Tinnitus and Hearing Survey: A Screening Tool to Differentiate Bothersome Tinnitus From Hearing Difficulties
Publication: American Journal of Audiology
Volume 24, Number 1
Pages 66-77
Abstract
Purpose
Individuals complaining of tinnitus often attribute hearing problems to the tinnitus. In such cases some (or all) of their reported “tinnitus distress” may in fact be caused by trouble communicating due to hearing problems. We developed the Tinnitus and Hearing Survey (THS) as a tool to rapidly differentiate hearing problems from tinnitus problems.
Method
For 2 of our research studies, we administered the THS twice (mean of 16.5 days between tests) to 67 participants who did not receive intervention. These data allow for measures of statistical validation of the THS.
Results
Reliability of the THS was good to excellent regarding internal consistency (α = .86–.94), test–retest reliability (r = .76–.83), and convergent validity between the Tinnitus Handicap Inventory (Newman, Jacobson, & Spitzer, 1996; Newman, Sandridge, & Jacobson, 1998) and the A (Tinnitus) subscale of the THS (r = .78). Factor analysis confirmed that the 2 subscales, A (Tinnitus) and B (Hearing), have strong internal structure, explaining 71.7% of the total variance, and low correlation with each other (r = .46), resulting in a small amount of shared variance (21%).
Conclusion
These results provide evidence that the THS is statistically validated and reliable for use in assisting patients and clinicians in quickly (and collaboratively) determining whether intervention for tinnitus is appropriate.
Get full access to this article
View all available purchase options and get full access to this article.
References
Cima, R. F., Vlaeyen, J. W., Maes, I. H., Joore, M. A., & Anteunis, L. J. (2011). Tinnitus interferes with daily life activities: A psychometric examination of the Tinnitus Disability Index. Ear and Hearing, 32, 623–633.
Coles, R. R. A. (1995). Classification of causes, mechanisms of patient disturbance, and associated counseling. In Vernon, J. A., & Moller, A. R. (Eds.), Mechanisms of tinnitus (pp. 11–19). Needham Heights, MA: Allyn & Bacon.
Coles, R. R. A. (2000). Medicolegal issues. In Tyler, R. S. (Ed.), Tinnitus handbook (pp. 399–417). San Diego, CA: Singular.
Constand, M. K., MacDermid, J. C., Dal Bello-Haas, V., & Law, M. (2014). Scoping review of patient-centered care approaches in healthcare. BMC Health Services Research, 14, 271–280.
Dauman, R., & Bouscau-Faure, F. (2005). Assessment and amelioration of hyperacusis in tinnitus patients. Acta Oto-Laryngologica, 125, 503–509.
Dauman, R., & Tyler, R. S. (1992). Some considerations on the classification of tinnitus. In Aran, J.-M., & Dauman, R. (Eds.), Proceedings of the Fourth International Tinnitus Seminar, Bordeaux, France (pp. 225–229). Amsterdam, the Netherlands: Kugler.
Davis, A., & Refaie, A. E. (2000). Epidemiology of tinnitus. In Tyler, R. (Ed.), Tinnitus handbook (pp. 1–23). San Diego, CA: Singular.
Dobie, R. A. (2004). Overview: Suffering from tinnitus. In Snow, J. B. (Ed.), Tinnitus: Theory and management (pp. 1–7). Shelton, CT: PMPH-USA.
Fleiss, J. L. (1981). Statistical methods for rates and proportions. New York, NY: Wiley.
George, D., & Mallery, P. (2003). SPSS for Windows step by step: A simple guide and reference. (11.0 update; 4th ed.). Boston, MA: Allyn & Bacon.
Heller, A. J. (2003). Classification and epidemiology of tinnitus. Otolaryngologic Clinics of North America, 36, 239–248.
Henry, J. A., Frederick, M., Sell, S., Griest, S., & Abrams, H. (2015). Validation of a novel combination hearing aid and tinnitus therapy device. Ear and Hearing, 36, 42–52.
Henry, J. A., Galvez, G., Turbin, M. B., Thielman, E. J., McMillan, G. P., & Istvan, J. A. (2012). Pilot study to evaluate ecological momentary assessment of tinnitus. Ear and Hearing, 33, 179–290.
Henry, J. A., McMillan, G. P., Thielman, E. J., Galvez, G., Zaugg, T. L., Porsov, E., & Silaski, G. (2013). Evaluating psychoacoustic measures for establishing presence of tinnitus. Journal of Rehabilitation Research and Development, 50, 573–584.
Henry, J. A., Schechter, M. A., Loovis, C., Zaugg, T., Kaelin, C., & Montero, M. (2005). Clinical management of tinnitus using a “progressive intervention” approach. Journal of Rehabilitation Research and Development, 42(Suppl. 2), 95–116.
Henry, J. A., Zaugg, T. L., Myers, P. M., & Kendall, C. J. (2010). Progressive tinnitus management: Clinical handbook for audiologists. San Diego, CA: Plural.
Henry, J. A., Zaugg, T. L., Myers, P. J., Kendall-Schmidt, C. J., Kaelin, C., Thielman, E., … Carlson, K. (2012). Pilot study to develop telehealth tinnitus management for persons with and without traumatic brain injury. Journal of Rehabilitation Research and Development, 49, 1025–1042.
Henry, J. A., Zaugg, T. L., Myers, P. J., & Schechter, M. A. (2008). The role of audiologic evaluation in progressive audiologic tinnitus management. Trends in Amplification, 12, 169–184.
Henry, J. A., Zaugg, T. L., & Schechter, M. A. (2005). Clinical guide for audiologic tinnitus management: I. Assessment. American Journal of Audiology, 14, 21–48.
Hoare, D. J., Edmondson-Jones, M., Sereda, M., Akeroyd, M. A., & Hall, D. (2014). Amplification with hearing aids for patients with tinnitus and co-existing hearing loss (Art. No. CD010151). Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD010151.pub2
Hoffman, H. J., & Reed, G. W. (2004). Epidemiology of tinnitus. In Snow, J. B. (Ed.), Tinnitus: Theory and management (pp. 16–41). Shelton, CT: PMPH-USA.
Jastreboff, P. J., & Hazell, J. W. P. (1998). Treatment of tinnitus based on a neurophysiological model. In Vernon, J. A. (Ed.), Tinnitus treatment and relief (pp. 201–217). Needham Heights, MA: Allyn & Bacon.
Jastreboff, P. J., & Hazell, J. W. P. (2004). Tinnitus retraining therapy: Implementing the neurophysiological model. New York, NY: Cambridge University Press.
Krog, N. H., Engdahl, B., & Tambs, K. (2010). The association between tinnitus and mental health in a general population sample: Results from the HUNT Study. Journal of Psychosomatic Research, 69, 289–298.
Mazurek, B., Olze, H., Haupt, H., & Szczepek, A. J. (2010). The more the worse: The grade of noise-induced hearing loss associates with the severity of tinnitus. International Journal of Environmental Research and Public Health, 7, 3071–3079.
McNeill, C., Tavora-Vieira, D., Alnafjan, F., Searchfield, G. D., & Welch, D. (2012). Tinnitus pitch, masking, and the effectiveness of hearing aids for tinnitus therapy. International Journal of Audiology, 51, 914–919.
Meikle, M. B., Henry, J. A., Griest, S. E., Stewart, B. J., Abrams, H. B., McArdle, R., … Vernon, J. A. (2012). The Tinnitus Functional Index: Development of a new clinical measure for chronic, intrusive tinnitus. Ear and Hearing, 33, 153–176.
Myers, P. J., Griest, S., Kaelin, C., Legro, M. W., Schmidt, C. J., Zaugg, T. L., & Henry, J. A. (2014). Development of a progressive audiologic tinnitus management program for veterans with tinnitus. Journal of Rehabilitation Research and Development, 51, 609–622.
Nelson, J. J., & Chen, K. (2004). The relationship of tinnitus, hyperacusis, and hearing loss [Review]. Ear, Nose, & Throat Journal, 83, 472–476.
Newman, C. W., Jacobson, G. P., & Spitzer, J. B. (1996). Development of the Tinnitus Handicap Inventory. Archives of Otolaryngology—Head and Neck Surgery, 122, 143–148.
Newman, C. W., & Sandridge, S. A. (2004). Tinnitus questionnaires. In Snow, J. B. (Ed.), Tinnitus: Theory and management (pp. 237–254). Shelton, CT: PMPH-USA.
Newman, C. W., Sandridge, S. A., & Jacobson, G. P. (1998). Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcome. Journal of the American Academy of Audiology, 9, 153–160.
Newman, C. W., Sandridge, S. A., & Jacobson, G. P. (2014). Assessing outcomes of tinnitus intervention. Journal of the American Academy of Audiology, 25, 76–105.
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory (3rd ed.). New York, NY: McGraw-Hill.
Ratnayake, S. A., Jayarajan, V., & Bartlett, J. (2009). Could an underlying hearing loss be a significant factor in the handicap caused by tinnitus? Noise & Health, 11, 156–160.
Savastano, M. (2008). Tinnitus with or without hearing loss: Are its characteristics different? European Archives of Oto-Rhino-Laryngology, 265, 1295–1300.
Searchfield, G. D., Kaur, M., & Martin, W. H. (2010). Hearing aids as an adjunct to counseling: Tinnitus patients who choose amplification do better than those that don't. International Journal of Audiology, 49, 574–579.
Shargorodsky, J., Curhan, G. C., & Farwell, W. R. (2010). Prevalence and characteristics of tinnitus among US adults. The American Journal of Medicine, 123, 711–718.
Shekhawat, G. S., Searchfield, G. D., & Stinear, C. M. (2013). Role of hearing aids in tinnitus intervention: A scoping review [Review]. Journal of the American Academy of Audiology, 24, 747–762.
Tyler, R. S., & Baker, L. J. (1983). Difficulties experienced by tinnitus sufferers. Journal of Speech and Hearing Disorders, 48, 150–154.
Tyler, R. S., & Conrad-Armes, D. (1983). The determination of tinnitus loudness considering the effects of recruitment. Journal of Speech and Hearing Research, 26, 59–72.
U.S. Department of Health and Human Services. (2006). Guidance for industry. Patient-reported outcome measures: Use in medical product development to support labeling claims. Rockville, MD: U.S. Food and Drug Administration.
Yenigün, A., Doğan, R., Aksoy, F., Akyüz, S., & Dabak, H. (2014). Assessment of tinnitus with Tinnitus Severity Index, Tinnitus Handicap Inventory and distortion product otoacoustic emissions in patients with normal hearing and hearing loss. Kulak Burun Boğaz İhtisas Dergisi [The Turkish Journal of Ear, Nose, and Throat], 24, 11–16.
Zaugg, T. L., Schechter, M. A., Fausti, S. A., & Henry, J. A. (2002). Difficulties caused by patients' misconceptions that hearing problems are due to tinnitus. In Patuzzi, R. (Ed.), Proceedings of the Seventh International Tinnitus Seminar (pp. 226–228). Crawley, Western Australia, Australia: The University of Western Australia.
Information & Authors
Information
Published In
Copyright
Copyright © 2015 American Speech-Language-Hearing Association.
History
- Received: Aug 29, 2014
- Revised: Nov 15, 2014
- Accepted: Nov 21, 2014
- Published in issue: Mar 1, 2015
Authors
Metrics & Citations
Metrics
Article Metrics
View all metricsCitations
Download article citation data for:
If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.
For more information or tips please see 'Downloading to a citation manager' in the Help menu.
Citing Literature
- Gregory M. Ellis, Rebecca Bieber, Alyssa Davidson, LaGuinn Sherlock, Michele Spencer, Douglas Brungart, Improving the Predictive Strength of Better-Ear Four-Frequency Pure-Tone Average With the Addition of the Tinnitus and Hearing Survey-Hearing Subscale, Ear & Hearing, 10.1097/AUD.0000000000001633, (2025).
- Lori Zitelli, Emma Alscher, Establishing a Comprehensive Tinnitus Care Pathway—Part 2: Implementation, Seminars in Hearing, 10.1055/s-0045-1804901, (2025).
- James A. Henry, Tinnitus Stepped-Care: A Model for Standardizing Clinical Services for Tinnitus, Seminars in Hearing, 10.1055/s-0045-1804509, (2025).
- Parvathi Perumareddi, Tinnitus, Primary Care: Clinics in Office Practice, 10.1016/j.pop.2024.09.008, 52, 1, (61-70), (2025).
- Douglas S. Brungart, Gregory M. Ellis, Alyssa Davidson, Hector Galloza, Benjamin Sheffield, Jaclyn Schurman, Not-so-normal hearing: Temporary hearing changes lead to chronic difficulties for listeners with ”normal” audiometric thresholds, Hearing Research, 10.1016/j.heares.2025.109183, 458, (109183), (2025).
- Tyler J. Gallagher, Kaitlin Hori, Janet S. Choi, Access to Hearing Healthcare and Barriers Among United States Veterans: A Survey‐Based Study, OTO Open, 10.1002/oto2.70055, 9, 1, (2025).
- Alyssa J. Davidson, Gregory M. Ellis, Kimberly Jenkins, Melissa Kokx-Ryan, Douglas S. Brungart, Examining the Use and Benefits of Low-/Mild-Gain Hearing Aids in Service Members with Normal Hearing Thresholds and Self-Reported Hearing Difficulties, Healthcare, 10.3390/healthcare12050578, 12, 5, (578), (2024).
- Eldré W. Beukes, Gerhard Andersson, Vinaya Manchaiah, The Indirect Effect of an Internet-Based Intervention on Third-Party Disability for Significant Others of Individuals with Tinnitus, Audiology Research, 10.3390/audiolres14050068, 14, 5, (809-821), (2024).
- Louise A. Burke, Amr El Refaie, The Current State of Evidence Regarding Audiologist-Provided Cognitive Behavioural Therapy for the Management of Tinnitus: A Scoping Review, Audiology Research, 10.3390/audiolres14030035, 14, 3, (412-431), (2024).
- LaGuinn Sherlock, Gregory Ellis, Alyssa Davidson, Douglas Brungart, Rapid Assessment of Tinnitus Complaints with a Modified Version of the Tinnitus and Hearing Survey, Trends in Hearing, 10.1177/23312165241242235, 28, (2024).
- See more
View Options
Sign In Options
ASHA member? If so, log in with your ASHA website credentials for full access.
Member Login