Lenire — Bimodal Stimulation Treatment by Neuromod

Discussion in 'Treatments' started by Tinnitus Talk, Apr 20, 2019.

    1. Lurius
      Sad

      Lurius Member Benefactor Hall of Fame

      Location:
      Oslo, Norway
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      September 2018
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      Valsalva maneuver
      What proof do you have that the testimonies were made by "paid actors?" None.
       
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    2. Mathieulh
      No Mood

      Mathieulh Member Benefactor

      Location:
      Paris, France
      Tinnitus Since:
      05/24/2019
      Cause of Tinnitus:
      Chronic headphones use and acute noise induced trauma.
      Neuromod knew damn well what kind of demand they would generate and expect, when you sell something, including treatments or medical devices, you don't go blindly all in, you do a market study first.

      The truth is Neuromod chose the Republic of Ireland for its generous tax policies as well as the rather lenient EU regulations (and its rather generous research subsidies/grants), when it comes to medical devices as opposed to the stricter ones from the FDA or many other regulatory agencies.
      1. Neuromod actually is obligated to go through a peer review study to demonstrate the efficacy and safety of any medical devices they sell, so far we have seen none, all we have are testimonies from people on this forum which are a far cry from the over 60% improvement advertised by Neuromod. That's not "Tinnitus Talk Skeptics Non-Placebo Certification", it is however the law in most countries, around the world.

      2. What "level placebo sits at" is actually "decided", as a standard and through scientific consensus, by the use of control groups (because, you know? "Science"?), of which there was actually no such thing because there is NO PEER REVIEWED STUDY from Neuromod or anyone/anywhere else on Lenire, at least none we can access (i.e., none that was published). Feel free to prove me wrong on that point.

      Whereas you should actually read on the definition of placebo:
      https://en.wikipedia.org/wiki/Placebo

      That said, while Placebo is technically non linear by nature, it is usually estimated, through general consensus, that anything not offering over 20% changes (improvements or otherwise), is usually within the placebo range (or below).
      Says who? You? How is that "demonstrated" to be untrue?
       
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    3. Ruse
      No Mood

      Ruse Member Podcast Patron Benefactor

      Tinnitus Since:
      01/2019
      Cause of Tinnitus:
      NIHL & TMJ
      I’m sorry dude but it’s incredibly naive to think that an Irish medtech start up with limited resources can somehow both launch worldwide and meet worldwide demand with a click of their fingers.
      Of course, this has absolutely nothing to do with the fact that the founders are Irish and that the company was founded as a spin-off from research at Maynooth University in... you guessed it, Ireland!
      The irony in this is brilliant. You do realise that you have just chalked off every single person’s experience on Tinnitus Talk as placebo without the use of any means described above as a requirement to gauge placebo?
      Say the patients from the testimonials who have been contacted by members on Tinnitus Talk.
       
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    4. Bartoli

      Bartoli Member

      Tinnitus Since:
      2009,worsened 2019
      Cause of Tinnitus:
      Noise
      How have they been able to commercialize if they are obliged to go through peer review first?
       
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    5. Mathieulh
      No Mood

      Mathieulh Member Benefactor

      Location:
      Paris, France
      Tinnitus Since:
      05/24/2019
      Cause of Tinnitus:
      Chronic headphones use and acute noise induced trauma.
      That's a good question, my guess is that they sell this as a "treatment" to forego the EU regulation on medical devices.

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3326593/

      As you can see from this document, should Lenire be sold as a medical device, they would have to sell it as class IIa (at the very least).

      Which requires to undertake the following process:

      "IIa Special controls required: may include special labelling, mandatory performance standards & post-market surveillance" ("mandatory performance standards", do require a study, or at the very least, a risk assessment);

      Another link of interest:
      https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:01993L0042-20071011
      That said, since Lenire is likely sold as a treatment, it likely follows other sets of rules (one may say stricter rules to some degree).

      https://ec.europa.eu/health/human-use/legal-framework_en

      I would have to review Lenire's own documentation to know for sure how the product is sold and advertised however.
       
    6. Mathieulh
      No Mood

      Mathieulh Member Benefactor

      Location:
      Paris, France
      Tinnitus Since:
      05/24/2019
      Cause of Tinnitus:
      Chronic headphones use and acute noise induced trauma.
      So you've never heard of the Tinnitus Handicap Index then? (or, assuming you have the budget for it, even more precise measuring done through functional MRIs).

      I shall add that, in the meantime, Neuromod has not provided any more proof of the efficacy of Lenire than Ring Ease and the Tonaki Tinnitus Protocol have of their own products (in case you did not know, both of these products are notorious scams); that says a lot.
       
    7. JohnAdams
      Festive

      JohnAdams Member Benefactor Hall of Fame

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      This is true.
       
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    8. JohnAdams
      Festive

      JohnAdams Member Benefactor Hall of Fame

      Location:
      Vatican
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      Cause of Tinnitus:
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      I think Tinnitus Mix is helping me a little, and it has sounds that are very similar to the high frequency noises in the Lenire thing. That leads me to believe that there is evidence to suggest that this thing probably does work for some cases.

      I wonder what's better though, listening to the noises for ~8 hours while sleeping or the 30 minute sessions awake with your tongue getting zapped.
       
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    9. JayBowson

      JayBowson Member Podcast Patron Benefactor

      Tinnitus Since:
      2017
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      Idiopathic/Bad shoes?
      I was about to type a longer reply but I don't think I need to. Most of the points have been dealt with in this post.

      Just highlighting this part for particular lols. It takes some kind of cognitive dissonance to dismiss the positive user experiences under their own placebo criteria and in the same breath write what they did above. It's mind boggling.
       
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    10. Agrajag364

      Agrajag364 Member Benefactor

      Tinnitus Since:
      09/2017
      Cause of Tinnitus:
      Unknown
      Because of the crappy European medical devices regulations. Which are being tightened up in 2020 but not nearly enough.

      Panorama - The Great Implant Scandal


      Neuromod are not obliged to go through peer review before getting a CE mark and selling their device in the EU. They will probably need their trial published before getting past the FDA, according to my understanding. Scientific ethics are what oblige them to put their data through peer review and publish - and they have said for a while they are about to submit their 500 person trial for peer review - but we've not seen it published yet.
       
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    11. GlennS

      GlennS Member Podcast Patron Hall of Fame

      Tinnitus Since:
      1992
      Cause of Tinnitus:
      Loud music
      The stats really aren't improving that much. You're seeing what you want to see... through a pair of these:

      prejudice-rose-colored-glasses.jpg

      Every thread has a spectrum in the peanut gallery, some negative and some positive. You and Chris are going to be the die-hard evangelists. But don't for a moment think you represent the objective truth. You're both spinning. And that's fine. Spin if it makes you feel better. But people are going to call you out on it. Getting triggered won't change anyone's minds.
       
    12. Rogi Cetpla
      Frustrated

      Rogi Cetpla Member Benefactor

      Location:
      Europe
      Tinnitus Since:
      T 2010 / IT 2015 / VIT 2019
      Cause of Tinnitus:
      Noise exposure / Head trauma
      Hi Mathieulh,

      On the subject of treatment research... I have found that there is a ”specialised tinnitus/hyperacusis“ clinic in France... I am trying to find more information on this place.

      As you are French I wondered if you had heard of it? Looked into it? Have any views/opinions/feedback/testimonies?

      https://hearing-institute-of-resources.fr/en/

      Thanks in advance,
      Rogi
       
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    13. threefirefour
      Peeping tom

      threefirefour Member Benefactor Hall of Fame

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      140dB B R U H moment
      1. As has been shown earlier, even if you go only by testimonials on this site, improvement is at 60% of people. Neuromod said it was 66%, but given our small sample size this is well within a standard deviation of error.

      2. A peer review won’t completely turn over the results Neuromod has. Susan Shore’s theory for example is referenced in their paper, and she is peer reviewing it. She might at worst nitpick stuff like “that’s not necessarily my theory, you should change it to say this” or “I think you’re overstating the importance of the thalamus in tinnitus generation”, not “oh my god the numbers don’t add up this must be false!”. People overestimate how big the peer review process is to the final paper. It’s a speed bump, not a wall.

      3. Placebo is filtered by clinical significance instead of statistical significance. To overcome this at a good sample size, standard is measured usually at p=.05. Clinical is p=.13, not 20.

      And yes we tracked down one of the “paid actors” Ken. He confirmed he actually had a big reduction from Lenire and still uses it. What most likely happened was Neuromod found the people who responded the best and asked them to give positive reviews. And remember Neuromod his recorded reviews of people who said it helped them habituate because Neuromod wants this to be seen as a device that focuses on reducing tinnitus. If they were paid actors, why pay people to fabricate habituation stories, something that would harm Neuromod’s reputation?
       
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    14. Ruse
      No Mood

      Ruse Member Podcast Patron Benefactor

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      01/2019
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      NIHL & TMJ
      I have no idea why you’re asking me whether I’m familiar with THI.

      If you don’t understand the irony in the fact that you have just chalked every user’s experience as placebo based on your own personal opinion, before listing scientific criteria required to determine placebo, then there really is no hope in arguing with you.
       
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    15. Bartoli

      Bartoli Member

      Tinnitus Since:
      2009,worsened 2019
      Cause of Tinnitus:
      Noise
      I suspected this to be untrue. How else could devices as low level laser light and that TinniTool have seen the light of day if they had to put their findings through objective peer review?
       
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    16. JayBowson

      JayBowson Member Podcast Patron Benefactor

      Tinnitus Since:
      2017
      Cause of Tinnitus:
      Idiopathic/Bad shoes?
      I'm fine with you saying whatever you want about my biases. I don't think doesn't correlate to reality at all but so be it. You still have that quote of mine in your back pocket I'm assuming? Maybe have a look at it again?
      As @threefirefour says we now have a swing in the responder stats. Even so for consistencies sake I'll say it again. Its still too early to judge, the sample is still too small and could go either way.

      It's becoming a bit tedious Glenn. You accuse me of being biased almost every reply now.
      Without actually addressing the content of my posts. Without any sort of self reflection, that is to say you're doing the exact same thing you accuse me of but for the Anti-Lenire crowd.
      Hah, that gave me a genuine chuckle Glenn. :D I'm in no way "triggered". I'm slightly too old to be part of the woke generation, thankfully. I have a low tolerance for nonsense and conspiracy theories is all and I enjoy a good debate.
       
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    17. JohnAdams
      Festive

      JohnAdams Member Benefactor Hall of Fame

      Location:
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      Aspirin Toxicity/Possibly Noise
      They could do well to release their trial data, or at least tell us why they won't. The last trial's data hasn't been released yet right?
       
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    18. Bartoli

      Bartoli Member

      Tinnitus Since:
      2009,worsened 2019
      Cause of Tinnitus:
      Noise
      Agree, but let's not forget Shore's task in all this is to make certain the scientific research is properly conducted, as in checking whether they used correct methods to get to their results. She cannot compare to her own model or theory, as it's something else entirely, even if it's not to us.
      If Lenire's paper were to contain weak elements then these can be challenged but she still has to be objective.

      People shouldn't get too hung up on it. The results are already happening in front of our eyes. What one makes of it is up to the individual. If some want to wait out the peer review and recheck the numbers, they can. Actually, most of us WILL have to wait regardless with the current waiting list.
       
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    19. Agrajag364

      Agrajag364 Member Benefactor

      Tinnitus Since:
      09/2017
      Cause of Tinnitus:
      Unknown
      Needs to go through peer review. That can take three months or longer. They said a month or so ago they were about to do it. But to be fair they said the same thing in October 2018 on Twitter.
       
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    20. ChrisBoyMonkey

      ChrisBoyMonkey Member

      Location:
      US
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      2019
      Cause of Tinnitus:
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      There are still people saying Neuromod is placebo?

      It looks like they've traded in their tin hats for dunce hats.
       
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    21. Ruse
      No Mood

      Ruse Member Podcast Patron Benefactor

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      Dr. Ross O'Neil said in the podcast that they were about to submit for peer review and the journal they are targeting has a fairly quick turnaround time.
       
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    22. Mathieulh
      No Mood

      Mathieulh Member Benefactor

      Location:
      Paris, France
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      05/24/2019
      Cause of Tinnitus:
      Chronic headphones use and acute noise induced trauma.
      I haven't heard of them before, that said, being in Paris myself, they aren't exactly nearby.
       
    23. threefirefour
      Peeping tom

      threefirefour Member Benefactor Hall of Fame

      Location:
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      Them: Lenire is clearly inaffective if you just ignore the examples of people who had a reduction from it. This is clearly placebo.

      Everyone else: you’re being irrational.

      Them: You’re irrational!

      It’s fine to have your opinions and I’m glad Neuromod isn’t above criticism. But trutheriem is trutherism.
       
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    24. GlennS

      GlennS Member Podcast Patron Hall of Fame

      Tinnitus Since:
      1992
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      Loud music
      I already did. We're permanently stuck in a no-man's land where optimists perceive the user reports as more favorable than skeptics. To me, the data "objectively" looks a lot worse than their internal stats promised. To people like you, it matches or it's catching up. The math really isn't favoring the optimist case, so really the burden of proof ain't on the skeptics.
       
    25. GlennS

      GlennS Member Podcast Patron Hall of Fame

      Tinnitus Since:
      1992
      Cause of Tinnitus:
      Loud music
      How many people were calling into question the wishy-washy testimonial videos many months ago? Now here we are with the same sort of wishy washy testimonials that can barely be qualified as positive movement on people's condition. And the response of optimists is... sarcasm? Mockery? Strawmen? None of this sort of debate is new.

      We all wondered how to quantify "statistically significant" reductions and all we had to go by beyond the video testimonials were people like Clare B who said her tinnitus went away completely.

      So we had every reason to believe a positive result should be more dramatic than what you and other optimists file as a "success" checkbox. But no, some people here are clinging to anything even remotely positive in the hopes of making the math work (which it still doesn't).

      Excuse me for setting the bar higher. Look, you can go into many other threads where people are experimenting with other treatments (like supplements) and get just as many people claiming some marginal improvements. I don't know why in other threads people are rightfully skeptical and here you have some people circling the wagons.
       
    26. threefirefour
      Peeping tom

      threefirefour Member Benefactor Hall of Fame

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      Exhibit A.
       
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    27. JayBowson

      JayBowson Member Podcast Patron Benefactor

      Tinnitus Since:
      2017
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      Idiopathic/Bad shoes?
      You're contradicting yourself Glenn. Every time someone brings up the point that we think the skeptics were expecting miraculous changes in 60-70% of people you accuse people of building strawmen.

      Yet here you are plain as day. Written in ink. Clearly expecting miraculous results from the responders. Hinging your entire expectations off a few outlier stories.

      You can't have your cake and eat it. Either people are building strawmen or the vast majority of responders are going to be moderate improvers. Take your pick.
       
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    28. JayBowson

      JayBowson Member Podcast Patron Benefactor

      Tinnitus Since:
      2017
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      We're perceiving the user reports as the users themselves perceive them. If a user feels like they got some improvement thent that's really all there is to it.
       
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    29. LongWait

      LongWait Member

      Tinnitus Since:
      11/2017
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      Loud Concert
      Provide any evidence it is not placebo please.
       
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    30. Ruse
      No Mood

      Ruse Member Podcast Patron Benefactor

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      Anyone given Neuromod a poke recently regarding appointments? I emailed this morning but waiting on a response.
       
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