History and Science behind the Eating Assessment Tool-10 (Eat-10): Lessons Learned

Abstract

Introduction Oropharyngeal dysphagia (OD) is an underdiagnosed medical condition with a high prevalence in populations such as patients with frailty, neurological disease, or head and neck pathology. Potential barriers to its diagnosis include lack of (or low) awareness of the existence and severity of the condition, the hidden nature of the condition within the ‘normal ageing’ process, clinical limitations, and socioeconomic reasons. Consequently, an effective treatment is not systematically offered in a timely manner, and complications, such as dehydration and respiratory infections or aspiration pneumonia, can arise. To overcome this issue, the early use of screening questionnaires to identify people at risk of swallowing disorders represents the cornerstone of preventive medicine. Several screening tools have been created but few are widely used in clinical practice. The Eating Assessment Tool-10 (EAT-10) was developed as a quick, easy-to-understand, and self-administered screening tool for OD. Methods A literature review was conducted in five databases with no restrictions on the language, date of publication, or design of the study to identify aspects of the validation, applicability, and usefulness of EAT-10. Results and Conclusions Transcultural adaptation and translation studies, as well as studies involving various types of patients with dysphagia in different settings have shown the validity and reliability of EAT-10 in relation to the gold standard and other validation tools. The use of this standardised screening tool could be used as a primary screening instrument of dysphagia in routine clinical practice across a wide range of diseases and settings and thereby increase the likelihood of early diagnosis and management of a condition that lead to serious complications and impaired quality of life.

A Psychometric Evaluation of the Dysphagia Handicap Index Using Rasch Analysis

“…Overall, both CTT and IRT principles should be considered when developing new instruments and evaluating the psychometric properties of existing measures. Repeating limited CTT analyses for a single measure (repeated cross-cultural validation of a measure into numerous languages; for example, [26]) may not further strengthen the psychometric evidence to support its use, while introducing the IRT framework alongside CTT principles will lead to a better understanding of the robustness of the psychometric properties of a measure, prioritising the quality over quantity of psychometric analyses.…”