Development and validation of therapy outcome measures for inducible laryngeal obstruction and chronic cough.

<bold>Background:</bold> Therapy Outcome Measures (TOMs) are a practical tool for measuring outcomes of care and providing a quick and simple measure which can be used over time in a routine clinical setting. TOMs allow therapists to reflect on the dimensions of impairment, activity, participation and wellbeing on an 11-point ordinal scale. Currently there are no validated TOMs for Inducible Laryngeal Obstruction (ILO) and Chronic Cough (CC). <bold>Aim:</bold> The purpose of this study was to develop two TOMs, one for ILO (TOM ILO) and one for CC (TOM CC), and to test the reliability and validity of each. <bold>Method:</bold> TOM ILO and TOM CC were adapted using the Royal College of Speech and Language Therapist (RCSLT) framework. Professionals working with patients with ILO and CC from eight UK locations received training in the use of TOM ILO and TOM CC. Face validity, inter-rater reliability and test-retest reliability were tested and analysed. <bold>Results:</bold> TOM ILO and TOM CC both demonstrated strong face validity. The TOM ILO showed ‘almost perfect’ intra-rater reliability with a Kappa (k) greater than 0.9 by each therapist. The TOM CC co-efficient was less reliable with the highest percentage of therapists (50%) showing ‘fair’ intra-rater reliability with a kappa (k) of 0.21-0.40. The TOM ILO and TOM CC both had strong inter-rater reliability with a Krippendorff alpha co-efficient of 0.892 (TOM CC) and 0.881 (TOM ILO). <bold>Conclusion:</bold> Therapy outcome measures provide quantifiable data and insights into a patient’s wellbeing, symptoms and functioning allowing therapists to track progress and make informed decisions about treatment approaches. TOM ILO and TOM CC can now be used as a validated outcome measure.