A commentary on the complexity of tinnitus management: clinical guidelines provide a path through the fog.

There is a desire among many tinnitus researchers and clinicians for greater standardization in the assessment and management of tinnitus. In their commentary on the complexity of tinnitus, Hoare et al. have highlighted the need for strong evidence-based protocols. The authors make many valid and important conclusions as to the current state of clinical guidelines; they identify clear gaps in evidence and limited consensus as to clinical practice. While I agree with the bulk of their commentary there are a few areas where I will offer a counter view. In particular I will address their view that only high-level evidence has a place in forming practice guidelines for tinnitus.