The Tinnitus Functional Index

Journal of the American Academy of Audiology, 1998

This study assessed the test-retest reliability/repeatability and 95 percent confidence intervals (CIs) of the Tinnitus Handicap Inventory (THI) and developed categories for classifying self-perceived tinnitus handicap severity. Twenty-nine adults with tinnitus as their primary auditory complaint served as subjects. The THI was administered on two occasions (mean interval 20 days) using a paper-pencil format. Results support the contention that the THI is psychometrically robust. Specifically, the test-retest reliability/repeatability was high. Additionally, the 95 percent CI for the THI was 20-points, indicating that a 20-point or greater change had to occur from test to retest for a change to be considered statistically significant at the 5 percent confidence level. Quartiles calculated from raw scores were used to create a matrix of values representing tinnitus severity. We conclude that the THI is a brief, easily administered, and psychometrically robust measure that evaluates t...

Otology & Neurotology, 2008

To develop a screening version of the Tinnitus Handicap Inventory (THI-S) and establish its psychometric characteristics. Design: Prospective clinical study to analyze 1) the level of predictability between THI and THIS ; 2) test-retest reliability of the THIS ; 3) 95% confidence intervals (critical difference scores) for the THIS ; and 4) a THIS cutoff score used for referral purposes. Setting: Head and Neck Institute at the Cleveland Clinic, a tertiary care medical center. Patients: Thirty-three patients reporting tinnitus as their primary complaint. Interventions: There was, on average, a 16-day interval between test-retest administrations of the THIS. Main Outcome Measure: Comparability of scores between the THI and the THIS and test-retest reliability of the THIS was assessed using Pearson product-moment correlations. The level of agreement between the 2 administrations of the THIS was evaluated using Bland-Altman repeatability plots. Results: Comparability between the THI and THIS was high (r = 0.90). Test-retest reliability of the THIS was adequate (r = 0.81), as well as the level of agreement between administrations as demonstrated by the Bland-Altman plot. Based on 95% confidence intervals, pretreatment and posttreatment scores would have to differ by more than 10 points for intervention efforts to be considered significant. A 6-point cutoff score was analyzed as an appropriate fence for referral. Conclusion: The THIS is a psychometrically robust screening measure of activity limitation and participation restriction.

American Journal of Audiology, 2014

Purpose To create a questionnaire focused on the primary activities impaired by tinnitus and therefore more sensitive to treatments. Method Questions were developed on (a) emotions, (b) hearing, (c) sleep, and (d) concentration. A 20-item questionnaire was administered to 158 patients. First, confirmatory factor analysis was used to select 3 questions per domain. Second, factor analysis was used to evaluate the appropriateness of the 12-item questionnaire. Results The analysis indicated that the selected questions successfully represented 4 independent domains. Scores were correlated with the Tinnitus Handicap Questionnaire ( r = .77, p < .01) and loudness ( r = .40, p < .01). The Sleep subscale correlated with the Pittsburgh Sleep Index ( r = .68, p < .01); the Emotion subscale correlated with the Beck Inventory ( r = .66, p < .01) and the Trait Anxiety questionnaire ( r = .67, p < .01). The average scores went from 51% to 38% following treatment. Conclusion The Tinn...

2017

Background and Aim : Self-administered questionnaires are clinically important to document how tinnitus affects the daily life of patients. In this regard, there is a need to have an alternative questionnaire that covers relevant aspects of tinnitus and related symptoms. The present study aimed to develop and validate a new tinnitus questionnaire known as Tinnitus Handicap Que­stionnaire or Borang Evaluasi Soal selidik Tinitus (BEST) in Malay version. Methods : The present study had two consecutive phases. In phase 1 of study, BEST que­stionnaire was initially developed in English and underwent forward and backward transla­tion processes. Following relevant amendments, the final version of BEST (Malay version) was ready for subsequent tasks. It consists of 25 items categorized under 3M domain (mind, main and mental). In phase 2, 65 patients with tinnitus were recruited for determining the validity and reliability of BEST. Results : Content validity index (CVI) of BEST ranged from 0....

Heliyon, 2021

Introduction: Tinnitus is a condition with a subjective nature that requires self-report questionnaires for its assessment. Aspects such as quality of life, sleep or intrusiveness have been addressed by multiple tinnitus questionnaires, but the high responsiveness to treatment effects of the Tinnitus Functional Index (TFI) makes this questionnaire part of the standard practice in tinnitus screening. To date, the TFI has been translated to more than 20 languages and used in more than 22 countries. In this study, the TFI was translated to Dutch and validated through a clinical population in the Netherlands. Methods: After a back-translation procedure, the Dutch TFI was filled-out by 377 patients in the tinnitus outpatient clinic at the Ear, Nose and Throat (ENT) department of the University Medical Center Groningen, in the Netherlands. Reliability and construct validity of the questionnaire were assessed by correlations with one other tinnitus questionnaire (Tinnitus Handicap Inventory, THI) and with three psychological functioning questionnaires (Rand-36, Cantril's ladder and the Hospital Anxiety and Depression Scale (HADS)). The eight-factor structure of the Dutch TFI was tested by means of exploratory factor analysis using three different models (ICM-CFA, ESEM and ESEM-CFA). Results: The Dutch TFI showed a high internal consistency (α ¼ 0.95), and construct validity was proven by moderate-to high-convergent correlations with the THI (r ¼ 0.47-0.79) and by moderate convergent (r ¼ 0.55-0.67) and good-to moderate-divergent (r ¼ 0.12-0.47) correlations with the psychological functioning questionnaires. The eight-factor structure of the TFI was confirmed for the Dutch version by the three models. Conclusion: The Dutch version of the TFI is a reliable instrument for screening tinnitus impact in a clinical population, and its psychometric properties are comparable to the original TFI and other validated tinnitus questionnaires.

Otolaryngology–Head and Neck Surgery, 2011

Objective. To determine the minimum change of the Tinnitus Handicap Inventory (THI) score that could be considered clinically relevant, the authors compared the absolute change of the THI with the Clinical Global Impression–Improvement (CGI-I) score. Study Design. International studies register with standardized data collection. Setting. Tinnitus Research Initiative (TRI). Subjects and Methods. Two hundred ten patients of the TRI database were eligible for this study. In the first analysis, the THI score change and CGI-I ratings were compared with equipercentile linking. In a second analysis, the authors categorized the CGI-I into the 4 groups much better or better, minimally better, no change, and worse and calculated the corresponding differences of the THI score and the effect sizes. An effect size separating the minimally better and the no-change groups was chosen, and the referring THI mean score difference was calculated. Results. According to the linking method, a CGI-I value...

Otolaryngology-Head and Neck Surgery, 2010

To identify all disease-specific health-related quality-of-life (HR-QoL) instruments used to assess tinnitus in clinical trials and detail their psychometric properties. DATA SOURCES: A literature search was performed in the bibliographical databases of PubMed and Embase to identify all articles using specific HR-QoL instruments in tinnitus trials. REVIEW METHODS: The HR-QoL instruments used in these articles were investigated in more detail, focusing on characteristics and psychometric values by two independent reviewers. RESULTS: Seventeen studies were identified by the systematic search. The most used HR-QoL questionnaire was the Tinnitus Questionnaire, followed by the Tinnitus Handicap Inventory, the Tinnitus Reaction Questionnaire, and the Tinnitus Handicap Questionnaire. Internal consistency (Cronbach's ␣ Ͼ 0.9) and reproducibility (Ͼ 0.8) were high for all questionnaires, and there was heterogeneity in responses between patients, endorsing the use of these questionnaires for discriminative purposes. However, the responsiveness, i.e., the usefulness of these questionnaires in evaluating treatment effects, is not known yet. CONCLUSION: The HR-QoL instruments used in tinnitus trials appear not to be validated to measure effectiveness of interventions. Using tests or instruments that are valid and reliable is a crucial component of research quality, and both should therefore be studied before final conclusions can be drawn from the questionnaires in upcoming clinical trials.

Health and Quality of Life Outcomes, 2012

Background: Tinnitus research in an international context requires standardized and validated questionnaires in different languages. The aim of the present set of analyses was the reassessment of basic psychometric properties according to classical test theory of self-report instruments that are being used within the multicentre Tinnitus Research Initiative (TRI) database project.

Hearing Research, 2016

Objectives-Questionnaires are essential for measuring tinnitus severity and intervention-related change but there is no standard instrument used routinely in research settings. Most tinnitus questionnaires are optimised for measuring severity but not change. However, the Tinnitus Functional Index (TFI) claims to be optimised for both. It has not however been fully validated for research purposes. Here we evaluate the relevant psychometric properties of the TFI, specifically the questionnaire factor structure, reproducibility, validity and responsiveness guided by quality criteria for the measurement properties of health-related questionnaires. Methods-The study involved a retrospective analysis of data collected for 294 members of the general public who participated in a randomised controlled trial of a novel tinnitus device (ClinicalTrials.gov Identifier: NCT01541969). Participants completed up to eight commonly used assessment questionnaires including the TFI, Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), a Visual Analogue Scale of loudness (VAS-Loudness), Percentage Annoyance question, the Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), and the World Health Organisation Quality of Life-Bref (WHOQOL-BREF). A series of analyses assessed the study objectives. Forty four participants completed the TFI at a second visit (within 7-21 days and before receiving any intervention) providing data for reproducibility assessments. Results-The 8-factor structure was not fully confirmed for this general (non-clinical) population. Whilst it was acceptable standalone subscale, the 'auditory' factor showed poor loading with the higher order factor 'functional impact of tinnitus'. Reproducibility assessments for the overall TFI indicate high internal consistency (α = 0.80) and extremely high reliability (ICC: 0.91), whilst agreement was borderline acceptable (93%). Construct validity was demonstrated by high correlations between scores on the TFI and THI (r = 0.82

Journal of Psychosomatic Research, 2020

The original 52-item version of the Tinnitus Questionnaire (TQ) is a widely applied self-report instrument to measure tinnitus-related distress. One objective of the current study was the validation of the reported five-factor structure of the German TQ in a new, large sample of patients with chronic tinnitus. Since former studies have yielded conflicting results for the factor structure of the 12-item short version (Mini-TQ), analysis of its factor structure and the generation of a new short version were further study aims. Methods: Data of 7112 subsequent patients with chronic tinnitus that filled out the German 52-item version of the TQ at the Tinnitus Center at Charité University Hospital Berlin, Germany, were included in the study. Statistical analyses included exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results: CFA showed reasonably acceptable fit indices for a five-factor model for the 52-item version of the TQ, at least for RMSEA, one of the three fit indices (RMSEA = 0.059; CFI = 0.871; TLI = 0.861). Factors were called emotional distress, auditory perceptual difficulties, intrusiveness, sleep disturbances, and coping. Another CFA supports a three-factor model of the newly generated 15-item short version (RMSEA = 0.060; CFI = 0.942; TLI = 0.931) with the factors emotional distress, auditory perceptual difficulties, and intrusiveness. Conclusion: Validation of the German 52-item version of the TQ in a large, new sample of patients with chronic tinnitus supports the previously reported five-factor structure with slight differences concerning the identified factors. The new three-factorial 15-item short version allows a more rapid and economical assessment of tinnitus-related distress.