***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Publication bias , sometimes known as the " file-drawer problem " or " funnel-plot asymmetry , " is common in empirical research . The authors review the implication s of publication bias for quantitative research synthesis ( meta- analysis ) and describe existing techniques for detecting and correcting it . A new approach is proposed that is suitable for application to meta-analytic data sets that are too small for the application of existing methods . The model estimates parameters relevant to fixed-effects , mixed-effects or r and om-effects meta- analysis contingent on a hypothetical pattern of bias that is fixed independently of the data . The authors illustrate this approach for sensitivity analysis using 3 data sets adapted from a commonly cited reference work on research synthesis ( H. M. Cooper & L. V. Hedges , 1994 ) The effectiveness of a therapist-supported Internet intervention program for  tinnitus distress in an industrial setting was evaluated using a cluster r and omised design . Fifty-six Australian employees of two industrial organisations were r and omly assigned , based on their work site ( 18 work sites from BP Australia and five from BHP Billiton ) , to either a cognitive behavioural therapy ( CBT ) program or an information-only control program . Participants were assessed at pre- and postprogram , measuring tinnitus distress , depression , anxiety , stress , quality of life , and occupational health . The CBT program was not found to be superior to the information program for treating tinnitus distress . A high attrition rate and small sample size limit the generalisability of the findings , and further developments of the program and assessment process are needed to enhance engagement and compliance BACKGROUND Although effective therapies for social phobia exist , many individuals refrain from seeking treatment owing to the embarrassment associated with help-seeking . Internet-based cognitive-behavioural self-help can be an alternative , but adherence is a problem . AIMS To evaluate a 9-week programme of internet-based therapy design ed to increase treatment adherence by the addition of short weekly telephone calls , nine in all , with a total duration of 95 min . METHOD In a r and omised controlled trial the effects of internet-based cognitive-behavioural therapy in the treatment group ( n=29 ) were compared with a waiting-list control group ( n=28 ) . RESULTS Compared with the control group the treated participants experienced greater reductions on measures of general and social anxiety , avoidance and depression . Adherence to treatment was high , with 93 % finishing the complete treatment package . One year later all improvements were maintained . CONCLUSIONS This study provides evidence to support the use of internet-based treatment supplemented by short , weekly telephone calls OBJECTIVE Using a r and omized group design , the efficacy of an outpatient cognitive-behavioral Tinnitus Coping Training ( TCT )  was compared to two minimal-contact ( MC ) interventions . METHODS TCT was conducted in a group format with 11 sessions ( total n=43 ) . One MC [ MC-E ( education ) , n=16 ] consisted of two group sessions in which education on tinnitus was presented and self-help strategies were introduced . The second MC [ MC-R ( relaxation ) , n=16 ] comprised four sessions . Besides education , music-supported relaxation was suggested as self-help strategy and audiotapes with relaxing music were provided . Furthermore , a waiting-list control group was installed ( WC , n=20 ) . Data were assessed at baseline ( pretherapy ) and at posttherapy period . Only  TCT  was additionally evaluated at a 6-month and a 12-month follow-up . Several outcome variables ( e.g. , awareness of tinnitus ) were recorded in a tinnitus diary . Tinnitus coping and disability due to tinnitus were assessed by question naires . Subjective ratings of improvement were also requested from the patients . Furthermore , inventories of psychopathology were given to the patients . RESULTS Findings reveal highly significant improvements in  TCT  in comparison to the control group ( WC ) . MC interventions do not differ significantly from each other , but are superior to WC in a few domains of outcome . Outcome in TCT is somewhat superior to combined MC interventions in two domains of data , but not regarding disability reduction . Effect sizes , nevertheless , indicate distinct differences in degree of improvement , with TCT achieving the best results . CONCLUSIONS A sequential scheme for the treatment of chronic tinnitus  is discussed on the basis of cost-effectiveness considerations Tinnitus distress can be reduced by means of cognitive-behavior therapy ( CBT ) , and the treatment can be delivered in different ways . The most recent format is Internet-based self-help . The aim of this study was to compare this treatment ( n= 26 ) with  st and ard group-based CBT ( n=25 ) in a r and omized controlled trial . Outcomes on self-report inventories measuring tinnitus distress were evaluated immediately after and 1 year after treatment . Results showed that both groups had improved , and there were few differences between them . The effect size for the Internet treatment was d=0.73 ( 95 % CI=0.16 - 1.30 ) and for the group treatment was d=0.64 ( 95 % CI=0.07 - 1.21 ) . The Internet treatment consumed less therapist time and was 1.7 times as cost-effective as the group treatment . At pretreatment patients rated the Internet treatment as less credible than the group treatment . In conclusion ,  Internet treatment for tinnitus distress merits further investigation , as the outcomes achieved are promising Objective The aim of this study was to investigate if cognitive behavior therapy ( CBT ) provided via the Internet results in significant decreases of distress in individuals with tinnitus . Methods Participants were recruited through Web pages and newspaper articles and thereafter r and omly allocated to a CBT self-help manual in six modules or to a waiting-list control group ( WLC ) . All treatment and contact with participants were conducted via the Internet with Web pages and E-mail correspondence . Participants were 117 individuals with tinnitus of duration of more than 6 months . In the first r and omized controlled phase of the study , 26 completed all stages of treatment ( 51 % dropout ) , and 64 of the WLC group completed measures . At 1-year follow-up , all participants had been offered the program and 96 provided outcome measures ( 18 % dropout rate from baseline ) . Tinnitus-related problems were assessed before and after treatment and at the 1-year follow-up . Daily diary ratings were included for 1 week before and 1 week following the treatment period . Results Tinnitus-related distress , depression , and diary ratings of annoyance decreased significantly . Immediately following the r and omized controlled phase ( with a WLC ) , significantly more participants in the treatment group showed an improvement of at least 50 % on the Tinnitus Reaction Question naire . At the uncontrolled follow-up , 27 ( 31 % ) of all participants had achieved a clinical ly significant improvement . Conclusions CBT via the Internet can help individuals decrease annoyance associated with tinnitus . High dropout rates or delay in completing treatment can be a characteristic of treatment studies using the Internet but should be contrasted with the cost effectiveness and accessibility of the Internet UNLABELLED We conducted a r and omized clinical trial to examine the relative effectiveness of two psychological interventions for treating tinnitus .  People with tinnitus were initially offered a single session of psychoeducation about tinnitus , followed 2 months later by six weekly sessions of either mindfulness or relaxation training . Results indicated benefits from psychoeducation in reducing negative emotions , rumination and psychological difficulties of living with tinnitus . These effects were maintained or enhanced by mindfulness training that also emphasized acceptance , although they were eroded in the relaxation condition over the follow-up . Mediating processes are discussed , and suggestions for refining clinical interventions for this population are offered . KEY PRACTITIONER MESSAGE The present results suggest that mindfulness training might constitute a useful addition to psychoeducation for interventions targeting the psychological consequences of tinnitus The study compared the effects of Acceptance and Commitment Therapy ( ACT ) with Tinnitus Retraining Therapy ( TRT ) on tinnitus impact in a r and omised controlled trial . Sixty-four normal hearing subjects with tinnitus were r and omised to one of the active treatments or a wait-list control ( WLC ) . The ACT treatment consisted of 10 weekly 60 min sessions . The TRT treatment consisted of one 150 min session , one 30 min follow-up and continued daily use of wearable sound generators for a recommended period of at least 8h/day for 18 months . Assessment s were made at baseline , 10 weeks , 6 months and 18 months . At 10 weeks , results showed a superior effect of ACT in comparison with the WLC regarding tinnitus impact ( Cohen 's d=1.04 ) , problems with sleep and anxiety . The results were mediated by tinnitus acceptance . A comparison between the active treatments , including all assessment points , revealed significant differences in favour of ACT  regarding tinnitus impact ( Cohen 's d=0.75 ) and problems with sleep . At 6 months , reliable improvement on the main outcome measure was found for 54.5 % in the ACT condition and 20 % in the TRT condition . The results suggest that ACT can reduce tinnitus distress and impact in a group of normal hearing tinnitus patients BACKGROUND Chronic tinnitus is a frequent symptom presentation in clinical practice . No drug treatment to date has shown itself to be effective . The aim of the present study was to investigate the effects of cognitive behavioural therapy and meditation in tinnitus sufferers . METHODOLOGY Patients were selected from a dedicated tinnitus clinic in the Welsh Hearing Institute . A waiting list control design was used . Twenty-five chronic tinnitus sufferers were consecutively allocated to two groups , one receiving a cognitive behavioural therapy/meditation intervention of four one hour sessions with the other group waiting three months and subsequently treated in the same way , thereby acting as their own control . The main outcome was measured using the Hallam tinnitus question naire . A four to six month follow up was conducted . RESULTS These showed significant statistical reductions in tinnitus variables both in the active and also in the control group . Post-therapy , no significant change was found after the waiting list period . The improvement was maintained at the four to six month period . CONCLUSION The positive findings give support for the use of cognitive behavioural therapy/meditation for chronic tinnitus sufferers Acute tinnitus can lead to substantial distress and eventually result in long-lasting impairment . The aim of this study was to compare the efficacy of a cognitive-behavioural intervention ( delivered as Internet self-management , bibliotherapy or group training ) to the information-only control condition . Applicants suffered from subjective tinnitus for up to six months , were between 18 and 75 years old and received no other tinnitus-related psychological treatment . A total of 304 participants were r and omly assigned to one of the four study arms . Tinnitus distress , depressive symptoms , psychosomatic discomfort and treatment satisfaction were assessed . At the post- assessment tinnitus distress was significantly lower in the Internet and the group training conditions compared to the control condition . Inter-group effect sizes were moderate to large . At follow-up , all active training conditions showed significantly reduced tinnitus distress compared to the control condition ( intention-to-treat analysis ) . An additional completer analysis showed a significant reduction in tinnitus distress only for the group condition . All effect sizes were moderate . There were no differences regarding psychosomatic discomfort , but depressive symptoms were reduced in the group condition at the post- assessment ( intention-to-treat analysis ) . Treatment satisfaction was significantly higher in the training conditions . The dropout rate was 39 % . The present study shows that distress can be reduced as early as the acute stadium and that minimal-contact interventions are a promising way to do this . In particular , the Internet and group conditions led to a large , immediate decrease in distress , and the participants were highly satisfied with the training In this study conducted in the French-speaking part of Switzerl and , 52 individuals with social phobia were r and omly assigned either to an Internet-based cognitive-behavioral treatment with minimal contact with therapists via e-mail or to a waiting-list control group . Significant differences between the two groups were found at posttreatment on all primary outcome measures ( social anxiety measures ) and on two of the secondary outcome measures ( general symptomatology , therapy goal attainment ) . On average , within-groups effect sizes were large for the primary outcomes ( Cohen 's d=0.82 ) and for secondary outcomes ( Cohen 's d=1.04 ) . Moreover , subjects in the treatment group fulfilled the criteria of clinical ly significant improvement significantly more often than subjects in the control group on all measured dimensions ( 58 % vs. 20 % ) . Users ' acceptance of the program was high . The results from the present study lend further support to the hypothesis that Internet-delivered interventions with minimal therapist contact are a promising treatment approach to social phobia OBJECTIVE  Tinnitus distress can be reduced by means of cognitive-behavior therapy ( CBT ) . To compensate for the shortage of CBT therapists , we aim ed , in this study , to investigate the effects of a CBT-based self-help book guided by brief telephone support . METHODS Seventy-two patients were r and omized either to a self-help book and seven weekly phone calls or to a wait-list control condition , later on receiving the self-help book with less therapist support . The dropout rate was 7 % . Follow-up data 1 year after completion of treatment were also collected ( 12 % dropout ) . The Tinnitus Reaction Question naire ( TRQ ) was the main outcome measure , complemented with daily ratings of tinnitus and measures of insomnia , anxiety , and depression . RESULTS On the TRQ , significant reductions were found in the treatment group both immediately following treatment and at 1-year follow-up . In the treatment group , 32 % reached the criteria for clinical significance ( 
    Output:
    
There was no difference to the face-to-face controls ( group treatment ) .
Sensitivity analysis revealed that there might be a publication bias regarding the comparison to the face-to-face control .
However , the results suggest that CBT self-help interventions are an effective treatment for tinnitus distress .