RESEARCH FROM AROUND THE WORLD
Research Round-Up 2012: What’s New from Around the Globe
At ATA we’re routinely asked about the latest and greatest in the world of tinnitus research. Tinnitus patients want to know what kind of research is being conducted and which studies may hold promise for a new treatment or maybe a cure.
While there have been many exciting developments in the world of clinical research, there is still so much that the scientific community is learning about the parts of the brain involved with tinnitus perception and perhaps more impor- tantly, the specific role they play in tinnitus manifestation. In addition, the search for an objective measure for tinnitus and better diagnostics in general are some of the studies we highlight here.
Tinnitus Diagnostics
The Tinnitus Functional Index: Development of a New Clinical Measure for Chronic, Intrusive Tinnitus1
Objective: Effective tinnitus treatments are urgently needed, but evaluating them is hampered by the lack of standardized measures that are validated for both intake assessment and evaluation of treatment outcomes. This work was designed to develop a new self-report questionnaire, the Tinnitus Functional Index (TFI), that will provide documented validity both for scaling the severity and negative impact of tinnitus for use in intake assessment and for measur- ing treatment-related changes in tinnitus.
Methods: From nine widely used and variable tinnitus questionnaires, an expert panel identified 13 separate domains of tinnitus distress and selected 70 items most likely to be responsive to treatment effects. Eliminating redundant items while retaining content validity, and adding new items to achieve the recommended minimum of three to four items per domain, yielded 43 items which were then used for constructing TFI Prototype 1. Prototype 1 was
18 Tinnitus Today | Summer 2012
tested at five clinics on 326 participants. Using a predetermined list of criteria, the 30 best-functioning items were selected for constructing TFI Prototype 2. Prototype 2 was tested at four clinics with 347 partici- pants. Results were used to select the 25 best-func- tioning items for the final TFI.
Results: Both prototypes and the final TFI displayed strong measurement properties, high validity for scaling of tinnitus severity, good reliability, and few missing data. All TFI versions exhibited the same eight factors characterizing tinnitus severity and negative impact.
Why it’s important: There are currently many different tinnitus questionnaires and tools that are used for both tinnitus intake and treatment evaluation in clini- cal settings and research projects. Some are for tinni- tus severity, some are for patient reactions to tinnitus and some aim to quantify handicap associated with tinnitus. However, not all questionnaires are created equal and this can produce difficulty in comparing “apples to apples” in clinical outcomes, particularly in a research setting, which ultimately impacts stan- dardized treatment protocols.
We lead with a review of the Tinnitus Functional Index (TFI), the last work of ATA’s beloved Mary B. Meikle, Ph.D. If you’re a long time member of ATA, you know that Dr. Meikle was ATA’s very first grant recipient and the wife of ATA co-founder Jack A. Vernon, Ph.D. When Mary was diagnosed with ALS and had only a few months to live, she made it her final mission to prepare the paper on the TFI. This paper represents a culmination of the work that she and Jack, and many others, contributed to over decades of service to tinnitus patients. The hope? That it will become the gold standard of tinnitus evaluation in clinics around the world.
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