The Tinnitus Handicap Inventory (THI; Newman et al., 1996) is a 25-item self-report measure to determine perceived tinnitus handicap severity. The THI is a useful measure for determining the efficacy of psychological treatment for tinnitus (Zeman et al., 2011).
The THI comprises 25 items grouped into three subscales:
Studies concerning psychometric properties of THI report Cronbach’s alpha for the total score as very high, mostly above 0.90 (Gos et al., 2020). Alpha for the Functional and Emotional subscales ranged from 0.8 to 0.9, while for the Catastrophic subscale it was lower, about 0.6–0.7 (Gos et al., 2020). Although all three subscale scores are frequently used and reported, emphasis should be placed upon the total score (Gos et al., 2020).
In a validation study by Got et al. (2020), 1115 adult patients presenting at a tinnitus clinic (49.8% females, age range = 19 – 84; period of suffering tinnitus = 1 month – 50 years) were assessed using the THI and means (and standard deviations) were obtained:
These means and standard deviations are used to calculate percentiles for the THI total score and subscale scores.
The THI total score ranges from 0 to 100 where a higher score indicates more tinnitus handicap severity. In addition, a percentile is presented that shows the respondents scores in comparison to tinnitus patients. A percentile rank of 50 indicates that the individual has an average severity of tinnitus compared to other people suffering tinnitus.
Three three subscales are calculated:
A grading system, as determined by the British Association of Otolaryngologists, Head and Neck Surgeons, is also used for the THI total score (McCombe et al., 2001):
A change score of at least seven points has been considered to denote reliable clinically significant improvement on the THI (Zeman et al., 2011).
Newman, C. W., Jacobson, G. P., & Spitzer, J. B. (1996). Development of the Tinnitus Handicap Inventory. Archives of Otolaryngology–Head & Neck Surgery, 122(2), 143–148. https://doi.org/10.1001/archotol.1996.01890140029007
McCombe, A., Baguley, D., Coles, R., McKenna, L., McKinney, C., Windle-Taylor, P., & British Association of Otolaryngologists, Head and Neck Surgeons. (2001). Guidelines for the grading of tinnitus severity: the results of a working group commissioned by the British Association of Otolaryngologists, Head and Neck Surgeons, 1999. Clinical Otolaryngology and Allied Sciences, 26(5), 388–393. https://doi.org/10.1046/j.1365-2273.2001.00490.x
Gos, E., Sagan, A., Skarzynski, P. H., & Skarzynski, H. (2020). Improved measurement of tinnitus severity: Study of the dimensionality and reliability of the Tinnitus Handicap Inventory. PloS One, 15(8), e0237778. https://doi.org/10.1371/journal.pone.0237778
Zeman, F., Koller, M., Figueiredo, R., Aazevedo, A., Rates, M., Coelho, C., Kleinjung, T., de Ridder, D., Langguth, B., & Landgrebe, M. (2011). Tinnitus handicap inventory for evaluating treatment effects: which changes are clinically relevant? Otolaryngology–Head and Neck Surgery, 145(2), 282–287. https://doi.org/10.1177/0194599811403882