Abstract
BackgroundDifferent standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult. These questionnaires are also used to measure treatment-related changes in tinnitus although they were not designed for this purpose. To solve these problems, a new questionnaire - the Tinnitus Functional Index (TFI) - has been established. The TFI is highly responsive to treatment-related change and promises to be the new gold standard in tinnitus evaluation. The aim of the current study was to validate a German version of the TFI for a German-speaking population in Switzerland.MethodsAt the ENT department of the University Hospital Zurich, 264 subjects completed an online survey including the German version for Switzerland of TFI, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and sociodemographic variables. Internal consistency of the TFI was calculated with Cronbach’s alpha coefficient. Pearson correlation coefficients were used for the test-retest reliability of the TFI and to investigate convergent and discriminant validity between the THI and the BDI and BAI, respectively. Factor analysis was assessed using a principal component analysis with oblique rotation. The different factors extracted were then compared with the original questionnaire.ResultsThe German version of the TFI for Switzerland showed an excellent internal consistency (Cronbach’s alpha of 0.97) and an excellent test-retest reliability of 0.91. The convergent validity with THI was high (r = 0.86). The discriminant validity with BAI and BDI showed moderate results (BAI: r = 0.60 and BDI: r = 0.65). In the factor analysis only five factors with one main factor could be extracted instead of eight factors as described in the original version. Nevertheless, relations to the original eight subscales could be demonstrated.ConclusionThe German version of the TFI for Switzerland is a suitable instrument for measuring the impact of tinnitus. The reliability and validity of this version are comparable with the original version of the TFI. Although this study showed only five factors in the factor analysis, relations to the original eight subscales were identified. Therefore, the German version of the TFI for Switzerland can deliver relevant information regarding the different tinnitus domains.Trial registrationClinical trial registration number on clinicaltrial.gov: NCT01837368.
Highlights
Different standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult
Most people with tinnitus either cope with or habituate to the acoustic stimulus and report it having no impact on their quality of life, some people suffer from more severe tinnitus and view it as a debilitating condition that affects their quality of life and causes them to seek medical evaluation [2, 3]
The convergent validity of Tinnitus Functional Index (TFI) compared with Tinnitus Handicap Inventory (THI) total score showed a high correlation of 0.86 (p < 0.001) and the discriminant validity of TFI when compared with Beck Anxiety Inventory (BAI) was 0.60, and 0.65 with Beck Depression Inventory (BDI)
Summary
Different standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult. The lack of objective means for measuring tinnitus necessitates the use of self-report questionnaires for its evaluation [4] To this end, several psychometric questionnaires have been developed to assess the different aspects of daily life that are affected by tinnitus, such as such as concentration, sleep, emotional distress, tinnitus annoyance, and the quality of life in general. A problem, is that these questionnaires use different scaling, wording of items, and formatting, and have not been prospectively evaluated for assessing responsiveness, which makes it difficult to compare the outcomes of different trials and to determine the effectiveness of the investigated interventions [6] To overcome these shortcomings, the Tinnitus Research Consortium (TRC) supported the development and evaluation of a new outcome measure for tinnitus [7], with the aim of improving tinnitus research [7]. Meikle et al (2012) developed and validated the new Tinnitus Functional Index (TFI) at Oregon Health and Science University (OHSU) [7, 8]
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