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)

Overview

Journal Front Psychol

Date 2021 Mar 29

PMID 33776834

Citations 14

Authors

Benjamin Boecking

Petra Brueggemann

Tobias Kleinjung

Birgit Mazurek

Affiliations

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Abstract

Background: Measurement 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.

Objective: To 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.

Methods: Two-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.

Results: The 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.

Conclusion: The 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.

Citing Articles

Artificial intelligence approaches for tinnitus diagnosis: leveraging high-frequency audiometry data for enhanced clinical predictions.

Sadegh-Zadeh S, Mamalo A, Kavianpour K, Atashbar H, Heidari E, Hajizadeh R Front Artif Intell. 2024; 7:1381455.

PMID: 38774833 PMC: 11106786. DOI: 10.3389/frai.2024.1381455.

[Rational timepoint of medical rehabilitation in chronic tinnitus : Applying for rehabilitation options for a chronic course].

Brueggemann P, Kastellis G, Hesse G, Mazurek B HNO. 2024; 72(7):526-535.

PMID: 38683408 DOI: 10.1007/s00106-024-01473-4.

Minimal Clinically Important Difference of Tinnitus Outcome Measurement Instruments-A Scoping Review.

Langguth B, Ridder D J Clin Med. 2023; 12(22).

PMID: 38002730 PMC: 10671865. DOI: 10.3390/jcm12227117.

[Analysis of items on the short forms of the tinnitus questionnaire: Mini-TQ-12 and Mini-TQ-15].

Brueggemann P, Goebel G, Boecking B, Hofrichter N, Rose M, Mazurek B HNO. 2023; 71(11):708-718.

PMID: 37702795 PMC: 10589196. DOI: 10.1007/s00106-023-01365-z.

Cognitive Behavioral Group Therapy for Chronic Tinnitus in a German Tertiary Clinical Real-World Setting.

Schecklmann M, Weber F, Lehner A, Langguth B, Schoisswohl S Int J Environ Res Public Health. 2023; 20(6).

PMID: 36981891 PMC: 10048916. DOI: 10.3390/ijerph20064982.

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