Measures of Subjective Tinnitus: What Does Visual Analog Scale Stand for?

Seung Ho Shin, Sung Wan Byun, Soo Jin Kim, Ho Yun Lee

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background Patients with tinnitus may have different severity levels of tinnitus distress. Visual analog scale (VAS) is a simple method to measure the extent of subjective distress caused by tinnitus. It includes ratings of tinnitus loudness, awareness, annoyance, and impact of tinnitus on life. Purpose The purpose of this study was to evaluate what led to different distress levels in patients with bilateral tinnitus by analyzing the relationships among all subscales of VAS scores for tinnitus distress and the documented variables. Research Design This study was a retrospective cohort study. Study Sample The medical records of 268 patients who visited a tinnitus clinic between March and December 2020 were reviewed. Data Collection and Analysis Epidemiologic characteristics, subjective tinnitus distress factors including tinnitus loudness, awareness, annoyance, and impact of tinnitus on life, questionnaire results including those from the Tinnitus Handicap Inventory (THI) and Beck Depression Inventory (BDI), and audiometric profiles were documented. Based on a bivariate analysis between variables and subtypes of subjective tinnitus distress, stepwise logistic regression was performed to identify potential influencing factors for aggravating each subtype. Results Data from a total of 122 patients with bilateral tinnitus were collected. The cohort included 77 males and 45 females with a mean age of 51.16 ± 13.50 years. Tinnitus loudness was associated with an accompanying headache (p < 0.001), the BDI score (p = 0.001), and the duration of tinnitus (p = 0.006). A high THI (p < 0.001) and an accompanying headache (p = 0.016) were both associated with tinnitus annoyance. Hearing thresholds at 250 Hz (p = 0.011) and 500 Hz (p = 0.002) on the left side were associated with an impact of tinnitus on life. The hearing threshold at 4 kHz on the left side alone was associated with tinnitus awareness (p = 0.013). Conclusion Psychologic complaints are mainly associated with tinnitus loudness and annoyance. On the other hand, hearing loss is linked with tinnitus awareness and its impact on life. Thus, an individualized, sequential approach that considers different subtypes of tinnitus severity to assess subjective tinnitus distress is needed.

Original languageEnglish
Pages (from-to)92-97
Number of pages6
JournalJournal of the American Academy of Audiology
Issue number2
StatePublished - 1 Sep 2022

Bibliographical note

Publisher Copyright:
© 2022 American Academy of Audiology. All rights reserved.


  • questionnaires
  • surveys
  • tinnitus
  • visual analog scale


Dive into the research topics of 'Measures of Subjective Tinnitus: What Does Visual Analog Scale Stand for?'. Together they form a unique fingerprint.

Cite this