# Validated French translation of the ESIT-SQ
standardized tinnitus screening questionnaire

Robin Guillard, F. Decobecq, M.-J. Fraysse, A. Favre, Marco Congedo, V.

Loche, M. Boyer, A. Londero

► To cite this version:

Robin Guillard, F. Decobecq, M.-J. Fraysse, A. Favre, Marco Congedo, et al. Validated French translation of the ESIT-SQ standardized tinnitus screening questionnaire. European Annals of Otorhinolaryngology, Head and Neck Diseases, 2023, 140 (4), pp.153-157. 10.1016/j.anorl.2022.12.007. hal-04940836

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Original article

# Validated French translation of the ESIT-SQ standardized tinnitus screening questionnaire

<figure><img src="image_2.png" /></figure>

R. Guillard<sup>a,b,*</sup>, F. Decobecq<sup>c</sup>, M.-J. Fraysse<sup>c,d</sup>, A. Favre<sup>b</sup>, M. Congedo<sup>a</sup>, V. Loche<sup>c,e</sup>, M. Boyer<sup>c,f</sup>, A. Londero<sup>c,g</sup>

## INFO ARTICLE

Keywords :

Tinnitus

ESIT-SQ

AFREPA

France-Acouphènes

Siopi

## ABSTRACT

**Objectives.** – The heterogeneity of tinnitus in terms of etiology, presentation and sometimes severe impact on quality of life hinders treatment and clinical research. The European School for Interdisciplinary Tinnitus Research Screening Questionnaire (ESIT-SQ) collects standardized tinnitus characteristics for patient subtyping. A validated French translation of the ESIT-SQ is presented here.

**Method.** – On the initiative of the French Interdisciplinary Tinnitus Association (AFREPA), 3 translators (1 professional translator, 1 clinician and 1 researcher) were missioned to translate the English version of the ESIT-SQ into French, adhering to good practice guidelines. Nine patients were recruited with the help of the France-Acouphènes patient association, to test and validate the translation. Lastly, an exploratory survey of responses to the French questionnaire was conducted online via the Siopi mobile phone application.

**Results.** – The French translation of the ESIT-SQ was successfully validated. 105 patients responded to the exploratory survey, and their characteristics are presented here.

**Conclusion.** – This new validated French translation of the ESIT-SQ will enable epidemiological and clinical data to be collected in French-speaking populations, and thus compiled and compared with data collected with other versions of this questionnaire already published in other languages.

© 2022 L'Auteur(s). Published par Elsevier Masson SAS. Cet article est publié en Open Access sous licence

CC BY (http://creativecommons.org/licenses/by/4.0/).

## 1. Introduction

Tinnitus is defined as an auditory sensation without external acoustic stimulation or meaning which may be experienced as disagreeable and impacting quality of life [1]. Prevalence is high, at 10% of the population [2], and impact can be severe [3]. Tinnitus remains a scientific and clinical challenge that is only partially understood, largely due to its intrinsic heterogeneity [4]. To elucidate this heterogeneity, the European School for Interdisciplinary Tinnitus Research (ESIT) was set up, one aim being to collect epidemiological data in a centralized database at European level [5]. This extended the Tinnitus Database project (https://tinnitus-database.eu), launched in 2010 by Landgrebe's and colleagues [6]. The first step in

patient follow-up through the Tinnitus Database was a screening step, for which ESIT developed a standardized screening questionnaire, the ESIT-SQ [7].

This questionnaire replaced the the Tinnitus Research Initiative's 2006 Tinnitus Sample Case History Questionnaire [8], and enabled administration to subjects free of tinnitus, with more ecological assessment, more broadly including pathologies and symptoms associated with tinnitus and the chronological relations between tinnitus and such comorbidities [7,9].

The ESIT-SQ was published in English, Flemish, German, Italian, Polish, Spanish, Swedish and Albanian [7,10,11]. Despite its having been largely founded on a French questionnaire used in the Georges Pompidou European Hospital in Paris (see Appendix A [7]), no French translation of ESIT-SQ was previously available.

In France, the French Interdisciplinary Tinnitus Association (AFREPA, https://www.afrepa.org) brought together medical and paramedical professionals to improve the standard of care in

<footnote><sup>a</sup> Université de Grenoble Alpes, CNRS, Grenoble INP, GIPSA-lab, Grenoble, France</footnote>

<footnote><sup>b</sup> Siopi SAS, Paris, France</footnote>

<footnote><sup>c</sup> Association Francophone des Équipes Pluridisciplinaires en Acouphénologie, 10, rue Falguière, 75015 Paris, France</footnote>

<footnote><sup>d</sup> Service ORL, centre hospitalier universitaire Purpan, Toulouse, France</footnote>

<footnote><sup>e</sup> Service ORL, centre régional hospitalier universitaire de Lille, Lille, France</footnote>

<footnote><sup>f</sup> Toulouse Neurolmaging Center (ToNIC), Inserm-University of Toulouse Paul Sabatier, Toulouse, France</footnote>

<footnote><sup>g</sup> Hôpital Européen Georges-Pompidou, service d'oto-rhino-laryngologie et chirurgie cervico-faciale, Paris, France</footnote>

<footnote>* Corresponding author.
Adresse e-mail : robin.guillard@gmail.com (R. Guillard).</footnote>
tinnitus via a multidisciplinary approach, and seeks to contribute to clinical research [12,13]. To improve and harmonize practices in each of its teams, AFREPA sought to standardize initial assessment. The ESIT-SQ, which had the further advantage of making data available for European-level research, was chosen as the optimal candidate.

The main aim of the present study was therefore to translate the ESIT-SQ into French, following the good practice guidelines laid out in [14], so that it could be made available to all French-speaking health practitioners managing tinnitus patients, and allow interested patients to contribute to European-level research. The secondary objective was to conduct an exploratory survey of results on the French ESIT-SQ, administered online via the Siopi tinnitus sufferers' community mobile phone app (Siopi, https://siopi.ai/fr).

## 2. Method

The translation was made between April and December 2020, and the exploratory survey data were collected between September and December 2021.

Translation adhered rigorously to the good conduct guidelines laid out by Hall et al. [14]. Thus, 3 translators were recruited: 1 professional translator, 1 neuroscience PhD student specializing in tinnitus, and 1 ENT specialist (respectively, F. Decobecq, R. Guillard and A. Londero). They were all graduates, and native French speakers, with a good level of English. After a first meeting to explain the procedure, F. Decobecq and R. Guillard produced 2 independent translations, which A. Londero then combined in a version that was discussed and validated in a dedicated meeting including all 3 translators. The France-Acouphènes tinnitus patients' association (https://www.france-acouphenes.fr) was then contacted to recruit experienced volunteer patients for real-life validation. Nine tinnitus patients were thus asked to fill out the questionnaire, reading it closely so as to screen for:

* spelling or grammatical mistakes and;

* problems in the formulation of the questions and responses that might lead to ambiguity and thus difficulty in answering.

This test phase revealed some minor spelling and grammatical mistakes, leading to one change in wording to avoid ambiguity: in question 5, at the beginning of the question, “comment” (“how”) was replaced by “quelle” (“what”) regarding the subject’s economic situation. The translation team then validated this revised and final version of the questionnaire.

The secondary study objective involved an exploratory online survey in a sample of volunteers. The Siopi platform is a community mobile phone app enabling mutual aid between patients with comparable symptom profiles and introducing those who wish to the ecosystem of clinical research. Before medical data, such as responses on our survey, are collected by the application, users are informed of the procedure and accept the general conditions of use, including anonymized export of the database for public-sector research purposes. Responses were collected in a database hosted by an approved health-data host, and separated from personal data so as to ensure strict anonymity.

Siopi developed a specific module for the survey, and users were informed by email of the possibility of participating: information about tinnitus communities had been posted on social media was shared by the France-Acouphènes patient association with the members of its network.

In total, 105 users responded to the survey between September and December 2021. The dataset had no missing data. Respondents reported no particular difficulties in filling out the questionnaire.

<caption>**Table 1**</caption>

Demographic data for respondents to the exploratory survey (n = 105). Sample demographics. 42 female, 63 male.

<table><thead><tr><th></th><th>Mean</th><th>SD</th><th>Median</th><th>Min</th><th>Max</th></tr></thead><tbody><tr><td>Age (years)</td><td>45.03</td><td>14.4</td><td>45</td><td>18</td><td>77</td></tr><tr><td>Height (cm)</td><td>172.8</td><td>9.2</td><td>174</td><td>149</td><td>196</td></tr><tr><td>Weight (kg)</td><td>76.42</td><td>16.25</td><td>75</td><td>50</td><td>140</td></tr><tr><td>Time since onset (years)</td><td>5.05</td><td>8.12</td><td>2</td><td>0</td><td>54</td></tr></tbody></table>

Abbreviations: SD: standard deviation

Respondents were informed that the data would be used for research purposes via Siopi's data management policy and directly on the survey homepage. Moreover, on filling out the questionnaire, respondents received a notice about the nature of the study, enabling them to apply their data privacy rights and decline use.

Siopi, in charge of data processing, exported the anonymized survey responses for analysis from the secure database in comma separated value (CSV) using the Jupyter Notebook module under Anaconda Python 3.7 software to obtain the visualizations reported below in the Results section.

## 3. Results

### 3.1. French-language version of the ESIT-SQ

The final French-language version of the ESIT-SQ is provided here as Appendix A, “Validated French translation of the ESIT-SQ questionnaire”. It is complete and includes all the optional fields of ESIT-SQ, in 2 parts, the first of which can be filled out by anyone, whether suffering from tinnitus or not.

### 3.2. Exploratory survey

The results of the exploratory survey are presented in three Tables: Table 1 shows demographic characteristics of the sample of respondents, Table 2 general characteristics of the sample, and Table 3 characteristics of the tinnitus and comorbidities. The sample comprised 42 women and 63 men, with a mean age of 45.03 ± 14.4 years, and a mean time since tinnitus onset of 5.05 ± 8.12 years. The general characteristics show an international French-speaking population with varying lifestyle and diet. 102 of the 105 respondents reported experiencing tinnitus, the characteristics of which illustrated the heterogeneous presentation of this symptom. Other oto-neurological symptoms were often associated: 49.52% of respondents reported episodes of vertigo at least once a year, 76.19% at least mild hyperacusis, 73.33% at least mild hearing loss, and only 1 person (0.95%) reported no painful syndrome. Fig. 1 presents causes of change in tinnitus level (aggravation or reduction), showing that many factors can increase or decrease severity in some subjects. Some tended to increase severity rather than reduce it: stress aggravated tinnitus in 65.69% of cases and decreased the level in only 6.68%; likewise, clenching the teeth aggravated tinnitus in 28.43% of cases and decreased the level in only 1.96%. Fig. 2 shows previous treatments attempted by respondents: 51.96% had not sought help from any of the health professionals listed (hearing aid professional, physiotherapist, psychologist, psychiatrist, “other practitioner”).

### 3.3. Discussion

The present study produced a validated French translation of the ESIT-SQ. It was made by 3 translators then validated in 9 tinnitus sufferers, following good practice guidelines [14]. It can be used in France for tinnitus research and epidemiological surveys and in current practice. It can probably be used in other French-speaking
<table><caption>**Table 2**
General characteristics of respondents to the exploratory survey (n = 105). General sample characteristics (N = 105).</caption><thead><tr><th>Criterion</th><th>Number of responders</th><th>Percentage</th><th>Criterion</th><th>Number of responders</th><th>Percentage</th><th>Criterion</th><th>Number of responders</th><th>Percentage</th></tr></thead><tbody><tr><td>Handedness:</td><td></td><td></td><td>Meat consumption</td><td></td><td></td><td>Phone use</td><td></td><td></td></tr><tr><td>Right</td><td>89</td><td>84.80%</td><td>Never / Vegetarian</td><td>4</td><td>3.81%</td><td>&lt; 1 h per month</td><td>15</td><td>14.28%</td></tr><tr><td>Left</td><td>14</td><td>13.30%</td><td>Occasional</td><td>6</td><td>5.71%</td><td>1 h per month</td><td>8</td><td>7.61%</td></tr><tr><td>Ambidextrous</td><td>2</td><td>1.90%</td><td>1 time per week</td><td>12</td><td>11.40%</td><td>2–3 h per month</td><td>19</td><td>18.09%</td></tr><tr><td>Country:</td><td></td><td></td><td>2–3 times per week</td><td>43</td><td>40.95%</td><td>1 h per week</td><td>14</td><td>13.33%</td></tr><tr><td>France</td><td>93</td><td>88.60%</td><td>4–5 times per week</td><td>22</td><td>20.95%</td><td>2–6 h per week</td><td>16</td><td>15.23%</td></tr><tr><td>Belgium</td><td>6</td><td>5.70%</td><td>≥6 times per week</td><td>18</td><td>17.14%</td><td>1 h per day</td><td>14</td><td>13.33%</td></tr><tr><td>Canada</td><td>3</td><td>2.85%</td><td>Fish consumption</td><td></td><td></td><td>&gt;1 h per day</td><td>19</td><td>18.09%</td></tr><tr><td>Other</td><td>3</td><td>2.85%</td><td>Never / Vegetarian</td><td>5</td><td>4.76%</td><td>Use of headphones</td><td></td><td></td></tr><tr><td>Sport:</td><td></td><td></td><td>Occasional</td><td>30</td><td>28.57%</td><td></td><td></td><td></td></tr><tr><td>&lt;2h / week</td><td>59</td><td>56.20%</td><td>1 time per week</td><td>41</td><td>39.05%</td><td>Never</td><td>47</td><td>44.76%</td></tr><tr><td>2–4h / week</td><td>30</td><td>28.60%</td><td>2–3 times per week</td><td>29</td><td>27.62%</td><td>&lt;1 h per month</td><td>16</td><td>15.23%</td></tr><tr><td>4–7h/week</td><td>9</td><td>8.50%</td><td>Fruit consumption</td><td></td><td></td><td>1 h per month</td><td>4</td><td>3.81%</td></tr><tr><td>&gt;7h/week</td><td>7</td><td>6.70%</td><td>Never</td><td>1</td><td>0.95%</td><td>2–3 h per month</td><td>7</td><td>6.67%</td></tr><tr><td>Sleep</td><td></td><td></td><td>Occasional</td><td>14</td><td>13.33%</td><td>1 h per week</td><td>5</td><td>4.76%</td></tr><tr><td>&lt;6h</td><td>20</td><td>19.04%</td><td>1–6 times per week</td><td>33</td><td>31.42%</td><td>2–6 h per week</td><td>10</td><td>9.51%</td></tr><tr><td>6h</td><td>27</td><td>25.71%</td><td>1 time a day</td><td>28</td><td>26.66%</td><td>1 h per day</td><td>4</td><td>3.81%</td></tr><tr><td>7h</td><td>38</td><td>36.19%</td><td>2–3 times a day</td><td>23</td><td>21.90%</td><td>&gt; 1 h per day</td><td>12</td><td>11.43%</td></tr><tr><td>8h</td><td>15</td><td>14.29%</td><td>≥4 times a day</td><td>6</td><td>5.71%</td><td>Night or shift work</td><td></td><td></td></tr><tr><td>≥9h</td><td>5</td><td>4.76%</td><td>Vegetable consumption</td><td></td><td></td><td></td><td></td><td></td></tr><tr><td>Smoking</td><td></td><td></td><td>Occasional</td><td>9</td><td>8.57%</td><td>Never</td><td>70</td><td>66.67%</td></tr><tr><td>Non-smoker</td><td>50</td><td>47.62%</td><td>1–6 times a week</td><td>32</td><td>30.47%</td><td>Before</td><td>33</td><td>31.40%</td></tr><tr><td>Ex-smoker</td><td>38</td><td>36.20%</td><td>1 time a day</td><td>36</td><td>34.28%</td><td>Now</td><td>2</td><td>1.90%</td></tr><tr><td>Smoker</td><td>17</td><td>16.20%</td><td>2–3 times a day</td><td>21</td><td>20.00%</td><td></td><td></td><td></td></tr><tr><td></td><td></td><td></td><td>≥4 times a day</td><td>7</td><td>6.67%</td><td></td><td></td><td></td></tr></tbody></table>

<table><caption>**Table 3**
Symptom characteristics of respondents to the exploratory survey (n = 105). Symptom characteristics (N = 105).</caption><thead><tr><th>Criterion</th><th>Number of responders</th><th>Percentage</th><th>Criterion</th><th>Number of responders</th><th>Percentage</th><th>Criterion</th><th>Number of responders</th><th>Percentage</th></tr></thead><tbody><tr><td>Tinnitus</td><td></td><td></td><td>Lateralization*</td><td></td><td></td><td>Vertigo</td><td></td><td></td></tr><tr><td>Never</td><td>3</td><td>2.86%</td><td>Left</td><td>17</td><td>16.19%</td><td>Never</td><td>53</td><td>50.48%</td></tr><tr><td>Not last year</td><td>2</td><td>1.9%</td><td>More left than right</td><td>25</td><td>23.81%</td><td>&lt; 1 per year</td><td>20</td><td>19.05%</td></tr><tr><td>Sometimes</td><td>10</td><td>9.52%</td><td>Both ears / head</td><td>25</td><td>23.81%</td><td>≥1 per year</td><td>32</td><td>30.48%</td></tr><tr><td>Very often</td><td>8</td><td>7.62%</td><td>More right than left</td><td>7</td><td>6.67%</td><td>Hyperacusis</td><td></td><td></td></tr><tr><td>Always</td><td>82</td><td>78.1%</td><td>Right</td><td>1</td><td>0.95%</td><td>Never</td><td>25</td><td>23.81%</td></tr><tr><td>Bother</td><td></td><td></td><td>Other</td><td>27</td><td>26.47%</td><td>Mild</td><td>31</td><td>29.52%</td></tr><tr><td>None</td><td>4</td><td>3.81%</td><td>Diurnal variation *</td><td></td><td></td><td>Moderate</td><td>25</td><td>23.81%</td></tr><tr><td>Slight</td><td>11</td><td>10.48%</td><td>Stable</td><td>16</td><td>15.24%</td><td>Severe</td><td>14</td><td>13.33%</td></tr><tr><td>Moderate</td><td>33</td><td>31.43%</td><td>Sometimes fluctuating</td><td>64</td><td>60.95%</td><td>Very strong</td><td>10</td><td>9.52%</td></tr><tr><td>Severe</td><td>57</td><td>54.29%</td><td>Always fluctuating</td><td>25</td><td>23.81%</td><td>Hearing loss</td><td></td><td></td></tr><tr><td>Number of sounds*</td><td></td><td></td><td>Description *</td><td></td><td></td><td>None</td><td>28</td><td>26.67%</td></tr><tr><td>1 only</td><td>51</td><td>50.00%</td><td>Pure tone</td><td>44</td><td>43.13%</td><td>Mild</td><td>28</td><td>26.67%</td></tr><tr><td>Several</td><td>51</td><td>50.00%</td><td>Melodious tone</td><td>2</td><td>1.96%</td><td>Moderate</td><td>24</td><td>22.86%</td></tr><tr><td>Onset *</td><td></td><td></td><td>Noise</td><td>11</td><td>10.78%</td><td>Severe</td><td>20</td><td>19.05%</td></tr><tr><td>Progressive</td><td>38</td><td>36.19%</td><td>Crickets</td><td>10</td><td>9.80%</td><td>Deafness</td><td>5</td><td>4.76%</td></tr><tr><td>Sudden</td><td>67</td><td>63.81%</td><td>Other</td><td>35</td><td>34.33%</td><td>Pain syndrome</td><td></td><td></td></tr><tr><td>Type*</td><td></td><td></td><td>Pitch*</td><td></td><td></td><td>Migraine</td><td>23</td><td>21.90%</td></tr><tr><td>Subjective</td><td>95</td><td>90.48%</td><td>High</td><td>85</td><td>80.95%</td><td>Neck pain</td><td>25</td><td>23.88%</td></tr><tr><td>Objective</td><td>10</td><td>9.52%</td><td>Medium</td><td>16</td><td>15.24%</td><td>Ear pain</td><td>8</td><td>7.61%</td></tr><tr><td>Rhythm*</td><td></td><td></td><td>Low</td><td>4</td><td>3.81%</td><td>Jaw pain</td><td>3</td><td>2.85%</td></tr><tr><td>No</td><td>89</td><td>87.25%</td><td>Consultations *</td><td></td><td></td><td>Facial pain</td><td>3</td><td>2.85%</td></tr><tr><td>Cardiac</td><td>6</td><td>5.88%</td><td>Never</td><td>27</td><td>25.71%</td><td>Other</td><td>42</td><td>40.00%</td></tr><tr><td>Respiration</td><td>1</td><td>0.98%</td><td>1 consultation</td><td>19</td><td>18.1%</td><td>None</td><td>1</td><td>0.95%</td></tr><tr><td>Head or jaw movement</td><td>4</td><td>3.92%</td><td>2–4 consultations</td><td>38</td><td>36.19%</td><td></td><td></td><td></td></tr><tr><td>Other</td><td>3</td><td>2.94%</td><td>≥5 consultations</td><td>21</td><td>20.0%</td><td></td><td></td><td></td></tr></tbody></table>

countries after checking compatibility with local linguistic particularities; it is noteworthy that Belgian, Swiss and Canadian subjects were able to respond to Siopi's online survey with no apparent difficulty.

The exploratory survey provided some initial information on the epidemiological characteristics investigated by the questionnaire in a French-speaking sample. The results showed wide disparities in symptom profiles, tinnitus presentation and subjective experience.

Results concerning factors modulating tinnitus were in agreement with previous reports. Stress modulated tinnitus, with

aggravation during stress episodes and decrease during relaxation, as frequently reported elsewhere; a review can be found in [15]. Somatosensory modulation was also frequently reported, notably in the review by Ralli et al. [16], and may depend on particular pathophysiological mechanisms, on which light has recently been shed [17]. There was great intersubject variation in response to acoustic level: very quiet environment, low intensity sound and high intensity sound; in each case, some subjects reported increased or decreased tinnitus loudness, but with a tendency for aggravation in quiet and high intensity stimulation and for decrease with lower intensity sound. This finding was not surprising,

<footnote>*: For these questions, 102 responses were taken into account, excluding the subjects that declared not experiencing any tinnitus.</footnote>
<figure><img src="image_3.png" /><figcaption>**Fig. 1.** Tinnitus modulation as reported by responders to the exploratory survey (n = 102). For "No modulation", the blue bar represents those who experienced no increase in any of the proposed situations, and the green bar those who experienced no decrease.</figcaption></figure>

<figure><img src="image_4.png" /><figcaption>**Fig. 2.** Tinnitus treatments tried out by respondents (n = 102).</figcaption></figure>

considering the beneficial effect of acoustic masking reported by some patients [18].

Several remarks can be made concerning the management of the sample subjects. Table 3 shows that, while 54% of respondents suffered greatly from their tinnitus and that 74% had sought at least one medical consultation (5 or more consultations in 20% of cases), many failed to adhere to the prescribed treatment and preferred to manage their tinnitus themselves (Fig. 2). It would thus seem that a large number of respondents either had not received treatment proposals or were not satisfied with them and decided not to continue. Another possible explanation is that the sample include both patients who were and patients who were not seeking help, as described in [19].

We did not undertake a back-translation into English, which may be considered to be a limitation, although there is no consensus on the benefit this would provide [20]. We adhered to a rigorous translation procedure (see [14]) intended to reduce the risk of error in three ways: firstly, two translators made two independent translations which a third translator combined, thus minimizing the risk that the final translation might be colored by the translator's personal style. Secondly, the translators' native language was French, ensuring that the translation would be linguistically and culturally adapted for the target population. And thirdly, the questionnaire was validated in 9 experienced tinnitus patients, to ensure that it was clear and non-ambiguous.

The exploratory survey had certain limitations. Data were collected via a digital platform open to all-comers with no supervision of response entry by a health professional. Responses were self-reported by platform users, who may have had problems with

certain medical terms and in self-assessing medical criteria such as degree of hearing loss. Also, some items referred to past events, memory of which could be defective.

Notably, a large number of respondents chose the response "Other" in the question about the sound of their tinnitus, suggesting that the range of possible responses failed to match the experience of many patients.

Moreover, the sample was too small to represent the exact characteristics of the French tinnitus population as a whole.

Finally, although the questionnaire was validated to some extent in reports of previous translations in other languages [10,11], it would still be useful to complete the validation by test-retest analysis and extensive psychometric tests. We hope that this will soon be done in studies of the international data-sets collected by the Tinnitus Database project.

The Tinnitus Database aims to collate epidemiological data such as those collected using ESIT-SQ at European level. Adding this new French version will broaden the sample to include French speakers. Questionnaire administration via a Siopi-type free and freely available mobile phone application is also an advance in mass collection of epidemiological data in French-speaking countries. And the French translation of ESIT-SQ is a step forward for good quality standardized screening for epidemiological studies and current clinical practice, as advocated by the AFREPA for its teams.

An interesting future project would be to develop a digital tool allowing practitioners to collect data from questionnaires such as the ESIT-SQ as part of their day-to-day practice so as to assess their patients' symptom profiles and also to centralize the data they
collect so as to advance our understanding of tinnitus in the hope of soon being able to shed light on the mystery of its heterogeneity.

**Disclosure of interest**

R. G. and A. F. are employed by Siopi; R. G. holds shares in Siopi. The other authors declare that they have no competing interest.

**Acknowledgments**

We especially thank Ms Hajar Sayeh for helping make available the French version of ESIT-SQ, which we produced on the Tinnitus Database platform. We thank Mr Louis Korczowski for help in developing the Siopi application.

We thank the Jean-Jacques Foundation and Félicia Lopez-Loreta and BPI France for funding the Siopi application and this present publication.

We also thank the AFREPA and the France-Acouphènes association for the work of their volunteers and their support during the study.

The French version of ESIT-SQ is in open access.

The exploratory survey data are available on request.

**Appendix A. Supplementary data**

Supplementary data associated with this article can be found, in the online version, at doi:10.1016/j.anorl.2022.12.007.

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