Tinnitus Handicap Inventory (THI) — Free Online Assessment
The Tinnitus Handicap Inventory is a clinically validated questionnaire used by audiologists worldwide to measure how much tinnitus affects your daily life. Answer 25 simple questions and receive an instant, personalized severity assessment with detailed scoring across functional, emotional, and catastrophic dimensions.
Whether you are newly experiencing tinnitus or have been living with it for years, the THI can help you understand the extent of its impact and provide a baseline for tracking changes over time.
What Is the Tinnitus Handicap Inventory?
The Tinnitus Handicap Inventory (THI) is the most widely used tinnitus questionnaire in the world. It was developed in 1996 by Craig W. Newman, PhD, Gary P. Jacobson, PhD, and John B. Spitzer, PhD, and published in the Archives of Otolaryngology—Head & Neck Surgery. Since its publication, it has been translated into dozens of languages and adopted as a standard assessment tool in audiology clinics and tinnitus research studies globally.
The questionnaire consists of 25 items that evaluate the impact of tinnitus across three domains: functional limitations (difficulty concentrating, hearing, sleeping, and performing daily activities), emotional reactions (anger, frustration, anxiety, and depression), and catastrophic responses (feelings of desperation, loss of control, and inability to cope). Each question is answered with "Yes" (4 points), "Sometimes" (2 points), or "No" (0 points), producing a total score from 0 to 100.
The THI has excellent psychometric properties, with internal consistency (Cronbach's alpha) above 0.90 and strong test-retest reliability. It is routinely used to assess baseline tinnitus severity, measure treatment outcomes, screen patients for clinical intervention, and track changes over time.
Understanding Your THI Score
Your total THI score falls into one of five severity grades, each corresponding to a different level of tinnitus impact on daily life. The table below shows what each grade means in practical terms:
| Score Range | Severity | What It Means |
|---|---|---|
| 0 – 16 | Slight (Grade 1) | Tinnitus is only heard in quiet environments. Easily masked. No significant impact on daily life. |
| 18 – 36 | Mild (Grade 2) | Tinnitus can be easily masked by environmental sounds. May occasionally interfere with sleep and quiet activities. |
| 38 – 56 | Moderate (Grade 3) | Tinnitus is noticed even in the presence of background noise. May interfere with sleep and daily activities. |
| 58 – 76 | Severe (Grade 4) | Tinnitus is almost always heard. Leads to significant disturbance of sleep patterns and can interfere with daily activities. |
| 78 – 100 | Catastrophic (Grade 5) | Tinnitus is always heard. Disturbs sleep patterns. Difficulty with virtually all daily activities. May indicate need for professional mental health support. |
Note: Because each item scores 0, 2, or 4, the total score is always an even number. The gaps between severity ranges (e.g., 17, 37) are scores that cannot occur.
The Three Subscales Explained
Beyond the total score, the THI breaks down tinnitus impact into three subscales, each measuring a distinct dimension of how tinnitus affects you:
Functional (11 items)
Measures limitations in mental, social, occupational, and physical functioning. This includes difficulty concentrating, hearing, reading, sleeping, and performing job or household responsibilities.
Maximum score: 44 points
Emotional (9 items)
Measures affective reactions to tinnitus, including anger, frustration, irritability, anxiety, depression, and the stress it places on relationships with family and friends.
Maximum score: 36 points
Catastrophic (5 items)
Measures catastrophic thinking, feelings of desperation, perceived loss of control over tinnitus, and the belief that one can no longer cope.
Maximum score: 20 points
How Often Should You Take the THI?
For tracking changes in your tinnitus over time, it is recommended to take the THI approximately every four weeks. Research has established that a change of 7 or more points on the total score between administrations indicates a reliable, clinically meaningful change (McCombe et al., 2001). This means that small fluctuations of a few points are normal variation, but a shift of 7 or more points suggests a genuine improvement or worsening of your tinnitus handicap.
This tool allows you to save your results to your browser, so you can track your scores over time and see whether any changes you experience are clinically meaningful.
Frequently Asked Questions
The THI is a clinically validated 25-question self-assessment developed by Newman, Jacobson, and Spitzer in 1996. It measures the perceived handicap caused by tinnitus across functional, emotional, and catastrophic dimensions, producing a score from 0 to 100. It is the most widely used tinnitus questionnaire in the world and is routinely used in clinical practice and research.
Each of the 25 questions is answered Yes (4 points), Sometimes (2 points), or No (0 points). Total scores range from 0 to 100 and are classified into five severity grades: Slight (0-16), Mild (18-36), Moderate (38-56), Severe (58-76), and Catastrophic (78-100).
The THI typically takes about 5 minutes to complete. It consists of 25 yes/sometimes/no questions about your experience with tinnitus. There is no time limit.
No. The THI is a self-assessment screening tool, not a medical diagnosis. It provides a standardized measure of how much tinnitus affects your daily life, but it should not replace a professional evaluation by an audiologist or ENT specialist. If your tinnitus is causing significant distress, please consult a healthcare professional.
It is recommended to take the THI approximately every 4 weeks to track changes. A change of 7 or more points between assessments is considered clinically meaningful, indicating a reliable change in your tinnitus handicap rather than normal variation.
The THI has three subscales: Functional (11 items) measures limitations in mental, social, occupational, and physical functioning; Emotional (9 items) measures affective reactions like anger, frustration, anxiety, and depression; Catastrophic (5 items) measures catastrophic thinking and feelings of desperation or loss of control.
Yes. Your answers and results are processed entirely in your browser and are not sent to our servers. If you choose to save your results, they are stored only on your device using your browser's local storage. Clearing your browser data will remove saved results.
Tinnitus Handicap Inventory (THI) Results
Generated by AudioNotch THI Assessment Tool —
Your THI Results
What This Means
Important
Your score suggests your tinnitus is having a severe impact on your daily life. We strongly encourage you to seek professional help from an audiologist, ENT specialist, or mental health professional.
If you are experiencing thoughts of self-harm, please contact the 988 Suicide & Crisis Lifeline (call or text 988) or contact emergency services immediately.
Subscale Breakdown
Track Your Progress
Take this assessment again in about 4 weeks to track changes in your tinnitus. A change of 7 or more points is considered clinically meaningful.
Your Assessment History
| Date | Total Score | Severity | Change |
|---|
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