{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:40:51Z","timestamp":1789771251527,"version":"4.0.1"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To develop and validate a clinical prediction model for moderate-to-severe tinnitus (THI\u202f\u2265\u202f38) in patients with hearing loss and to identify the key psychological and clinical factors associated with its risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective single-centre study included 301 patients with hearing loss who visited Qinghai University Affiliated Hospital between August 2024 and May 2025. The cohort was randomly divided into a training set (<jats:italic>n<\/jats:italic> =\u202f210) and a validation set (<jats:italic>n<\/jats:italic> =\u202f91) in a 7:3 ratio. Moderate-to-severe tinnitus served as the outcome of interest. Psychological and clinical risk factors were initially screened using univariate logistic regression, and variables with <jats:italic>p<\/jats:italic> &amp;lt;\u202f0.05 were subsequently included in a multivariable logistic regression model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The final multivariable model identified five independent psychological and clinical risk factors for moderate-to-severe tinnitus: older age (OR\u202f=\u202f2.415), hypertension (OR\u202f=\u202f2.120), poor sleep quality (OR\u202f=\u202f2.821), anxiety (OR\u202f=\u202f1.967), and severe hearing loss (OR\u202f=\u202f3.452). The model demonstrated good discriminative performance, with an AUC of 0.734 in the training set and 0.760 in the validation set.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with hearing loss, psychological and clinical risk factors\u2014including poor sleep quality, anxiety, hypertension, and severe hearing loss\u2014were significantly associated with moderate-to-severe tinnitus. These findings underscore the need for integrated management strategies that address both psychological and clinical components of tinnitus risk.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1647071","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T04:13:35Z","timestamp":1753244015000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Identifying psychological and clinical risk factors for moderate-to-severe tinnitus in older patients with hearing loss: a multivariable prediction model"],"prefix":"10.3389","volume":"16","author":[{"given":"Chenguang","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yicong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlong","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rou","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenghao","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1001\/jamaneurol.2022.2189","article-title":"Global 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