Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


Objective: The objective of this selective EBM review is to determine whether or not binaural beats are effective at reducing anxiety in patients undergoing medical intervention.

Study Design: Literature review of three English peer-reviewed studies, published on or after January 1, 2008.

Data Sources: Three randomized controlled trials (RCTs) were found using a search via the Cochrane Collaboration. These studies were selected based on relevance to binaural audio being used for reduction of anxiety and that the outcomes mattered to patients.

Outcomes Measured: The outcomes addressed in this study include patient anxiety levels preand post-operatively. Outcomes were measured using the Spielberger State-Trait Anxiety Inventory (STAI) and the Visual Analogue Scale (VAS).

Results: Isik et al found that at the pretest measurement of patients about to undergo dental surgery there was no significant difference (p=0.402) in anxiety felt in the experimental and control groups (t= -0,250, df 58, 95% CI of difference between means -1.323 to 1.030; difference= -0.147), however the second measurement performed after application of binaural audio to the experimental group demonstrated a significant difference (p= 0.006) in which the experimental group felt less anxiety (t= -2.843, df 58; 95% CI -3.061 to -0.532; difference = - 1.797) (British journal of oral & maxillofacial surgery. 2017;55(6):571‐574). Weiland et al found that out of the 169 patients undergoing emergency room procedures who completed the pre and post intervention anxiety self-assessments, there was a significant decrease (all P<0.001) in anxiety levels among patients exposed to binaural audio composition with state anxiety reduced 10-15% in moderately anxious emergency department patients (Medical journal of Australia. 2011;195(11):694‐698). Wiwatwongwana et al found that patients in the binaural beats (BB) and musical intervention (MI) group showed a significant reduction of STAI state scores after music intervention compared with the control group (P<0.001); additionally, the difference between the BB and MI groups was not found to be significant (STAI-S score MI group -7.0, BB group -9.0, P = 0.085) (Eye [london, England]. 2016;30(11):1407‐1414).

Conclusions: All three studies demonstrated that binaural beats are a beneficial and effective treatment to reduce preoperative anxiety. Implementing binaural beats may be a valuable nonpharmacologic treatment option for anxious preoperative patients when compared to toxic and addictive anxiolytics such as benzodiazepines.