RFAs offer the advantage of focusing research on the most promising topics identified by the field at large. At the same time, Tinnitus Quest celebrates open-mindedness and out of the box thinking. We acknowledge that it is entirely possible that the blockbuster therapy of the future may not fall within any of these categories. For that reason, we will always have a fourth category of proposals that welcomes applications that don’t fit the mold of the more focused RFAs.

Over the years, most clinical research on tinnitus has prioritized approaches to alleviate tinnitus symptoms via sound therapy, education, and behavioral training. These approaches are low-risk, non-invasive and can be helpful. However, our funding will focus on interventions designed to silence the noise of tinnitus rather than improve one’s compensation to their tinnitus. To this end, we will be funding drug- or device-based therapies that target the biological mechanisms responsible for precipitating or generating the phantom sound of tinnitus rather than therapies based on masking, compensation, or habilitation.

We are emphasizing near-term translation into treatments for patients, so we are especially eager to fund applications using human research participants. But we recognize that promising therapies often lie in novel drugs or devices that must first be evaluated in preclinical models. We will encourage proposals using human research participants where possible but will fund proposals on preclinical models for exciting early-stage ideas, if these concern therapy concepts that can (at a later stage) also be tested directly in human participants.

Rigorous, well-controlled studies will be necessary to establish any therapy that is widely effective beyond the benefits provided by placebo. But it isn’t strictly necessary to invest the time and effort into more complicated experimental designs if there isn’t a large effect – a “signal” – to control for. To move things forward at a faster pace with smaller budgets, the initial funding will support the research necessary to determine whether a given intervention produces a signal that warrants further investigation. If an encouraging signal is found, a second round of funding will provide the means to replicate the treatment effect with pre-registered outcome measures and perform additional controls.

Clinical research typically measures tinnitus burden and loudness through subjective self-report measures (e.g., THI, TFI, loudness matching). These measures are rapid, widely used, and offer excellent face validity. But tinnitus reductions measured through subjective self-report can be inflated by placebo effects. Objective measures offer the advantage of greater placebo resilience but have a less certain relationship to the salience (i.e., loudness) of the tinnitus percept. Tinnitus Quest will encourage clinical research projects to use standard self-report measures for the initial funding milestone but to implement rigorous placebo controls and/or objective secondary outcome measures if they are invited to seek an additional round of funding.

Pre-clinical models offer the advantage of supporting direct measurements of the biological process hypothesized to cause (or mitigate) the phantom sound of tinnitus. On the other hand, pre-clinical research cannot accurately model the spectrum of neuropsychiatric sequelae associated with severe tinnitus in humans, nor the natural time course of tinnitus induction and stabilization. Preclinical proposals would be encouraged to assess treatment efficacy through direct measurement of biological processes related to the generation of the phantom percept, especially those with analogs to non-invasive measures in humans. Operant behavioral approaches can support direct measurement of phantom sound awareness in pre-clinical models though the extended testing required to measure these outcomes is better suited to a second round of funding than the initial milestone. Reflexive behaviors do not measure the tinnitus generator, nor do they model phantom sound awareness and would likely be judged as less appropriate outcomes measures for either stage of funding.

Once the call for proposals is announced, we will gladly accept applications from researchers with primary appointments at non-profit institutions that offer sufficient research infrastructure to complete the work. We expect applications from established tinnitus research labs, but we also encourage proposals from researchers new to tinnitus with proven expertise in related fields. Applications will not be accepted from persons on the Executive, Scientific, or Innovation Boards of Tinnitus Quest, though colleagues at their institution may apply. Awardees would be expected to participate in the annual Tinnitus Quest research meeting (details forthcoming) to present their project, and to engage with the broader tinnitus community around project milestones.

The exact process has not yet been defined, but the overall goal is to lessen the onerous time investment associated with writing grant proposals and to make the evaluation process more interactive and informative for the applicant and the review panel. After completing a brief application form, we expect to evaluate select applications in greater detail through short ‘pitch’ presentations attended by members of the Executive, Innovation, Scientific Advisory, or Patient Advisory Boards.

Our goal is to provide sufficient funds to complete the work in a timely fashion. As described above, we anticipate a two-stage funding model featuring a smaller initial seed investment followed by the possibility of a larger award one the initial milestones have been evaluated. Additional details on award size and number of awards depend on our success during the current fundraising period.

Our Innovation Board is responsible for creating the framework for our grants program – this means determining who and what we fund and how we will successfully put our grants program into action. Our Executive Board – consisting of three tinnitus patients and two tinnitus researchers – makes final decisions on the allocation of research funding, with input from the other boards (Innovation Board, Scientific Advisory Board, and Patient Advisory Board). Thus, patients are uniquely strongly represented in Tinnitus Quest. This sets us apart from all other tinnitus research funders and is meant to ensure that we only fund research with optimal potential benefit for tinnitus sufferers.

We will communicate openly about the research that we fund. Unlike what is typical in academia, where patients often must wait for years to hear about the outcomes, we will ask our research collaborators to update you quarterly along the way, so that you can truly be a part of our research journey. We will be transparent on both our successes and failures, as both can yield important insights that bring us closer to a cure.