Estimation of Minimal Clinically Important Difference for Tinnitus Handicap Inventory and Tinnitus Functional Index

Milena Engelke; Laura Basso; Berthold Langguth; Florian Zeman; Winfried Schlee; Stefan Schoisswohl; Rilana Cima; Dimitris Kikidis; Jose Antonio Lopez-Escamez; Petra Brüggemann; Birgit Mazurek; Jorge Piano Simões

doi:10.1002/ohn.1217

Estimation of Minimal Clinically Important Difference for Tinnitus Handicap Inventory and Tinnitus Functional Index

Milena Engelke^*
, Laura Basso
, Berthold Langguth
, Florian Zeman
, Winfried Schlee
, Stefan Schoisswohl
, Rilana Cima
, Dimitris Kikidis
, Jose Antonio Lopez-Escamez
, Petra Brüggemann
, Birgit Mazurek
, Jorge Piano Simões

^*Corresponding author for this work

Psychology, Health & Technology

Research output: Contribution to journal › Article › Academic › peer-review

5 Citations (Scopus)

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Abstract

Objective: The minimal clinically important difference (MCID) represents the smallest change in treatment outcome deemed clinically meaningful. This study estimates the MCID for 2 widely used tinnitus measures: the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI), using anchor-based approaches while accounting for baseline severity and time interval.

Study Design: A multi-center randomized clinical trial. Setting: European tinnitus centers.

Methods: Anchor-based approaches, including the effect size, receiver-operating characteristics, and ΔTHI/TFI methods, were employed to determine the MCID. The “minimally improved” category of the Clinical Global Impression Scale-Improvement (CGI-I) served as the anchor. The standard error of measurement was used to assess random variation.

Results: For the THI, MCID estimates ranged from 7.8 to 12, with a point estimate of 11 after 12 weeks of treatment (N = 364). For the TFI, MCID estimates ranged from 7.3 to 9.4, with a point estimate of 9 points after 12 weeks (N = 359). Both measures indicated that higher baseline severity and longer time intervals required greater score reduction for clinical relevance.

Conclusion: This study highlights the context-specific nature of MCID values for tinnitus measures and emphasizes the need for consensus on optimal anchor-based approaches to improve comparability.

Original language	English
Pages (from-to)	69-79
Number of pages	11
Journal	Otolaryngology - Head and Neck Surgery (United States)
Volume	173
Issue number	1
DOIs	https://doi.org/10.1002/ohn.1217
Publication status	Published - Jul 2025

Keywords

Minimal clinically important difference
Tinnitus
Tinnitus Functional Index (TFI)
Tinnitus Handicap Inventory (THI)

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Engelke, M., Basso, L., Langguth, B., Zeman, F., Schlee, W., Schoisswohl, S., Cima, R., Kikidis, D., Lopez-Escamez, J. A., Brüggemann, P., Mazurek, B., & Simões, J. P. (2025). Estimation of Minimal Clinically Important Difference for Tinnitus Handicap Inventory and Tinnitus Functional Index. Otolaryngology - Head and Neck Surgery (United States), 173(1), 69-79. https://doi.org/10.1002/ohn.1217

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title = "Estimation of Minimal Clinically Important Difference for Tinnitus Handicap Inventory and Tinnitus Functional Index",

abstract = "Objective: The minimal clinically important difference (MCID) represents the smallest change in treatment outcome deemed clinically meaningful. This study estimates the MCID for 2 widely used tinnitus measures: the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI), using anchor-based approaches while accounting for baseline severity and time interval.Study Design: A multi-center randomized clinical trial. Setting: European tinnitus centers.Methods: Anchor-based approaches, including the effect size, receiver-operating characteristics, and ΔTHI/TFI methods, were employed to determine the MCID. The “minimally improved” category of the Clinical Global Impression Scale-Improvement (CGI-I) served as the anchor. The standard error of measurement was used to assess random variation.Results: For the THI, MCID estimates ranged from 7.8 to 12, with a point estimate of 11 after 12 weeks of treatment (N = 364). For the TFI, MCID estimates ranged from 7.3 to 9.4, with a point estimate of 9 points after 12 weeks (N = 359). Both measures indicated that higher baseline severity and longer time intervals required greater score reduction for clinical relevance.Conclusion: This study highlights the context-specific nature of MCID values for tinnitus measures and emphasizes the need for consensus on optimal anchor-based approaches to improve comparability.",

keywords = "Minimal clinically important difference, Tinnitus, Tinnitus Functional Index (TFI), Tinnitus Handicap Inventory (THI)",

author = "Milena Engelke and Laura Basso and Berthold Langguth and Florian Zeman and Winfried Schlee and Stefan Schoisswohl and Rilana Cima and Dimitris Kikidis and Lopez-Escamez, \{Jose Antonio\} and Petra Br{\"u}ggemann and Birgit Mazurek and Sim{\~o}es, \{Jorge Piano\}",

note = "Publisher Copyright: {\textcopyright} 2025 The Author(s). Otolaryngology–Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.",

year = "2025",

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Engelke, M, Basso, L, Langguth, B, Zeman, F, Schlee, W, Schoisswohl, S, Cima, R, Kikidis, D, Lopez-Escamez, JA, Brüggemann, P, Mazurek, B & Simões, JP 2025, 'Estimation of Minimal Clinically Important Difference for Tinnitus Handicap Inventory and Tinnitus Functional Index', Otolaryngology - Head and Neck Surgery (United States), vol. 173, no. 1, pp. 69-79. https://doi.org/10.1002/ohn.1217

TY - JOUR

T1 - Estimation of Minimal Clinically Important Difference for Tinnitus Handicap Inventory and Tinnitus Functional Index

AU - Engelke, Milena

AU - Basso, Laura

AU - Langguth, Berthold

AU - Zeman, Florian

AU - Schlee, Winfried

AU - Schoisswohl, Stefan

AU - Cima, Rilana

AU - Kikidis, Dimitris

AU - Lopez-Escamez, Jose Antonio

AU - Brüggemann, Petra

AU - Mazurek, Birgit

AU - Simões, Jorge Piano

N1 - Publisher Copyright: © 2025 The Author(s). Otolaryngology–Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.

PY - 2025/7

Y1 - 2025/7

N2 - Objective: The minimal clinically important difference (MCID) represents the smallest change in treatment outcome deemed clinically meaningful. This study estimates the MCID for 2 widely used tinnitus measures: the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI), using anchor-based approaches while accounting for baseline severity and time interval.Study Design: A multi-center randomized clinical trial. Setting: European tinnitus centers.Methods: Anchor-based approaches, including the effect size, receiver-operating characteristics, and ΔTHI/TFI methods, were employed to determine the MCID. The “minimally improved” category of the Clinical Global Impression Scale-Improvement (CGI-I) served as the anchor. The standard error of measurement was used to assess random variation.Results: For the THI, MCID estimates ranged from 7.8 to 12, with a point estimate of 11 after 12 weeks of treatment (N = 364). For the TFI, MCID estimates ranged from 7.3 to 9.4, with a point estimate of 9 points after 12 weeks (N = 359). Both measures indicated that higher baseline severity and longer time intervals required greater score reduction for clinical relevance.Conclusion: This study highlights the context-specific nature of MCID values for tinnitus measures and emphasizes the need for consensus on optimal anchor-based approaches to improve comparability.

AB - Objective: The minimal clinically important difference (MCID) represents the smallest change in treatment outcome deemed clinically meaningful. This study estimates the MCID for 2 widely used tinnitus measures: the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI), using anchor-based approaches while accounting for baseline severity and time interval.Study Design: A multi-center randomized clinical trial. Setting: European tinnitus centers.Methods: Anchor-based approaches, including the effect size, receiver-operating characteristics, and ΔTHI/TFI methods, were employed to determine the MCID. The “minimally improved” category of the Clinical Global Impression Scale-Improvement (CGI-I) served as the anchor. The standard error of measurement was used to assess random variation.Results: For the THI, MCID estimates ranged from 7.8 to 12, with a point estimate of 11 after 12 weeks of treatment (N = 364). For the TFI, MCID estimates ranged from 7.3 to 9.4, with a point estimate of 9 points after 12 weeks (N = 359). Both measures indicated that higher baseline severity and longer time intervals required greater score reduction for clinical relevance.Conclusion: This study highlights the context-specific nature of MCID values for tinnitus measures and emphasizes the need for consensus on optimal anchor-based approaches to improve comparability.

KW - Minimal clinically important difference

KW - Tinnitus

KW - Tinnitus Functional Index (TFI)

KW - Tinnitus Handicap Inventory (THI)

UR - https://www.scopus.com/pages/publications/105000819517

U2 - 10.1002/ohn.1217

DO - 10.1002/ohn.1217

M3 - Article

C2 - 40111205

AN - SCOPUS:105000819517

SN - 0194-5998

VL - 173

SP - 69

EP - 79

JO - Otolaryngology - Head and Neck Surgery (United States)

JF - Otolaryngology - Head and Neck Surgery (United States)

IS - 1

ER -

Estimation of Minimal Clinically Important Difference for Tinnitus Handicap Inventory and Tinnitus Functional Index

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