Further Validation Of The Chinese (Mandarin) Tinnitus Handicap Inventory: Comparison Between Patient-Reported And Clinician-Interviewed Outcomes

Objective: The objective of this study was to evaluate the feasibility of the Chinese (Mandarin) Tinnitus Handicap Inventory (THI-C) by comparing patient-reported and clinician-interviewed outcomes and to raise awareness of the difficulties in using adapted international test measures. Design: All patients were required to first complete the THI-C independently. Then, clinicians conducted a face-to-face interview, explained the exact meaning of each item and re-evaluated every item based on the patient's descriptions. During this process, patients were encouraged to make comments about each item. Both the self-administered and clinician-interviewed scores were recorded and compared. Study sample: A total of 178 patients who reported tinnitus as a primary complaint were included. Results: Among these patients, 88 (49.4%) completed the questionnaire independently, while 79 (44.4%) patients experienced difficulty in understanding at least one item. The difference between the self-administered and clinician-interviewed scores was statistically significant (p<0.01). Conclusions: The feasibility of the THI-C is limited unless a revision is made. Follow-up studies are needed for validation when a newly translated self-administered questionnaire is put into use. In addition to semantic equivalence and idiomatic equivalence, experiential equivalence and conceptual equivalence should also be fully considered during the translation process.