The Tinnitus Functional Index

Ear and Hearing, 2011

The purposes of this study were to examine the readability of published patient-related outcome (PRO) questionnaires for persons with swallowing problems, and to compare the readability results to existing data about average reading levels of English-speaking adults living in the United States. A search was conducted to identify published PRO questionnaires related to swallowing problems that traditionally are completed by patients in a self-administered format. Reading grade levels were analyzed separately for four different swallowing-related PRO questionnaires using the Flesch Reading Ease, FOG, and FORCAST formulas as computed by a readability calculations software package. Descriptive statistics were also computed across the questionnaires. The results of this study demonstrate that all four PRO questionnaires exceeded the fifth-to sixth-grade reading levels recommended by health literacy experts regardless of the formula applied. In the demand for standardization of swallowingrelated quality-of-life assessment tools, developers should consider readability as another testable construct, since poor readability may affect validity, reliability, and sensitivity. The swallowing clinician should consider the average reading level needed to understand a particular PRO questionnaire when administering it to a patient or his or her proxy. Developers of PRO questionnaires should consider the reading level of respondents and include information about this when reporting psychometric data.

International Journal of Audiology

Objective Reporting of clinical significance is recommended because findings can be statistically significant without being relevant to patients. For aiding clinical interpretation of the Tinnitus Questionnaire (TQ), many investigators use a 5-point change cut off as a minimal clinically important difference (MCID). But there are shortcomings in how this value was originally determined. Design The MCID was evaluated by analysing retrospective clinical data on the TQ (German-version). Following recommended standards, multiple estimates were computed using anchor-and distribution-based statistical methods. These took into account not only patients' experience of clinical improvement, but also measurement reliability. Study sample Pre-and post-intervention scores were assessed for 202 patients. Results Our six estimates ranged from 5 to 21 points in TQ change score from pre-to postintervention. The 5-point TQ change score was obtained using a method that considered change between groups, and did not account for measurement error or bias. The size of the measurement error was considerable, and this comprises interpretation of individual patient change scores. Conclusions To enhance confidence that a TQ change over time in individual patients is clinically meaningful, we advise at least the median MCID of 12 points.

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.

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....

Ear and Hearing, 2011

Objectives: Expressing the outcomes of treatment in quality-adjusted life years is increasingly important as a tool to aid decision makers concerning the allocation of scarce resources within the health care sector. A quality-adjusted life year is a measure of life expectancy that is weighted by health-related quality of life. These weights are referred to as utility scores and are usually measured by multiattribute utility measures. Several studies found that different utility measures provide different estimates of the same person's level of utility. The aim of this study was to investigate which of two widely used utility measures, the EQ-5D and the HUI mark III, is preferred in a tinnitus population.

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.

The international tinnitus journal, 2012

To determine the validity and reliability of a Filipino translation of the Tinnitus Handicap Inventory (THI), a self-report measure of tinnitus handicap. Psychometric cross-sectional validation Study sample: Seventy-five patients, aged 18-82 with tinnitus recruited consecutively at the Ear Unit of the Philippine General Hospital after receiving assessment at the Ear, Nose, and Throat-Out Patient Department. The THI-PH showed robust internal consistency reliability (Cronbach's alpha = 0.92), only slightly lower than the original version (THI-US Cronbach's alpha = 0.93), and its Danish (Cronbach's alpha = 0.93), Portuguese (Cronbach's alpha = 0.94), and German (Cronbach's alpha = 0.93) translations. Two of the subscales, the Functional and Emotional subscales, also showed good internal consistency reliability (Cronbach's alpha = 0.86 and Cronbach's alpha = 0.82, respectively). The Catastrophic subscale showed poorer internal consistency reliability (Cronbac...

Iranian journal of otorhinolaryngology, 2014

Tinnitus is a common otologic symptom that can seriously affect a patient's quality of life. The purpose of the present study was to translate and validate the Iowa Tinnitus Handicap Questionnaire (THQ) into the Persian language, and to make it applicable as a tool for determining the effects of tinnitus on a patient's life. The main version of the THQ was translated into the Persian language. The agreed Persian version was administered to 150 tinnitus patients. The validity of the Persian THQ was evaluated and internal reliability was confirmed using Cronbach's α-coefficient. Finally, the effect of independent variables such as age, mean patient threshold, gender, and duration of tinnitus were considered in order to determine the psychometric properties of tinnitus. After an exact translation process, the Persian THQ was found to exhibit face validity. In terms of content validity, content validity index in total questionnaire was 0.93. Further, in structural validity m...

Frontiers in Psychology, 2016

Objective: The need for validated measures enabling clinicians to classify tinnitus patients according to the severity of tinnitus and screen the progress of therapies in our country led us to translate into Polish and to validate two tinnitus questionnaires, namely the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). Design: The original English versions of the questionnaires were translated into Polish and translated back to English by three independent translators. These versions were then finalized by the authors into a Polish THI (THI-Pl) and a Polish TFI (TFI-Pl). Participants from three laryngological centers in Poland anonymously answered the THI-Pl (N = 98) and the TFI-Pl (N = 108) in addition to the Polish versions of the Center for Epidemiologic Studies Depression Scale as a measure of self-perceived level of depression, and the Satisfaction With Life Scale to assess self-perceived quality of life. Both were used to determine discriminant validity. Two Visual Analog Scales were used to measure tinnitus annoyance and tinnitus loudness in order to determine convergent validity. Results: Similar to the original version of the THI, the THI-Pl showed a high internal consistency (Cronbach's α = 0.93). The exploratory factor analysis revealed that the questionnaire has a three-factorial structure that does not correspond to the original division for functional, catastrophic, and emotional subscales. Convergent and discriminant validities were confirmed. The TFI-Pl showed high internal consistency (Cronbach's α = 0.96) with the reliability ranging from 0.82 to 0.95 for its different subscales. Factor analysis confirmed an eight-factorial structure with factors assigning all items to appropriate subscales reported in the original version of the questionnaire. Discriminant and convergent validities were also confirmed for the TFI-Pl. Conclusion: We translated and validated the Polish versions of the THI and the TFI to make them suitable for clinical use in Poland.

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