RP403 - Tinnitus Needs, Goals, and Outcomes: Applying the Client-Oriented Scale of Improvement in Tinnitus (COSIT) in Practice

Abstract: Investigate the convergent validity and responsiveness of the COSIT to TFI and its application in a digital therapy.

Methods: Secondary data analysis of COSIT and TFI measures from 99 trial participants.

Results: The five most common COSIT goals were reducing tinnitus by addressing: 1. Well-being. 2. Hearing. 3. Sleep. 4. Focus 5. Context. Change in TFI and COSIT change scores, and Final TFI and COSIT Final scores showed a moderate-strong agreement.

Conclusion: The TFI and COSIT measured similar constructs; both differentiated responders from non-responders. The COSIT is a valuable goal-setting and attainment tool for tinnitus.

Summary: Instructional level
Intermediate, basic clinical knowledge of tinnitus would be helpful, but expertise is not needed.
Rationale/Purpose
The purpose of the Client Oriented Scale of Improvement in Tinnitus (COSIT) is to set treatment goals and assess individual outcomes. The Tinnitus Functional Index (TFI) was developed as a comprehensive questionnaire to measure individual and population responses to tinnitus therapies.

Objective: To investigate the convergent validity and responsiveness of the COSIT and TFI.

Methods.
A secondary data analysis of COSIT and TFI measures from 99 participants who used sound-based therapy with hearing aids or earphones was undertaken. A thematic analysis of COSIT goals was applied. Non-parametric statistical methods were used to measure convergence of COSIT “change with treatment scores” and “final scores” to change in TFI scores pre and post treatment and the final TFI scores with treatment. The level of agreement between the measures were determined using receiver operating characteristic (ROC) curves. Treatment responsiveness was determined by comparing treatment-related change in total scores and subscales for responders vs. non-responders according to >13-point change in the TFI and COSIT score of ≥2.

Results
The five most common COSIT goals were reducing tinnitus by addressing: 1. Well-being. 2. Hearing. 3. Sleep. 4. Focus 5. Context. The change in TFI and COSIT change scores, and Final TFI and COSIT Final scores showed a moderate to strong agreement. The COSIT classified a higher percentage (78%) of participants as responders than the TFI did (43%). There was a fair agreement between the clinically meaningful change scores for TFI and COSIT (κ = 0.29).

Conclusion.
The TFI and COSIT measured similar constructs, and both differentiated responders from non-responders. Our results are consistent with the COSIT being an ideal “one for one” tool because of its high responsiveness to individual goals. The talk will conclude with how this tool has been incorporated into a digital therapeutic

Brief Summary of Clinical Takeaways: The COSIT is an ideal “one for one” measurement tool because of its high responsiveness to individual goals. The TFI is superior for group comparisons due to its standardized format.

Assumptions: Intermediate, basic clinical knowledge of tinnitus would be helpful, but expertise is not needed.