Assess Your Tinnitus
The Tinnitus Functional Index.
The Tinnitus Functional Index (TFI) is a scientifically validated questionnaire used worldwide to understand how tinnitus affects your daily life, including sleep, concentration, and emotional well-being. Click the button below to start the test.
Assess Your Tinnitus
The Tinnitus Functional Index.
The Tinnitus Functional Index (TFI) is a scientifically validated questionnaire used worldwide to understand how tinnitus affects your daily life, including sleep, concentration, and emotional well-being. Click the button below to start the test.
How Does It Work?
A clear picture of tinnitus impact.
Tinnitus affects people in different ways. For some, it interferes with sleep or concentration; for others, it increases stress or reduces enjoyment of everyday activities. The Tinnitus Functional Index (TFI) is a clinically validated tool designed to measure these effects in a clear, standardized way. It is structured into 8 domains and 25 questions.
TFI Domains
The Tinnitus Functional Index evaluates tinnitus impact across several clinically recognized domains. Each domain represents an area where tinnitus commonly affects daily life.
- Intrusiveness: how prominent and attention-capturing the tinnitus is.
- Sense of Control: perceived ability to manage or cope with tinnitus.
- Cognitive: effects on concentration, thinking, and mental clarity.
- Sleep: difficulty falling asleep or staying asleep due to tinnitus.
- Auditory: interference with hearing and understanding sounds or speech.
- Relaxation: difficulty relaxing or being at ease because of tinnitus.
- Quality of Life: impact on enjoyment of life and daily activities.
- Emotional: measures feelings of anxiety, frustration and/or depression.
TFI Questions
The TFI test includes 25 questions, grouped into different domains. Each question is rated on a 0–10 scale (or 0–100%), based on your experience over the past week, not just how your tinnitus feels today.
Domain 1: How intrusive is your tinnitus?
Over the past week…
- What percentage of your time awake were you consciously aware of your tinnitus?
- How strong or loud was your tinnitus?
- What percentage of your time awake were you annoyed by your tinnitus?
Domain 2: How does your tinnitus affect your sense of control?
Over the past week…
- How often did you feel in control of your tinnitus?
- How easy was it for you to cope with your tinnitus?
- How easy was it for you to ignore your tinnitus?
Domain 3: How does your tinnitus affect your mental wellbeing?
Over the past week, how often did your tinnitus interfere with…
- Your ability to concentrate?
- Your ability to think clearly?
- Your ability to focus your attention on other things beside your Tinnitus?
Domain 4: How bad is the impact of tinnitus on your sleep?
Over the past week…
- How often did your Tinnitus make it difficult to fall asleep or stay asleep?
- How often did your Tinnitus cause you difficulty in getting as much sleep as you needed?
- How much of the time did your tinnitus keep you from sleeping as deeply or as peacefully as you would have liked?
Domain 5: Do you have trouble hearing due to tinnitus?
Over the past week, how often did your tinnitus interfere with…
- Your ability to hear clearly?
- Your ability to understand people who are talking?
- Your ability to follow conversations in a group or at meetings?
Domain 6: Can you still relax although you have tinnitus?
Over the past week, how often did your tinnitus interfere with…
- Your quiet resting activities?
- Your ability to relax?
- Your ability to enjoy “peace and quiet”?
Domain 7: How does tinnitus affect your quality of life?
Over the past week, how often did your tinnitus interfere with…
- Your enjoyment of social activities?
- Your enjoyment of life?
- Your relationships with friends, family and other people?
- How often did your tinnitus cause you to have difficulty performing your work or other tasks, such as home maintenance, school work or caring for children or others?
Domain 8: Is your tinnitus causing depression?
Over the past week…
- How anxious or worried has your tinnitus made you feel?
- How bothered or upset have you been because of your tinnitus?
- How depressed were you because of your tinnitus?
Free Test
Get your free official TFI score by completing the 2-minute questionnaire. Click the button at the top of the page→
Free Test.
Get your TFI score for free by clicking the button at the top of the page→
Understanding Your TFI Results
Your Tinnitus Functional Index (TFI) score mainly reflects the current level of tinnitus-related impact on your daily life. The perceived loudness of the sound itself is only one small part of the overall score. It is a standardized measure used by clinicians and researchers to understand tinnitus-related distress and to track changes over time. A higher score indicates that tinnitus is having a greater impact on areas such as concentration, sleep, emotions, and quality of life.
TFI Score Categories
Scores are best interpreted as a starting point for understanding patterns, rather than as a diagnosis or prediction.
Not a problem (0 to 17):
Tinnitus is present but causes little or no disruption to daily life.
Small problem (18 to 31):
Tinnitus is noticeable at times and may be mildly bothersome, but overall impact is limited.
Moderate problem (32 to 53):
Tinnitus has a meaningful impact on daily functioning and may affect concentration, sleep, or emotional well-being.
Big problem (54 to 72):
Tinnitus causes significant distress and interferes with multiple areas of daily life.
Very big problem (73 to 100):
Tinnitus has a severe impact on quality of life and is associated with high levels of distress.
A higher TFI score does not mean tinnitus is permanent, worsening, or untreatable. It reflects how distressing tinnitus feels at this point in time. Evidence-based tinnitus approaches, such as the Still Tinnitus course, focus on reducing distress and improving quality of life, which is why the TFI is often used to track progress over time.
While some questions relate to loudness or awareness, first improvements often reflect tinnitus becoming less intrusive and easier to live with as it fades into the background.
About the TFI Test
Who developed the test?
The Tinnitus Functional Index (TFI) was developed in 2012 by a multidisciplinary research team led by Richard Meikle at the Oregon Health & Science University1, and was further developed in collaboration with tinnitus researchers and clinicians across audiology, psychology, and neuroscience such as Richard Meikle2.
The goal of the TFI was very specific: to create a reliable, scientifically valid tool that is sensitive to change over time, particularly for use in clinical trials and treatment monitoring. In other words, the TFI was designed not just to describe tinnitus impact at one moment, but to detect meaningful improvement or worsening in tinnitus-related distress.
Differences to THI
The Tinnitus Handicap Inventory (THI) was developed earlier, in 1996, by Craig Newman and colleagues3. It became one of the most widely used tinnitus questionnaires in clinical practice. The table below illustrates the main differences.
| Feature | Tinnitus Functional Index (TFI) | Tinnitus Handicap Inventory (THI) |
|---|---|---|
| Year developed | 2012 | 1996 |
| Primary purpose | Measure impact and change | Measure overall handicap |
| Sensitivity to changes | High (designed for this) | Moderate |
| Score range | 0-100 | 0-100 |
| Domains | 8 Detailed domains | 3 Broad sub scales |
| Typical use today | Research + clinical monitoring | Screening + clinical overview |
| Feature | TFI | THI |
|---|---|---|
| Year developed | 2012 | 1996 |
| Primary purpose | Measure impact and change | Measure overall handicap |
| Sensitivity to changes | High (designed for this) | Moderate |
| Score range | 0-100 | 0-100 |
| Domains | 8 Detailed domains | 3 Broad sub scales |
| Typical use today | Research + clinical monitoring | Screening + clinical overview |
Many modern tinnitus programs use the TFI when monitoring outcomes, especially for therapies aimed at reducing distress and improving quality of life.
1 Henry et al., Tinnitus Functional Index: Development, validation, outcomes research, and clinical application, Ear and Hearing (2016), PMID 26074306
2 Meikle et al., The Tinnitus Functional Index: Development of a new clinical measure for chronic, intrusive tinnitus, Ear and Hearing (2012), PMID 22156949.
3 Newman et al. Development of the Tinnitus Handicap Inventory, Archives of Otolaryngology–Head & Neck Surgery (1996), PMID 8630207