Development and Psychometric Adequacy of the Screening Version of the Tinnitus Handicap Inventory

OBJECTIVE: 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 THI-S; 2) test-retest reliability of the THI-S; 3) 95% confidence intervals (critical difference scores) for the THI-S; and 4) a THI-S 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 THI-S. MAIN OUTCOME MEASURE: Comparability of scores between the THI and the THI-S and test-retest reliability of the THI-S was assessed using Pearson product-moment correlations. The level of agreement between the 2 administrations of the THI-S was evaluated using Bland-Altman repeatability plots. RESULTS: Comparability between the THI and THI-S was high (r = 0.90). Test-retest reliability of the THI-S 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 THI-S is a psychometrically robust screening measure of activity limitation and participation restriction.