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A critical review of established tinnitus patient-reported outcomes as measures of Tinnitus Severity and Tinnitus Distress and exemplar analysis of the Tinnitus Handicap Inventory as a formative or reflective measure

Authors :
Nathan A. Clarke
Derek J. Hoare
Andrew Trigg
Source :
Frontiers in Audiology and Otology, Vol 1 (2024)
Publication Year :
2024
Publisher :
Frontiers Media S.A., 2024.

Abstract

Tinnitus Severity and Tinnitus Distress are frequently referenced and conflated constructs in research, measured using established tinnitus patient-reported outcome measures (PROs). Confusion regarding these constructs and their relation to fundamental scientific conceptions of tinnitus represents a threat to the validity of PROs as applied in tinnitus research, the conclusions that are reached when applying them, and subsequent progress of theory and clinical interventions for those experiencing tinnitus. Therefore, we critically review relevant literature, providing the Severity of Symptoms (SoS) and Correlates of Complaint (CoC) framework to link tinnitus theory to these constructs. We provide researchers with an overview of latent variable fundamentals (including distinctions between formative and reflective measures, and psychometric and clinimetric measurement traditions). We then provide a synthesis of the relationship between Tinnitus Severity and Tinnitus Distress, the SoS/CoC framework, and latent variable measurement to elucidate their distinctions. Finally, we take the Tinnitus Handicap Inventory (THI) as an exemplar of established tinnitus PROs and use study data (N = 200) to empirically evaluate the appropriateness of the THI as a reflective measure of Tinnitus Distress. Subsequently, conceptual and criterion mediation tests provide evidence that the THI is not a reflective measure of Tinnitus Distress according to the CoC conception and should be considered as a formative measure. Researchers should therefore consider whether established tinnitus PROs, such as the THI, are congruent with the scientific conceptions and subsequent theories that they aim to evaluate.

Details

Language :
English
ISSN :
28136055
Volume :
1
Database :
Directory of Open Access Journals
Journal :
Frontiers in Audiology and Otology
Publication Type :
Academic Journal
Accession number :
edsdoj.92cb8e156a01405c8c24b959d8b670bb
Document Type :
article
Full Text :
https://doi.org/10.3389/fauot.2023.1325137