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BackTable / ENT / Tool
Tinnitus Handicap Inventory
The Tinnitus Handicap Inventory is a scoring tool designed to evaluate the impact of tinnitus on a patient's quality of life. Tinnitus, or the perception of ringing, buzzing, or hissing in the ears without an external source, can significantly affect a person's emotional well-being, concentration, and quality of life.
Developed by Craig W. Newman, PhD, Gary P. Jacobson, PhD, and John B. Spitzer, PhD, the Tinnitus Handicap Inventory (THI) is a simple, structured questionnaire that helps clinicians assess the severity of tinnitus symptoms and guide treatment decisions. It provides a standardized approach to evaluating the functional, emotional, and catastrophic impact of tinnitus across clinical and research settings.
Tinnitus Handicap Inventory Chart
How to Use the Tinnitus Handicap Inventory
The Tinnitus Handicap Inventory consists of 25 questions. Each question should be answered based on the patient's experience with tinnitus over the past week. After completing all the questions, the clinician or patient will total the points to calculate the overall score, which can then be interpreted using the guidelines provided below. The possible answers are:
• Yes (4 points)
• Sometimes (2 points)
• No (0 points)
Tinnitus Handicap Inventory Scoring
After completing all 25 questions, combine the points to calculate the patient's Tinnitus Handicap Inventory score. Interpretation of the Tinnitus Handicap Inventory score is as follows:
• 0–16 (Grade 1): Slight or no handicap; tinnitus is only noticeable in quiet environments.
• 18–36 (Grade 2): Mild handicap; easily masked by environmental sounds and often forgotten during activities.
• 38–56 (Grade 3): Moderate handicap; noticeable even with background noise, but daily activities remain manageable.
• 58–76 (Grade 4): Severe handicap; tinnitus is almost always perceived, disrupting sleep and interfering with daily activities.
• 78–100 (Grade 5): Catastrophic handicap; tinnitus is constantly perceived, severely disturbing sleep and limiting the ability to perform activities.
Higher scores indicate greater perceived disability due to tinnitus. This scoring system helps guide treatment decisions, from patient education and reassurance to more intensive interventions like counseling, cognitive behavioral therapy, or sound therapy. Repeated use of the Tinnitus Handicap Inventory can also track changes in a patient’s condition over time.
Learn more on the BackTable ENT Podcast
BackTable is a knowledge resource for physicians by physicians. Get practical advice on the Tinnitus Handicap Inventory and how to build your practice by listening to the BackTable Podcast.
References
[1] Newman, C. W., Jacobson, G. P., & Spitzer, J. B. "Development of the Tinnitus Handicap Inventory." Archives of Otolaryngology–Head & Neck Surgery, 1996;122(2):143–148.
[2] Newman, C. W., Sandridge, S. A., & Jacobson, G. P. "Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcome." Journal of the American Academy of Audiology, 1998;9(2):153–160.
[3] Meikle, M. B., Stewart, B. J., Griest, S. E., & Henry, J. A. "Tinnitus Outcomes Assessment." Trends in Amplification, 2008;12(3):223–235.
Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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