The Eating Assessment Tool-10 (EAT-10) represents a validated, easy to administer patient report dysphagia severity scale. Although its ability to detect swallowing impairment has been investigated in other patient populations, the utility of this instrument in individuals with head and neck cancer (HNC) has not been studied. The aim of the current investigation was to determine the relationship between patient ratings of swallowing impairment (EAT-10) and objective clinical ratings of swallow physiology in individuals with HNC. Forty-four HNC participants completed the EAT-10 and a standardized videofluoroscopy swallow study. Blinded raters determined airway safety using the penetration-aspiration scale (PAS) and swallowing function using the modified barium swallow impairment profile (MBSImP™©). Participants were stratified into three groups (pre-treatment through 1 year post-treatment, 1-5 years post-treatment, and >5 years post-treatment). Independent t tests, Pearson's and Spearman's Rho correlations, and a Bonferroni correction for multiple comparisons were performed. EAT-10 scores were significantly higher in HNC patients with unsafe swallowing (M 24.45, SD 8.32) compared to those with safe swallowing (M 16.20, SD 12.14), t(21) = -2.36, p < 0.04. Significant correlations were revealed between EAT-10 scores and the MBSImP™© (pharyngeal composite), and PAS scores (p < 0.05) for the pre-treatment to within 1 year post-treatment group. No associations, however, were observed for HNC patients in the time groups representing greater than 1-year post cancer treatment.

Purpose While flexible endoscopic evaluation of swallowing (FEES) is a common clinical procedure used in the head and neck cancer (HNC) population, extant outcome measures for FEES such as bolus-level penetration–aspiration and residue scores are not well suited as global patient-level endpoint measures of dysphagia severity in cooperative group trials or clinical outcomes research. The Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) was initially developed and validated for use during videofluoroscopic evaluations as a way to grade safety, efficiency, and overall pharyngeal swallowing impairment. The purpose of this study was to adapt and validate DIGEST for use with FEES. Method A modified Delphi exercise was conducted for content validation, expert consensus, adaptation, and operationalization of DIGEST-FEES. Three blinded, expert raters then evaluated 100 de-identified post-HNC treatment FEES examinations. Intra- and interrater reliability were tested with quadratic weighted kappa. Criterion validity against the MD Anderson Dysphagia Inventory, Functional Oral Intake Scale, Secretion Severity Scale, and Yale Residue Rating Scale was assessed with Spearman correlation coefficients. Results Interrater reliability was almost perfect for overall DIGEST-FEES grade (κ w = 0.83) and safety grade (κ w = 0.86) and substantial for efficiency grade (κ w = 0.74). Intrarater reliability was excellent for all raters (0.9–0.91). Overall DIGEST-FEES grade correlated with MD Anderson Dysphagia Inventory ( r = −.43, p < .0001), Functional Oral Intake Scale ( r = −.43, p < .0001), Secretion Severity Scale ( r = .47, p < .0001), Yale Vallecular Residue ( r = .73, p < .0001), and Yale Pyriform Sinus Residue ( r = .65, p < .0001). Conclusion DIGEST-FEES is a valid and reliable scale to describe the severity of pharyngeal dysphagia in patients with HNC. Supplemental Material https://doi.org/10.23641/asha.14642787

Background We aimed to: (1) examine relationships between the Functional Oral Intake Scale (FOIS), Eating Assessment Tool‐10 (EAT‐10), and objective measures of swallowing (Modified Barium Swallow Impairment Profile [MBSImP©] and penetration‐aspiration scale [PAS]) in patients with head and neck cancer, (2) compare outcomes between oral intake vs tube‐dependent patients, and (3) compare outcomes across time points. Methods A total of 58 patients with head and neck cancer completed the FOIS, EAT‐10, and underwent a standardized videofluoroscopy (VFSS). VFSS were analyzed using the PAS and MBSImP©. Nonparametric analyses were performed. Results A relationship between the FOIS and EAT‐10 (r = −0.46; P < .001) was revealed. No other associations were observed (P < .05). Feeding status did not impact PAS or MBSImP©; however, patients with head and neck cancer who were tube dependent demonstrated higher (worse) EAT‐10 scores (P = .01). Conclusions In this cohort, a relationship between patient‐perceived swallowing impairment and functional oral intake was revealed; however, no associations were observed between the FOIS and objective measures of swallowing impairment or swallowing safety.

No abstract

participants. Pre-and postintervention surveys were conducted to assess the needs of the population and the overall satisfaction with the program. Results: The pilot program took place on May 18, 2015. Target enrollment was 30 patients and caregivers; 30 people registered and 28 attended (15 men, 13 women; 20 survivors, 8 caregivers). Most of the HNC survivors were >2 years from diagnosis and >1 year from their last cancer treatment. The key components of the program included (1) motivational welcome by physician staff; (2) physical activity programs including gentle yoga, NEAT (non-exercise activity thermogenesis), and a physical therapy session entitled "Open & Release Your Neck & Shoulders"; (3) resiliency participatory group sessions for both survivors and caregivers; and (4) a hands-on nutrition/cooking session demonstrating strategies to increase consumption of vegetables and fruits by making whole food smoothies and soup. Twenty-one participants responded to the preintervention survey. The top 2 reasons for participation were to improve overall health and increase energy. Other common reasons included to increase strength, increase flexibility, improve quality of life or longevity, and reduce weight or improve body composition. Twenty-six of the 28 participants responded to the postintervention survey. Sixty-one percent and 33% of patients were very satisfied and satisfied, respectively, and 1 person (6%) was neutral. Eighty-eight percent and 12% of caregivers were very satisfied and satisfied, respectively. No participants were dissatisfied. On the postintervention survey, the following components were rated most valuable: gentle yoga, NEAT, and the nutrition session. Physician referral was cited as an important motivator to participation. Conclusion: A comprehensive HNC-specific wellness intervention is feasible in this underserved patient population, and further programs for HNC patients should be developed.