Validity and reliability study of three tinnitus self-assessment scales: loudness, annoyance and change.

CONCLUSIONS: The three tinnitus self-rating scales described herein can be employed as part of "minimal datasets" to reflect the patient's current tinnitus status. These tests are simple and easy to use and can be completed by the patient alone. The results are easy to interpret and provide a good foundation for an effective doctor-patient dialogue. OBJECTIVE: To investigate the reliability and validity of three tinnitus self-rating scales: a six-point response scale for tinnitus loudness; an eight-point response scale for tinnitus annoyance; and a six-point response scale for tinnitus change. MATERIAL AND METHODS: The data for 273 patients participating in 2 separate studies were assessed in terms of their validity and reliability. We used criterion validity to determine whether the scales had empirical associations with external criteria, in this case an already firmly established tinnitus questionnaire. In addition we examined construct validity, i.e. its subcategories convergent and discriminant validity, in order to find out how related or unrelated items or scales were. We tested the reliability and repeatability of the scales using patients on our waiting list for tinnitus desensitization. RESULTS: The test-retest reliability was 0.72 for tinnitus loudness and 0.62 for tinnitus annoyance. Calculations showed that all three scales correlated positively with validated complex scales and thus we considered convergent validity to be adequate.

Phase III results with a totally implantable piezoelectric middle ear implant: speech audiometry, spatial hearing and psychosocial adjustment.

OBJECTIVE: To evaluate the treatment efficacy of an electromechanical middle ear amplifier implant (AI) in patients with chronic moderate-to-severe sensorineural hearing loss (SNHL). The AI is a piezoelectric system with a sound processor and a rechargeable battery within a hermetically sealed titanium canister. Its titanium-sealed microphone is placed in the bony region of the ear canal. The incus-coupled transducer (actuator), which is also inside a titanium casing, is fastened to the adjacent bone. MATERIAL AND METHODS: This was a phase III study comprising 20 intention-to-treat patients. Telemetrical adjustments followed electromechanical amplifier implantations. We used a word recognition test as our primary efficacy measure (Freiburg Speech Recognition Test: DIN 45621). Secondary efficacy measures were the sentence comprehension test (Goettinger Satztest, 1996) for auditory orientation within noisy and quiet environments and a psychosocial adjustment test (Gothenburg Profile Test, 1998). The 6-month follow-up comprised a complete medical examination. Nineteen patients completed the study (per-protocol patients; 100% reference). RESULTS: Seventeen patients (89%) demonstrated improved binaural recognition of phonetically balanced monosyllables. Fourteen postoperative patients (74%) attained a perfect score (100%) on this test, compared to only 3 preoperative patients (16%). Thirteen patients (68%) reached the sentence recognition threshold at a 2:1 dB signal-to-noise ratio during noisy trials. Correct identification of the noise source direction in the horizontal plane occurred in 89% of the trials. The Gothenburg Profile Test scores showed that the subjective evaluation of hearing, orientation, social behavior and self-confidence increased from 48% to 88%. Three patients did not benefit from the implant. CONCLUSION: Treatment of SNHL with a totally implantable hearing system can be an efficient method for those patients unable to wear hearing aids. However, in order to avoid implantation in non-responders, there is a need for more specific audiological indication criteria.