Document Type


Publication Title

Otolaryngology--Head and Neck Surgery


Objective: To explore the feasibility of ecological momentary assessments (EMAs) as a tool to more accurately assess the level of bother from tinnitus.

Study design: Longitudinal observational study.

Setting: Washington University Department of Otolaryngology-Head and Neck Surgery faculty practice plan.

Subjects and methods: Twenty participants with moderately to severely bothersome tinnitus were enrolled. All participants owned a smartphone device, and all communications were conducted via email, phone, and text messaging. Participants received 4 EMAs per day for 2 weeks via text message and a final survey on the 15th day. In each survey, participants recorded their level of tinnitus bother, their location at the time of response, their stress level, how they were feeling, and what they were doing. Response rates as a proxy for the feasibility of the program.

Results: There were a total of 1120 surveys sent to 20 participants (56 surveys per participant), and 889 (79.4%) of the surveys were completed and returned. The median time to response from the moment of receiving the text message was 7 minutes. The distribution of responses to the EMA question, "In the last 5 minutes, how bothered have you been by your tinnitus?" displayed both high between- and within-subject variability. At the end of 2 weeks, the median score on the Tinnitus Handicap Inventory was 37, with a range of 10 to 82 points; the median Tinnitus Functional Index score was 43, with a range of 10 to 82 points.

Conclusion: This study suggests bothered tinnitus patients will use smartphones as part of EMA.



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ecological momentary assessment, outcome measure, tinnitus