J Am Acad Audiol 2019; 30(04): 327-337
DOI: 10.3766/jaaa.17119
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A Client Oriented Scale of Improvement in Tinnitus for Therapy Goal Planning and Assessing Outcomes

Grant D. Searchfield
*   Eisdell Moore Centre, Centre for Brain Research and Audiology Section, The University of Auckland, Auckland, New Zealand
†   Brain Research New Zealand, Auckland, New Zealand
› Author Affiliations
Further Information

Publication History

Publication Date:
26 May 2020 (online)



There is a need to develop methods to help clinicians work with clients to select and personalize tinnitus therapies. The use of validated measures to determine treatment success is also essential for research and clinical practice. A goal planning method widely used in audiologic rehabilitation is the client oriented scale of improvement (COSI). A modified version of the COSI has been used to identify tinnitus treatment goals and outcomes (client oriented scale of improvement in tinnitus [COSIT]).


The aims of this study were to identify treatment goals in a clinic sample and ascertain the convergent validity of the COSIT to three widely used standardized questionnaires.

Research Design:

A retrospective evaluation of client treatment goals using thematic analysis and correlational analysis of secondary research data comparing the COSIT to tinnitus handicap questionnaire (THQ), tinnitus handicap inventory (THI), and tinnitus functional index (TFI).

Study Sample:

One hundred and twenty-two adult patients and research participants attending the University of Auckland Hearing and Tinnitus Clinic.


Specific treatment goals were categorized into 11 themes. The most common treatment goals (>10% of responses) were: (1) Reducing tinnitus’ effects on Hearing. (2) Improved wellbeing and being less depressed. (3) Coping with or controlling the tinnitus. (4) Managing the effect of the environment (context) on tinnitus. (5) Improving sleep. (6) Understanding tinnitus. Individuals differed in their complaints and priorities for treatment. The COSIT showed moderate convergent validity with the THQ, THI, and TFI indicating that the total scores measured similar constructs.


The COSIT is a pragmatic method for determining tinnitus treatment goals and priorities in a format that should be familiar to audiologists.

The author’s tinnitus research is currently funded from grants awarded by the American Tinnitus Association and the Oticon Foundation of New Zealand.


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