Validation of a new questionnaire measure of tinnitus functioning and disability for use in the UK: the Tinnitus Functional Index (TFI)

Fackrell, Kathryn L. (2016) Validation of a new questionnaire measure of tinnitus functioning and disability for use in the UK: the Tinnitus Functional Index (TFI). PhD thesis, University of Nottingham.

[img] PDF (Thesis - as examined) - Repository staff only until 31 July 2018. Subsequently available to Repository staff only - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (18MB)


The Tinnitus Functional Index (TFI) was developed in the USA as a standard for assessing the functional impact of tinnitus based on eight tinnitus-related domains. The finalised 25-item version was never formally validated. This PhD seeks to assess the psychometric properties of the questionnaire and evaluate its suitability as the tool of choice for use in the diagnostic and outcome assessment of tinnitus for clinical and research purposes in the UK.

The primary objectives were to (i) determine whether the TFI is reliable, (ii) verify its factor structure, and (iii) evaluate its responsiveness to treatment-related change. These objectives were evaluated in two UK studies. The first was a prospective multi-centre longitudinal validation study in which 255 NHS patients were recruited from audiology clinics to complete the TFI over four different time points in a nine-month period. The second was a retrospective analysis of data collected on the TFI and a battery of other health questionnaires from 294 members of the general public who had previously participated in two-centre randomised controlled trial of a novel tinnitus device. Approaches to psychometric analysis included classical and modern test theories, including Rasch measurement theory. Both approaches led to similar conclusions. Seven of the eight subscales were reliable and valid in both studies, although not as sensitive as the original developers proposed. Classical testing showed the auditory subscale to be reasonably reliable, but Rasch modelling indicated that it did not measure the functional impact of tinnitus. The overall factor structure was not confirmed. The sleep and auditory subscales did not relate to the other subscales and did not fit the model. My recommendation is to calculate the composite TFI score using only six subscales. The sleep subscale should be scored separately and the auditory subscale should not be used.

Item Type: Thesis (University of Nottingham only) (PhD)
Supervisors: Hoare, D.J.
Hall, D.A.
Barry, J.
Keywords: Tinnitus, Health surveys, Questionnaires
Subjects: W Medicine and related subjects (NLM Classification) > WV Otolaryngology
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 33119
Depositing User: Fackrell, Kathryn
Date Deposited: 19 Jul 2016 06:40
Last Modified: 14 Sep 2016 21:16

Actions (Archive Staff Only)

Edit View Edit View