Tinnitus Functional Index Research Articles

A Study to Grade the Severity of Tinnitus and its Psychological Impact Using Tinnitus Functional Index (tfi).

Chronic tinnitus has a lot impact on the quality of life of person by affecting his/ her physical health, occupational health and social relations. It can lead to sleep interference, cognitive difficulties, lack of concentration, anxiety, frustration, anger and depression. The present study showed the severity and impact of tinnitus on quality of life of subjects with or without hearing loss using tinnitus functional index (TFI). Subjects with history of tinnitus with or without hearing loss including informed consent, otoscopy, pure tone audiometry (PTA) were done. Grading of tinnitus was done by using tinnitus functional index score. The mean age of participants were 50.20 ± 4.2years and male to female ratio were found to be 1.05:1. On PTA, 122 participants had hearing loss and 28 had no hearing loss. 49 patients had mild TFI score, 85 had moderate TFI score and 16 had severe hearing loss. The difference in the severity of tinnitus using TFI between normal hearing and sensorineural hearing loss individual was statistically significant. On the other hand, the severity of tinnitus and degree of hearing loss were also found to be statistically significant with p value < 0.0001 chi. Sq = 77.39. This shows that with increase in increase in hearing loss there is increase in TFI sore. Tinnitus has a negative impact on the quality of life like pshycological, emotional and physical effects. The effects of tinnitus is more in those with co-existing hearing loss.

Long-term effects of a single psycho-educational session in chronic tinnitus patients

To evaluate the effects of a single psycho-educational session on tinnitus burden in chronic tinnitus patients. The session is organized at a tertiary referral center for otologic disorders at the University Hospital Antwerp as a group session (maximum of 10-15 patients a time) lasting for approximately 3-4h. The session focusses on different aspects of tinnitus. The current manuscript reports on 96 patients who completed the Tinnitus Functional Index (TFI), Visual Analogue Scale for mean loudness (VAS), Hyperacusis Questionnaire (HQ), and the Hospital Anxiety and Depression Scale (HADS) prior to treatment and at 6-month follow-up. The TFI was chosen as the primary outcome. Paired-samples T tests were performed to evaluate therapy effect at 6-month follow-up. In addition, a logistic regression model revealed baseline TFI/VAS scores and duration of tinnitus as contributing factors to a significant decrease of the TFI. The TFI total score showed a significant decrease (p < 0.001) at the 6-month follow-up time point. At follow-up, 75% of patients reported their tinnitus to be under control not requiring any additional treatment. The logistic regression model showed that patients with higher baseline TFI scores, lower baseline mean VAS loudness ratings, and shorter tinnitus duration were more likely to show clinically significant improvement on the TFI scale. Tinnitus Retraining Therapy or Cognitive Behavioural Therapy are effective, though very time-consuming and expensive treatments. A single psycho-educational group session was shown to be highly effective in decreasing the tinnitus burden, which increases feasibility and cost-effectiveness. Not applicable as this is a retrospective reporting of tinnitus outcome in the daily clinical practice, not a clinical trial.

Virtual reality for tinnitus management: a randomized controlled trial

Objective Sound therapy (ST) and stress reduction regimens have been successfully used to manage tinnitus. Virtual reality (VR) has been used to manage chronic conditions like intractable pain. The aim of the present study was to investigate whether the use of VR in conjunction with ST revealed additional improvements in tinnitus attributes as compared to ST alone. Design This study was a randomised controlled trial (RCT) with a cross-over design. All participants received two interventions – ST alone (control) and ST with VR stimuli (experimental). ST consisted of fractal tones while VR stimuli comprised of nature videos presented via VR goggles. A multilevel mixed-effects linear regression model was used to estimate the intervention effect. Study sample Twenty adults with subjective, continuous, chronic tinnitus participated in the study. Results After adjusting for period and baseline tinnitus loudness, significant improvements were observed in tinnitus loudness and Tinnitus Functional Index scores. Although not statistically significant, mean minimum masking levels were lower after the experimental intervention. Conclusions Study participants benefitted from the use of VR in conjunction with ST in a laboratory setting. Additional effectiveness trials and blinded RCTs will be needed before validating the use of VR for tinnitus management in clinical settings.

ICF domains covered by the Tinnitus Questionnaire and Tinnitus Functional Index

Purpose Tinnitus frequently causes disability as it affects daily living, which is objectified using several tinnitus questionnaires. To what extent they cover domains of the International Classification of Functioning, Disability and Health (ICF) is currently unknown. Therefore, this study aims to investigate which ICF domains are measured by two questionnaires and to describe the health status of somatic tinnitus patients in ICF terms. Materials and methods All questions of the Tinnitus Questionnaire (TQ) and Tinnitus Functional Index (TFI) were linked to the ICF using linking rules. A count-based method was used to link all individual answers of 80 tinnitus patients, to the ICF categories. Results Most of the linked questions concerned “body functions”. TFI covered more categories of “activity and participation” than TQ. Patients reported severe impairments in “mental functions”, “sensory functions and pain”, and “sleep functions”. Additionally, severe limitations were scored in “focusing attention”. Conclusions The TFI and TQ measure distinct domains but can be used complementary or solely, depending on the research question. The TFI identifies a broad spectrum of problems, where the TQ focuses on the psychological impact of tinnitus. Somatic patients in our study reported impairments and disabilities in all covered domains, especially in “onset of sleep” and “sound detection”. Implications for Rehabilitation The Tinnitus Functional Index (TFI) and the Tinnitus Questionnaire (TQ) cover different domains of the International Classification of Functioning, Disability and Health. The TFI identifies problems in “body functions” and “activity and participation”. The TQ focuses on the psychological impact of tinnitus.

German-language versions of the Tinnitus Functional Index : Comparison of the two validated German-language versions of the Tinnitus Functional Index for Switzerland and Germany

HintergrundEs existieren zwei deutschsprachige, validierte Versionen des Tinnitus Functional Index (TFI), eine für die Schweiz und eine für Deutschland. Der TFI gilt als möglicher neuer Standard-Fragebogen für die Evaluation eines Tinnitus-Schweregrads und einer Tinnitus-Therapie.Ziel der ArbeitIn Anbetracht der stattfindenden Standardisierung bei der Tinnitus-Evaluation war es unser Ziel, die beiden TFI-Versionen miteinander zu vergleichen und im deutschsprachigem Raum nur eine TFI-Version zu empfehlen.Material und MethodenDie beiden deutschsprachigen TFI-Versionen wurden in einer multizentrischen randomisierten Online-Fragebogenstudie im Cross-over-Design miteinander verglichen.ErgebnisseDie Gesamtscores der beiden TFI-Versionen unterschieden sich in der gesamten Population nicht. Bei weiterer Aufschlüsselung in Bezug auf die Population und Reihenfolge der abgegeben TFI-Versionen zeigten sich allerdings teilweise signifikante Unterschiede mit jedoch nur moderaten Effektstärken. Dies deutet darauf hin, dass sich die beiden Versionen leicht unterscheiden, aber trotzdem miteinander vergleichbar sind. Bei der Faktoranalyse konnten bei der TFI-Version für Deutschland in der gesamten Population wie auch für die schweizerische Population 6 Faktoren extrahiert werden. Hingegen konnten bei der deutschen Population in beiden TFI-Versionen und bei der schweizerischen Population in der schweizerischen TFI-Version nur 5 Faktoren extrahiert werden.SchlussfolgerungDie beiden deutschsprachigen Versionen des TFI sind gut miteinander vergleichbar. Jedoch spricht die Faktoranalyse eher für die Verwendung der TFI-Version für Deutschland im gesamten deutschsprachigen Raum.

Translation, Cultural Adaptation and Validation to Brazilian Portuguese of the Tinnitus Functional Index Questionnaire.

Introduction Tinnitus affects a large portion of the world's population. There are several questionnaires being used for the evaluation of the severity of tinnitus and its impact in quality of life; however, they do not measure treatment-related changes. So, a new self-reported questionnaire was developed, the Tinnitus Functional Index (TFI), which has been translated into several languages. Objective To perform the translation, cultural adaptation and validation of the TFI questionnaire for Brazilian Portuguese. Method This is a multicenter project divided into two stages: translation and cultural adaptation; and validation and reliability. For the validation, the Brazilian Portuguese version of the TFI was correlated with the Tinnitus Handicap Inventory (THI) domains for tinnitus and quality of life and was evaluated by the Spearman ρ test. The reliability and internal consistency were evaluated by the Cronbach α test. Result The Brazilian version of the TFI was obtained through an initial translation process, synthesis of translations, backtranslation and evaluation by a committee of experts. This version was then applied in 88 patients complaining of tinnitus from speech therapy and otorhinolaryngology outpatient clinics of the three school clinics. The Brazilian version presented high reliability, as evidenced by the Cronbach α value (α = 0.870), and strong correlation (rho = 0.760 and p = 0.000). Conclusion The high reliability found in the results demonstrates that the Brazilian Portuguese version of the TFI is a valid and reliable instrument to evaluate the severity and impact of tinnitus on quality of life and changes related to its treatment.

Using Different Cutoffs to Define Tinnitus and Assess Its Prevalence-A Survey in the Dutch General Population.

Introduction: Tinnitus prevalence numbers in the literature range between 5 and 43%, depending on the studied population and definition. It is unclear when tinnitus becomes pathologic.Objectives: To assess the tinnitus prevalence in the Dutch general population with different cutoffs for definition.Methods: In this cross-sectional study, a questionnaire was sent to a sample (n = 2,251) of the Nivel (Netherlands Institute for Health Services Research) Dutch Health Care Consumer Panel. Three questions were asked to assess the presence of tinnitus, duration, and frequency of the complaint. We classified people as having pathologic tinnitus when participants experienced it for 5–60 min (daily or almost daily or weekly), or tinnitus for >60 min or continuously (daily or almost daily or weekly or monthly), so tinnitus impact on daily life was measured with the Tinnitus Functional Index (TFI) and a single-item question. Answers were stratified to mid-decade years of age. Prevalence numbers were weighted by gender and age to match the Dutch population.Results: Nine hundred thirty-two of 2,251 participants (41%) filled out the questionnaire. The median age was 67.0 (IQR 17) years. Three hundred thirty-eight of 932 (36%) experienced tinnitus for an undefined amount of time during the last year. Two hundred sixteen of 932 (23%) met our definition of having pathologic tinnitus (21% when weighted for age and gender). The median TFI score for all pathologic tinnitus participants was 16.6 (IQR 21.8). A percentage of 50.4% of the pathologic tinnitus participants had a TFI in the range 0–17, which can be interpreted as not a problem.Conclusion: Twenty-three percent (unweighted) or 21% (weighted) of our sample met our definition of pathologic tinnitus, which was based on a combination of duration and frequency over the last year. The TFI score of 47.7% of the pathologic tinnitus participants is ≥18. This indicates that they consider the tinnitus to be at least “a small problem” [11.1% (unweighted) or 8.9% (weighted) of the total study group]. This study illustrates the difficulties with defining pathologic tinnitus. In addition, it demonstrates that tinnitus prevalence numbers vary with different definitions and, consequently, stresses the importance of using a uniform definition of tinnitus.

Validation of a Dutch version of the Tinnitus Functional Index in a tertiary referral tinnitus clinic

IntroductionTinnitus 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. MethodsAfter 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). ResultsThe Dutch TFI showed a high internal consistency (α = 0.95), and construct validity was proven by moderate-to high-convergent correlations with the THI (r = 0.47–0.79) and by moderate convergent (r = 0.55–0.67) and good-to moderate-divergent (r = 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. ConclusionThe 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.

Internet-based cognitive–behavioural therapy for tinnitus: secondary analysis to examine predictors of outcomes

ObjectivesThe current study examined predictors of outcomes of internet-based cognitive–behavioural therapy (ICBT) for individuals with tinnitus.DesignSecondary analysis of intervention studies.SettingInternet-based guided tinnitus intervention provided in the UK.Participants228 individuals who underwent...

Survey of tinnitus patients’ acceptance of high-definition transcranial direct current stimulation as a management option

Objectives To investigate acceptance of high-definition transcranial direct current stimulation (HD-tDCS) as a management option for tinnitus. Design Participants completed an online version of the Tinnitus Functional Index (TFI), after which they recorded their satisfaction ratings with different hypothetical intervention outcomes on a 10-point rating scale using Opinio survey software. Study sample Data from 272 tinnitus sufferers from English-speaking regions worldwide were collected, of which the majority had moderate to severe tinnitus as per TFI. Results The survey showed that HD-tDCS was considered an acceptable form of tinnitus management, and that the satisfaction rating depended significantly on a number of factors: (1) the strength of the tinnitus reduction following the intervention (p < 0.001); 2) the duration of the intervention (p < 0.001); and (3) the effects of the intervention on either tinnitus loudness or tinnitus-related distress (p < 0.001). Respondents rated their satisfaction with the intervention 10/10 only if it completely eliminated tinnitus loudness, although reductions of 50–80% were also rated highly acceptable. No association was found between tinnitus severity and acceptability ratings. Conclusions These findings are important for future HD-tDCS trials for tinnitus, as they demonstrate the need to optimise stimulation protocols to increase effect sizes and decrease time spent on the treatment.

Development and Preliminary Evaluation of the Tinnitus Severity Short Form.

Purpose Tinnitus, or the perception of sounds that occur without an external sound source, is a prevalent condition worldwide. For a subset of adults, tinnitus causes significant distress and impairment. Several patient-reported outcome measures have been developed to assess severity of tinnitus distress. However, at present, the field lacks a brief measure that is sensitive to treatment change. The purpose of the current study was to develop and preliminarily validate a brief questionnaire for tinnitus severity from two existing measures of tinnitus-related distress, the Tinnitus Handicap Inventory (THI) and Tinnitus Functional Index (TFI). Method Using data from nine study samples in the United States and United Kingdom, we conducted exploratory and confirmatory factor analyses to identify a short measure with good psychometric properties. We also assessed sensitivity to treatment-related change by examining associations with change in the TFI and THI. Finally, we conducted a confirmatory factor analysis of the final short questionnaire in a new sample of adults seeking treatment for tinnitus-related distress. Results We identified 10 items from the THI and TFI that exhibited limited loadings on secondary factors. The resulting Tinnitus Severity Short Form achieved good to excellent fit, including in a unique sample of individuals seeking online treatment for tinnitus, and appeared sensitive to treatment-related change. Conclusions The Tinnitus Severity Short Form developed in the current study may be a useful tool for the assessment of subjective severity and distress associated with tinnitus, especially when patient burden is a concern. Further research is necessary to fully validate the questionnaire for the assessment of treatment-related change.

Improving the assessment of functional impairment in tinnitus sufferers: validation of the German version of the Tinnitus Functional Index using a confirmatory factor analysis

Objectives Chronic tinnitus negatively impacts daily functioning. To specifically assess this impairment, the Tinnitus Functional Index (TFI) was developed. The current study investigated the hierarchical, eight-factorial structure for the German TFI and examined its psychometric properties. Design In an online assessment, the TFI and other validated health-related measurements were completed. Confirmatory factor analysis (CFA) was conducted to investigate the factorial structure by testing two competing models: (1) a general factor model, and (2) a hierarchical second-order factor model. Study sample 316 research volunteers (59.8% female) with low to moderate tinnitus distress were included. Results CFA revealed an insufficient fit of the data to the general factor model. For the hierarchical second-order factor model, an acceptable model fit was shown (χ2/df ratio = 2.74, RMSEA = 0.07, SRMR = 0.05, CFI = 0.95, TLI = 0.95). Correlational analyses between the TFI and measures assessing tinnitus distress, depression, sleeping difficulties, subjective well-being, and personality dimensions indicated high convergent and moderate discriminant validity. Internal consistency reliability was excellent. Conclusions The results confirm the hierarchical, eight-factorial structure of the German TFI. The TFI is a promising inventory that should be used on a regular basis. Highlights The results of our study confirm the hierarchical eight-factorial structure of the German TFI. Confirmatory factor analysis revealed an acceptable model fit of the data. Convergent validity of the German TFI was high. Discriminant validity of the German TFI was moderate. The German TFI is a reliable questionnaire to assess tinnitus functional impairment.

Dismantling internet-based cognitive behavioral therapy for tinnitus. The contribution of applied relaxation: A randomized controlled trial

BackgroundInternet-based cognitive behavioral therapy (ICBT) for tinnitus is an evidence-based intervention. The components of ICBT for tinnitus have, however, not been dismantled and thus the effectiveness of the different therapeutic components is unknown. It is, furthermore, not known if heterogeneous tinnitus subgroups respond differently to ICBT. AimsThis dismantling study aimed to explore the contribution of applied relaxation within ICBT for reducing tinnitus distress and comorbidities associated with tinnitus. A secondary aim was to assess whether outcomes varied for three tinnitus subgroups, namely those with significant tinnitus severity, those with low tinnitus severity, and those with significant depression. MethodsA parallel randomized controlled trial design (n = 126) was used to compare audiologist-guided applied relaxation with the full ICBT intervention. Recruitment was online and via the intervention platform. Assessments were completed at four-time points including a 2-month follow-up period. The primary outcome was tinnitus severity as measured by the Tinnitus Functional Index. Secondary outcomes were included for anxiety, depression, insomnia, negative tinnitus cognitions, health-related quality of life, hearing disability, and hyperacusis. Treatment engagement variables including the number of logins, number of modules opened, and the number of messages sent. Both an intention-to-treat analysis and completer's only analysis were undertaken. ResultsEngagement was low which compromised results as the full intervention was undertaken by few participants. Both the ICBT and applied relaxation resulted in large reduction of tinnitus severity (within-group effect sizes d = 0.87 and 0.68, respectively for completers only analysis), which were maintained, or further improved at follow-up. These reductions in tinnitus distress were greater for the ICBT group, with a small effect size differences (between-group d = 0.15 in favor of ICBT for completers only analysis). Tinnitus distress decreased the most at post-intervention for those with significant depression at baseline. Both ICBT and applied relaxation contributed to significant reductions on most secondary outcome measures, with no group differences, except for a greater reduction of hyperacusis in the ICBT group. ConclusionDue to poor compliance partly attributed to the COVID-19 pandemic results were compromised. Further studies employing strategies to improve compliance and engagement are required. The intervention's effectiveness increased with initial level of tinnitus distress; those with the highest scores at intake experienced the most substantial changes on the outcome measures. This may suggest tailoring of interventions according to tinnitus severity. Larger samples are needed to confirm this.

Cochlear implantation for tinnitus in adults with bilateral hearing loss: protocol of a randomised controlled trial

IntroductionTinnitus is the perception of sound without an external stimulus, often experienced as a ringing or buzzing sound. Subjective tinnitus is assumed to origin from changes in neural activity caused...

Behavioral Outcomes and Neural Network Modeling of a Novel, Putative, Recategorization Sound Therapy.

The mechanisms underlying sound’s effect on tinnitus perception are unclear. Tinnitus activity appears to conflict with perceptual expectations of “real” sound, resulting in it being a salient signal. Attention diverted towards tinnitus during the later stages of object processing potentially disrupts high-order auditory streaming, and its uncertain nature results in negative psychological responses. This study investigated the benefits and neurophysiological basis of passive perceptual training and informational counseling to recategorize phantom perception as a more real auditory object. Specifically, it examined underlying psychoacoustic correlates of tinnitus and the neural activities associated with tinnitus auditory streaming and how malleable these are to change with targeted intervention. Eighteen participants (8 females, 10 males, mean age = 61.6 years) completed the study. The study consisted of 2 parts: (1) An acute exposure over 30 min to a sound that matched the person’s tinnitus (Tinnitus Avatar) that was cross-faded to a selected nature sound (Cicadas, Fan, Water Sound/Rain, Birds, Water and Bird). (2) A chronic exposure for 3 months to the same “morphed” sound. A brain-inspired spiking neural network (SNN) architecture was used to model and compare differences between electroencephalography (EEG) patterns recorded prior to morphing sound presentation, during, after (3-month), and post-follow-up. Results showed that the tinnitus avatar generated was a good match to an individual’s tinnitus as rated on likeness scales and was not rated as unpleasant. The five environmental sounds selected for this study were also rated as being appropriate matches to individuals’ tinnitus and largely pleasant to listen to. There was a significant reduction in the Tinnitus Functional Index score and subscales of intrusiveness of the tinnitus signal and ability to concentrate with the tinnitus trial end compared to baseline. There was a significant decrease in how strong the tinnitus signal was rated as well as ratings of how easy it was to ignore the tinnitus signal on severity rating scales. Qualitative analysis found that the environmental sound interacted with the tinnitus in a positive way, but participants did not experience change in severity, however, characteristics of tinnitus, including pitch and uniformity of sound, were reported to change. The results indicate the feasibility of the computational SNN method and preliminary evidence that the sound exposure may change activation of neural tinnitus networks and greater bilateral hemispheric involvement as the sound morphs over time into natural environmental sound; particularly relating to attention and discriminatory judgments (dorsal attention network, precentral gyrus, ventral anterior network). This is the first study that attempts to recategorize tinnitus using passive auditory training to a sound that morphs from resembling the person’s tinnitus to a natural sound. These findings will be used to design future-controlled trials to elucidate whether the approach used differs in effect and mechanism from conventional Broadband Noise (BBN) sound therapy.

Audiometric Thresholds and Tinnitus Functional Index of Adult Patients with Tinnitus

Tinnitus is a common irritating symptom. Tinnitus functional index (TFI) and measurements of tinnitus match are useful tools for evaluating tinnitus impact. This study aimed at comparing the hearing thresholds to the Quality of life (QoL) of tinnitus patients. But the exact etiology of allergic rhinitis remains unclear, many studies have demonstrated that Toll-Like Receptors (TLRs) play an important role in the pathogenesis of allergic rhinitis. TLRs, known as Pattern Recognition Receptors (PRRs), are the crucial components of the innate immune system and express either on the cell membrane or in the endolysosomal compartments.

All for One and One for All? - Examining Convergent Validity and Responsiveness of the German Versions of the Tinnitus Questionnaire (TQ), Tinnitus Handicap Inventory (THI), and Tinnitus Functional Index (TFI).

BackgroundMeasurement of tinnitus-related distress and treatment responsiveness is key in understanding, conceptualizing and addressing this often-disabling symptom. Whilst several self-report measures exist, the heterogeneity of patient populations, available translations, and treatment contexts requires ongoing psychometric replication and validation efforts.ObjectiveTo investigate the convergent validity and responsiveness of the German versions of the Tinnitus Questionnaire [TQ], Tinnitus Handicap Inventory [THI], and Tinnitus Functional Index [TFI] in a large German-speaking sample of patients with chronic tinnitus who completed a psychologically anchored 7-day Intensive Multimodal Treatment Programme.MethodsTwo-hundred-and-ten patients with chronic tinnitus completed all three questionnaires at baseline and post-treatment. Intraclass correlation coefficients determined the convergent validity of each questionnaire’s total and subscale scores. Treatment responsiveness was investigated by [a] comparing treatment-related change in responders vs. non-responders as classified by each questionnaire’s minimal clinically important difference-threshold, and [b] comparing agreement between the questionnaires’ responder classifications.ResultsThe total scores of all three questionnaires showed high agreement before and after therapy (TQ | THI: 0.80 [Pre], 0.83 [Post], TQ | TFI: 0.72 [Pre], 0.78 [Post], THI | TFI: 0.76 [Pre] 0.80 [Post]). All total scores changed significantly with treatment yielding small effect sizes. The TQ and TFI yielded comparable (19.65 and 18.64%) and the THI higher responder rates (38.15%). The TQ | THI and TQ | TFI showed fair, and the THI | TFI moderate agreement of responder classifications. Independent of classification, responders showed significantly higher change rates than non-responders across most scores. Each questionnaire’s total change score distinguished between responders and non-responders as classified by the remaining two questionnaires.ConclusionThe total scores of all three questionnaires show high convergent validity and thus, comparability across clinical and research contexts. By contrast, subscale scores show high inconsistency. Whilst the TFI appears well suited for research purposes, the THI may be better suited to measure psychological aspects of tinnitus-related distress and their changes with accordingly focused treatment approaches.

Effectiveness of Hearing Aid Treatment in Patients with Chronic Tinnitus: Subscale Evaluations Using the Tinnitus Functional Index and Factor Analysis.

The tinnitus functional index (TFI) is becoming a new international gold standard for tinnitus assessment. This study aimed to evaluate the efficacy of hearing aids for chronic tinnitus, using the Japanese version of the TFI, while focusing on its subscales. This is a retrospective study. A total of 21 patients with chronic tinnitus were included. All participants were treated with hearing aids for at least 12 months. They answered the TFI and tinnitus handicap inventory (THI) at the first visit and 12 months later. We analyzed each TFI subscale score and the overall scores of TFI and THI. The overall TFI score decreased significantly after treatment (p=0.005) with moderate effect size (d=0.70). The scores of the intrusive, sense of control, sleep, and emotional subscales decreased significantly after the treatment. Large effect sizes were found in the intrusive and sense of control subscales (d=1.33 and d=1.25, respectively). Hearing aids are highly effective for improving the intrusive and sense of control subscales in patients with tinnitus. Identifying better treatments for the small effect size subscales and combining these with the use of hearing aids could achieve a higher therapeutic effect with better outcomes.

Mental Health Symptoms Among Veteran VA Users by Tinnitus Severity:A Population-based Survey.

Tinnitus is prevalent among Service members and Veterans and is often comorbid with mental health disorders. Associations between the severity of individuals' tinnitus and mental health symptoms are not well described. We conducted a population-based survey of a stratified random sample of 1,800 Veterans diagnosed with tinnitus. We used the Tinnitus Functional Index to measure tinnitus severity and the Primary Care-Posttraumatic Stress Disorder (PTSD) screen and the Hospital Anxiety and Depression Scale to assess PTSD, depression, and anxiety. Descriptive statistics and bivariable and multivariable regression models were used to estimate associations between Veterans' tinnitus severity and mental health symptoms. Inverse probability weights were used to account for sample stratification and survey non-response. Multivariable odds ratios (ORs) and 95% confidence intervals (CIs) controlled for Veterans' demographics, military history, and health diagnoses. A total of 891 Veterans completed surveys (adjusted response rate = 53%). Large proportions rated their tinnitus as severe (29.4%; 95% CI: 27.2-31.6) or very severe (18.7%; 95% CI: 16.8-20.5). In multivariable regression models, and compared with Veterans with none/mild tinnitus, the likelihood of screening positive for PTSD was increased for those who reported moderate (OR = 4.0; 95% CI: 1.6-10.3), severe (OR = 7.5; 95% CI: 3.1-18.5), or very severe (OR = 17.5; 95% CI: 4.4-70.0) tinnitus. Similarly, Veterans' likelihood of positive depression screens were elevated for those with moderate (OR = 2.6; 95% CI: 1.1-5.9), severe (OR = 3.0; 95% CI: 1.4-6.5), or very severe (OR = 15.5; 95% CI: 4.3-55.5) tinnitus, as was the likelihood of positive anxiety screens for those with severe (OR = 2.6; 95% CI: 1.1-6.3) or very severe (OR = 13.4; 95% CI: 4.0-44.3) tinnitus. Mental health symptoms are strongly associated with Veterans' tinnitus severity. A better understanding of the interplay between these conditions may help improve the provision of interdisciplinary (Audiology and Mental Health) care for Service members and Veterans.

Evaluation of tinnitus severity in military personnel after exposure to high intensity noise

Aim to evaluate the severity of tinnitus before and after medical treatment in military personnel exposed to high-intensity noise.&#x0D; Material and methods. The study involved 14 soldiers with complaints of tinnitus who suffered hearing damage caused by gunshot noise (AK74 gun) during military training without hearing protectors. The tinnitus severity and its dynamics during the treatment by glucocorticosteroids was assessed using the Tinnitus Functional Index (TFI). The Tinnitus Handicap Inventory (THI) was used before the treatment, on the 3rd and 7th days after the treatment.&#x0D; Results. It was found that the greatest discomfort was caused by the intrusiveness of noise and inability to control it during the day, and the least discomfort was associated with sleep. The changes in the severity of noise on the THI and TFI scales on the third and seventh days after treatment were significantly different, if compared with the pre-treatment results, and had a positive trend. The therapy provided the significant decrease of noise intrusiveness and established the sense of noise control during the day, as well as minimized its effect on relaxation, hearing and quality of life, if compared to the data before treatment.&#x0D; Conclusion. The TFI and THI scales are recommended for assessing the severity of tinnitus and monitoring the treatment of patients exposed to high-intensity noise. Particular attention should be paid to the use of personal hearing protection equipment when working in conditions of increased level of noise.