitus Questionnaire (TQ): Clinical and Research Perspectives","volume":"382","author":"Jacquemin","year":"2019","journal-title":"Hear. Res."},{"key":"ref_61","unstructured":"(2025, February 27). Tinnitus-Schweregrad-Test [Tinnitus Severity Grading Test], Deutsche Tinnitus-Liga. Available online: https:\/\/www.tinnitus-liga.de\/tinnitus\/tinnitus-schweregrad-test\/."},{"key":"ref_62","unstructured":"Zielke, M., and Kopf-Mehnert, C. (1978). VEV-Ver\u00e4nderungsfragebogen des Erlebens und Verhaltens [Questionnaire of Changes in Experiencing and Behavior], Beltz Test Gesellschaft."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1026\/1616-3443\/a000195","article-title":"Es ging mir schlechter, als ich dachte! Retrospektive Symptomeinsch\u00e4tzung und Psychotherapieerfolg. [I felt worse than I thought! Retrospective symptom assessment and psychotherapy success]","volume":"42","author":"Fydrich","year":"2013","journal-title":"Z. Klin. Psychol. Psychother."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1026\/1616-3443\/a000196","article-title":"Ziel Erreicht! Aber Auch Ver\u00e4ndert? Zwei Basale Perspektiven in Der Psychotherapieerfolgsbeurteilung. [Goal Reached! But Have You Changed? Two Perspectives on Measuring the Success of Psychotherapy.]","volume":"42","author":"Schulte","year":"2013","journal-title":"Z. Klin. Psychol. Psychother. Forsch. Prax."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Tiller, D., Herzog, B., Kluttig, A., and Haerting, J. (2015). Health Literacy in an Urban Elderly East-German Population-Results from the Population-Based CARLA Study. BMC Public Health, 15.","DOI":"10.1186\/s12889-015-2210-7"},{"key":"ref_66","unstructured":"R Core Team (2021). R: A Language and Environment for Statistical Computing, R Foundation for Statistical Computing. Available online: https:\/\/www.r-project.org\/."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.1080\/10543406.2013.834911","article-title":"Analysis of Longitudinal Trials with Protocol Deviation: A Framework for Relevant, Accessible Assumptions, and Inference via Multiple Imputation","volume":"23","author":"Carpenter","year":"2013","journal-title":"J. Biopharm. Stat."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"3533","DOI":"10.1177\/0962280220932189","article-title":"Bootstrap Inference for Multiple Imputation under Uncongeniality and Misspecification","volume":"29","author":"Bartlett","year":"2020","journal-title":"Stat. Methods Med. Res."},{"key":"ref_69","first-page":"400","article-title":"Maximum Likelihood Multiple Imputation: Faster Imputations and Consistent Standard Errors Without Posterior Draws","volume":"36","author":"Bartlett","year":"2021","journal-title":"Stat. Sci."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"van Buuren, S. (2018). Flexible Imputation of Missing Data, Taylor & Francis Group. [2nd ed.].","DOI":"10.1201\/9780429492259"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"295","DOI":"10.2307\/1267823","article-title":"Multiparameter Hypothesis Testing and Acceptance Sampling","volume":"24","author":"Berger","year":"1982","journal-title":"Technometrics"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/pst.291","article-title":"Gatekeeping Procedures with Clinical Trial Applications","volume":"6","author":"Dmitrienko","year":"2007","journal-title":"Pharm. Stat."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Gelman, A., and Hill, J. (2007). Data Analysis Using Regression and Multilevel\/Hierarchical Models, Cambridge University Press.","DOI":"10.32614\/CRAN.package.arm"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1080\/00031305.1980.10483031","article-title":"Population Marginal Means in the Linear Model: An Alternative to Least Squares Means","volume":"34","author":"Searle","year":"1980","journal-title":"Am. Stat."},{"key":"ref_75","unstructured":"Hedges, L.V., and Olkin, I. (1985). Statistical Methods for Meta-Analysis, Academic Press."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1300\/J079v21n04_02","article-title":"Qualitative Descriptors of Strength of Association and Effect Size","volume":"21","author":"Rosenthal","year":"1996","journal-title":"J. Soc. Serv. Res."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1198\/sbr.2011.10070","article-title":"Responder Analyses\u2014A PhRMA Position Paper","volume":"3","author":"Uryniak","year":"2011","journal-title":"Stat. Biopharm. Res."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1214\/aoms\/1177729952","article-title":"Note on the Consistency of the Maximum Likelihood Estimate","volume":"20","author":"Wald","year":"1949","journal-title":"Ann. Math. Stat."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1177\/1536867X0900900201","article-title":"Methods for Estimating Adjusted Risk Ratios","volume":"9","author":"Cummings","year":"2009","journal-title":"Stata J."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1111\/j.2517-6161.1995.tb02042.x","article-title":"Bayesian Model Choice Via Markov Chain Monte Carlo Methods","volume":"57","author":"Carlin","year":"1995","journal-title":"J. R. Stat. Soc. Ser. B Methodol."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Gelman, A., Carlin, J.B., Stern, H.S., Dunson, D.B., Vehtari, A., and Rubin, D.B. (2013). Bayesian Data Analysis, CRC Press. [3rd ed.].","DOI":"10.1201\/b16018"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1198\/jbes.2009.07145","article-title":"Model-Based Clustering of Non-Gaussian Panel Data Based on Skew-t Distributions","volume":"28","author":"Steel","year":"2010","journal-title":"J. Bus. Econ. Stat."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v067.i01","article-title":"Fitting Linear Mixed-Effects Models Using Lme4","volume":"67","author":"Bates","year":"2015","journal-title":"J. Stat. Softw."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"395","DOI":"10.32614\/RJ-2018-017","article-title":"Advanced Bayesian Multilevel Modeling with the R Package Brms","volume":"10","year":"2018","journal-title":"R J."},{"key":"ref_85","first-page":"1","article-title":"Brms: An R Package for Bayesian Multilevel Models Using Stan","volume":"80","year":"2017","journal-title":"J. Stat. Softw."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1080\/10618600.1998.10474787","article-title":"General Methods for Monitoring Convergence of Iterative Simulations","volume":"7","author":"Brooks","year":"1998","journal-title":"J. Comput. Graph. Stat."},{"key":"ref_87","unstructured":"Aragon, T.J., Fay, M.P., Wollschlaeger, D., and Omidpanah, A. (2025, March 12). Epitools: Epidemiology Tools. R Package Version 0.5-10.1. Available online: https:\/\/cran.r-project.org\/web\/packages\/epitools\/index.html."},{"key":"ref_88","unstructured":"L\u00fcdecke, D. (2025, March 12). Esc: Effect Size Computation for Meta Analysis (Version 0.5.1). Available online: https:\/\/cran.r-project.org\/web\/packages\/esc\/index.html."},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Schlee, W., Pryss, R.C., Probst, T., Schobel, J., Bachmeier, A., Reichert, M., and Langguth, B. (2016). Measuring the Moment-to-Moment Variability of Tinnitus: The TrackYourTinnitus Smart Phone App. Front. Aging Neurosci., 8.","DOI":"10.3389\/fnagi.2016.00294"},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"M\u00e4der, M., Timpel, P., Sch\u00f6nfelder, T., Militzer-Horstmann, C., Scheibe, S., Heinrich, R., and H\u00e4ckl, D. (2023). Evidence Requirements of Permanently Listed Digital Health Applications (DiGA) and Their Implementation in the German DiGA Directory: An Analysis. BMC Health Serv. Res., 23.","DOI":"10.1186\/s12913-023-09287-w"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1089\/tmj.2024.0050","article-title":"Short- and Long-Term Outcomes of e-Health and Internet-Based Psychological Interventions for Chronic Tinnitus: A Systematic Review and Meta-Analysis","volume":"31","author":"Sattel","year":"2025","journal-title":"Telemed. J. E-Health Off. J. Am. Telemed. Assoc."}],"container-title":["Audiology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4349\/15\/6\/173\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T14:58:27Z","timestamp":1765292307000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4349\/15\/6\/173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,9]]},"references-count":91,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["audiolres15060173"],"URL":"https:\/\/doi.org\/10.3390\/audiolres15060173","relation":{},"ISSN":["2039-4349"],"issn-type":[{"value":"2039-4349","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,9]]}}}