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Tinnitus Handicap Inventory (THI)

25-item self-report tinnitus burden questionnaire (Newman 1996). Each item: No (0), Sometimes (2), Yes (4). Total 0–100. Pick severity band — for full item-level score use the THI form.

Score interpretation

Slight Handicap (THI 0–16) 0

Grade 1 (McCombe 2001): heard only in quiet, easily masked; no interference with sleep or daily activities.

→ Reassurance, education on tinnitus mechanisms, sound enrichment (background noise, hearing aids if hearing loss).

Mild Handicap (THI 18–36) 1

Grade 2: easily masked by environmental sound and easily forgotten with activities; may occasionally interfere with sleep.

→ Reassurance, education on tinnitus mechanisms, sound enrichment (background noise, hearing aids if hearing loss).

Moderate Handicap (THI 38–56) 2

Grade 3: noticed in the presence of background noise, although daily activities can still be performed.

→ Refer audiology for hearing aids if SNHL; consider tinnitus retraining therapy (TRT) or CBT (NICE NG155). Sleep hygiene.

Severe Handicap (THI 58–76) 3

Grade 4: almost always heard, rarely masked; disturbs sleep and can interfere with daily activities.

→ Urgent ENT/audiology referral. Specialist tinnitus clinic. CBT-tinnitus formal programme. Screen for depression/suicidality. MRI if pulsatile or unilateral with asymmetric SNHL.

Catastrophic Handicap (THI 78–100) 4

Grade 5: always heard; disturbed sleep; difficulty with any activity.

→ Urgent ENT/audiology referral. Specialist tinnitus clinic. CBT-tinnitus formal programme. Screen for depression/suicidality. MRI if pulsatile or unilateral with asymmetric SNHL.

Interpretation bands for the THI. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.