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Narasimhan SV, Panarath A. An Evaluation of Psychometric Properties of EAT-10: A Malayalam Version. Dysphagia 2024; 39:586-592. [PMID: 38032481 DOI: 10.1007/s00455-023-10639-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/26/2023] [Indexed: 12/01/2023]
Abstract
The Eating Assessment Tool (EAT-10) is a 10-item self-administered questionnaire that assesses the severity of dysphagia symptoms, the impact of dysphagia on quality of life and treatment efficacy. EAT-10 has been adapted into several languages, including Malayalam. However, the information on the psychometric properties of EAT-10 MALAYALAM is not known. Therefore, the study aimed to evaluate the psychometric properties of the EAT-10 MALAYALAM. EAT-10 MALAYALAM questionnaire was administered to two groups of native Malayalam-speaking participants. Group 1 consisted of a total of 110 participants (76 males and 34 females) with a mean age of 52.9 ± 13.5 years diagnosed with oropharyngeal dysphagia. Group 2 consisted of 110 age and gender-matched healthy participants with normal swallow function and no history and symptoms of swallowing disorders. The test-retest reliability was assessed using Spearman's rank correlation coefficient between the test and the retest scores; internal consistency was assessed using Cronbach's alpha, and Known groups validity was evaluated by comparing the EAT-10 MALAYALAM scores between the participants of both groups. The results of Spearman's correlation coefficient showed 0.99, indicating that the EAT-10-MALAYALAM has excellent test-retest reliability. The Cronbach's alpha was 0.94, indicating strong internal consistency. Mann-Whitney U test showed significant differences in the scores of EAT-10-MALAYALAM between the participants of both groups. Therefore, it was inferred that EAT-10-MALAYALAM had good known groups validity. The EAT-10-MALAYALAM is a valid and reliable tool for screening Malayalam-speaking dysphagia patients.
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Affiliation(s)
| | - Afna Panarath
- JSS Institute of Speech & Hearing, Mysore, Karnataka, India
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Mandor EA, Ebada HA, El-Fattah AMA, Kamal E, Baz H, Tawfik A. Stapler versus conventional pharyngeal repair after total laryngectomy: a randomized clinical trial. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08696-9. [PMID: 38739184 DOI: 10.1007/s00405-024-08696-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 04/16/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVES The aim of the current study was to evaluate the functional outcomes of stapler pharyngeal closure after total laryngectomy by the incidence of PCT and assessment of swallowing after surgery. In addition, the study aimed to evaluate the oncological outcomes in terms of patients' survival rates. METHODS This randomized clinical trial was conducted on 58 patients with advanced laryngeal carcinoma who underwent total laryngectomy. Patients were randomly assigned to two groups according to the method of pharyngeal repair after laryngectomy: manual closure group (n = 28), and stapler group (n = 30). Functional and oncological outcomes were assessed and compared. RESULTS The incidence of pharyngocutaneous fistula was significantly less in the stapler group. Additionally, operative time was significantly shorter and swallowing function was better in the stapler group compared to the manual group. There was no statistically significant difference between groups regarding survival rates. CONCLUSION The stapler is a reliable method for pharyngeal closure after total laryngectomy if the limits of its indications regarding the primary tumor are considered. Stapler closure decreases the incidence of PCF and decreases the surgical time. Good swallowing outcomes are achieved without compromising the oncological outcomes.
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Affiliation(s)
| | - Hisham Atef Ebada
- Department of Otorhinolaryngology, Mansoura University, Mansoura, 35511, Egypt.
| | | | - Elsharawy Kamal
- Department of Otorhinolaryngology, Mansoura University, Mansoura, 35511, Egypt
| | - Hemmat Baz
- Phoniatrics, Mansoura University, Mansoura, Egypt
| | - Ali Tawfik
- Department of Otorhinolaryngology, Mansoura University, Mansoura, 35511, Egypt
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Abdel-Hay D, Abdelhay O, Ghatasheh HA, Al-Jarrah S, Eid S, Al Tamimi MA, Al-Mayata I. The Arabic EAT-10 and FEES in dysphagia screening among cancer patients: a comparative prospective study. Sci Rep 2024; 14:9258. [PMID: 38649708 PMCID: PMC11035686 DOI: 10.1038/s41598-024-58572-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 04/01/2024] [Indexed: 04/25/2024] Open
Abstract
Head and neck cancer treatments, such as radiotherapy, chemotherapy, and surgery, have diverse effects on patients, leading to dysphagia as a significant post-treatment issue. This study aims to evaluate the effectiveness of the Arabic version of the EAT-10 screening instrument (A-EAT-10) using Fiber-Optic Endoscopic Evaluation of Swallowing (FEES) as an imperfect gold standard. Additionally, we seek to establish a correlation between A-EAT-10 and PEG tube insertion in head and neck cancer (HNC) patients. Our sample comprised 130 head and neck cancer patients with varying cancer types at King Hussein Cancer Center (KHCC). We followed these patients throughout their distinct treatment plans up to one month after their final treatment session. During follow-up visits, we administered the A-Eat-10 instrument to monitor dysphagia. FEES were conducted at the initial and concluding visits to compare results with A-EAT-10 scores. The results in our tests, assuming independence or dependence, demonstrated excellent agreement. A-EAT-10 exhibited outstanding predictive capabilities with an AUC ranging from 93 to 97%. A-EAT-10 tended to slightly overestimate dysphagia at later treatment stages by approximately 20% compared to FEES, with an RR of 1.2 (95% CI 0.91, 1.56, p-value = 0.21), indicating statistical insignificance. In conclusion, A-EAT-10 is an excellent option for dysphagia evaluation, offering non-invasive, straightforward, and cost-effective advantages compared to FEES. Its utility extends to predicting the need for PEG tube insertion at initial patient visits, making it a valuable tool for informed treatment decisions. Notably, A-EAT-10 demonstrates a diminishing correlation with FEES over time.
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Affiliation(s)
- Da'ad Abdel-Hay
- Department of Surgery, King Hussein Cancer Centre, Queen Rania Street, Amman, 11941, Jordan.
| | - Osama Abdelhay
- Department of Data Science and Artificial Intelligence, Princess Sumaya University of Technology, Khalil Saket Street, Amman, 1438, Jordan
| | - Hamza A Ghatasheh
- Department of Radiation Oncology, King Hussein Cancer Centre, Queen Rania Street, Amman, 11941, Jordan
| | - Sameer Al-Jarrah
- Royal Rehabilitation Center, King Hussein Medical Center, King Abdullah II St 230, Amman, Jordan
| | - Suhaib Eid
- Department of Surgery, King Hussein Cancer Centre, Queen Rania Street, Amman, 11941, Jordan
| | - Mutaz A Al Tamimi
- Department of Nursing, King Hussein Cancer Centre, Queen Rania Street, Amman, 11941, Jordan
| | - Ibrahim Al-Mayata
- Department of Surgery, King Hussein Cancer Centre, Queen Rania Street, Amman, 11941, Jordan
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Dantas RO, Alves LMT, Silva ACV, Cassiani RA, Alves DC, Nascimento WV. Eating Assessment Tool (EAT-10) Scores to Detect Self-Reported Dysphagia in Brazilians. Dysphagia 2023; 38:1609-1614. [PMID: 37272949 DOI: 10.1007/s00455-023-10588-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/02/2023] [Indexed: 06/06/2023]
Abstract
The Eating Assessment Tool (EAT-10) detects swallowing impairments (dysphagia) self-reported by patients according to their perception. This noninvasive, inexpensive, self-administered instrument is quickly and easily filled out. The objective of this investigation was to evaluate the scores, sensitivity, and specificity of the method to define self-reported dysphagia in Brazilians. EAT-10 scores were evaluated in 443 healthy individuals (273 women and 170 men), aged 20 to 84 years, with no swallowing difficulties or diseases, and 72 patients with diseases that cause dysphagia (35 women and 37 men), aged 29 to 88 years. Each of the 10 instrument items has a 0-4 rating scale, in which 0 indicates no problem and 4, a severe problem; total results range from 0 to 40. The median EAT-10 score of healthy subjects was 0 (range: 0-20), and that of patients was 14.5 (range: 1-40). Considering a ≥ 3 cutoff score to define dysphagia risk, it was self-reported by 97.2% of patients with dysphagia and 9.5% of no-disease individuals (97.2% sensitivity and 90.7% specificity). The positive predictive value of the test was 63% and the negative predictive value was 99.5%. Healthy women had higher scores (median 0, range: 0-20) than healthy men (median 0, range: 0-8, p < 0.01) and more results indicative of self-reported dysphagia (11.7%) than healthy men (5.9%). The EAT-10 cutoff score to detect self-reported dysphagia in Brazilians should be 3, as previously considered. Healthy women complain more of self-reported dysphagia than healthy men. The test has high sensitivity and specificity.
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Affiliation(s)
- Roberto Oliveira Dantas
- Department of Medicine, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, SP, Brazil.
- , Ribeirão Preto, Brazil.
| | | | | | | | | | - Weslania Viviane Nascimento
- Laboratory of Gastrointestinal Physiology, Department of Surgery, Hospital of Mataró, Universitat Autonoma de Barcelona, Mataró, Spain
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Selvaraj JL, Venkatesh L, Varadharajan V, Chandrasekar K, Srinivas S, John C. Development and Evaluation of the Psychometric Properties of the Tamil Version of Eating Assessment Tool - 10 (EAT-10): Preliminary Findings from Persons with Head and Neck Cancer. Indian J Otolaryngol Head Neck Surg 2023; 75:632-640. [PMID: 37275015 PMCID: PMC10234939 DOI: 10.1007/s12070-022-03376-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Aims: This study aimed to develop and evaluate the psychometric properties of the Tamil version of the Eating Assessment Tool (EAT-10). Setting & Study Design: Prospective cross-sectional study on persons with Head and Neck Cancer (HNC) during their follow-up for oncological and swallowing consultation at a tertiary care hospital and healthy individuals recruited from the community. Methods: The study was conducted in two phases: (1) translation and development of the Tamil version of EAT-10 and (2) administration of Tamil EAT-10 to assess internal consistency reliability, test-retest reliability and known-group validity. 92 participants with HNC in the clinical group and 149 healthy adults in the control group completed the Tamil EAT-10. In addition, a subgroup of 20 participants with HNC repeated the questionnaire within a week to assess test-retest reliability. Results: The Cronbach alpha for the 10 items was 0.96 indicating high internal consistency reliability. The test-retest reliability of the individual items and the total scores (r = 0.98) of the Tamil version of EAT-10 were high. The total EAT-10 scores for the HNC group (14.4 ± 11.5) were significantly higher (p < 0.001) than the scores for healthy adults (0.72 ± 2.0). Conclusion: The Tamil version of the EAT-10 developed in this study is a reliable and valid self-administered tool for identifying concerns related to swallowing among persons treated for HNC and healthy adults. This tool can be implemented for clinical practice and research in dysphagia among a Tamil-speaking population. Supplementary Information The online version contains supplementary material available at 10.1007/s12070-022-03376-8.
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Affiliation(s)
- Jasmine Lydia Selvaraj
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Lakshmi Venkatesh
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Vasudharany Varadharajan
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Kavyashree Chandrasekar
- Sri Ramachandra Faculty of Audiology and Speech Language Pathology, Sri Ramachandra Institute of Higher Education and Research (Deemed to be University), 600116 Porur, Chennai, India
| | - Satish Srinivas
- Department of Radiation Oncology, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra Institute of Higher Education & Research, Porur, Chennai, India
| | - Christopher John
- Department of Radiation Oncology, Sri Ramachandra Medical College & Research Institute, Sri Ramachandra Institute of Higher Education & Research, Porur, Chennai, India
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Zayed AM, Afsah O, Elhadidy T, Abou-Elsaad T. Screening for oropharyngeal dysphagia in hospitalized COVID-19 patients: a prospective study. Eur Arch Otorhinolaryngol 2023; 280:2623-2631. [PMID: 36607433 PMCID: PMC9821362 DOI: 10.1007/s00405-022-07810-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 11/14/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE To screen for oropharyngeal dysphagia (OD) in hospitalized COVID-19 patients. METHODS A descriptive longitudinal study was conducted on 500 adult patients with confirmed COVID-19 in the age range of 19-65 years who were admitted to the main university isolation hospital (whether admitted in the ward or the intensive care unit). Screening for OD was done using the Arabic version of the Eating Assessment Tool (EAT-10) and the Yale swallow protocol. RESULTS 45.4% of the admitted and 40.97% of the discharged COVID-19 patients had a positive screen for OD. Several risk factors for OD could be detected. These include older age, longer duration of presenting symptoms of COVID-19, presence of ageusia and anosmia, presence of dysphonia, ICU admission, lower oxygen saturation, higher respiratory rate, presence of OD at admission, longer duration of hospital stay, and use of noninvasive ventilation (NIV) and/or invasive mechanical ventilation (IMV). CONCLUSIONS Screening for OD in hospitalized COVID-19 patients is a mandatory procedure, whether for admitted or discharged patients.
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Affiliation(s)
- Ahmed Mohamed Zayed
- Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Omayma Afsah
- Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt
| | - Tamer Elhadidy
- Chest Diseases Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Tamer Abou-Elsaad
- Phoniatric Unit, ORL Department, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt.
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Schindler A, de Fátima Lago Alvite M, Robles-Rodriguez WG, Barcons N, Clavé P. History and Science behind the Eating Assessment Tool-10 (Eat-10): Lessons Learned. J Nutr Health Aging 2023; 27:597-606. [PMID: 37702330 DOI: 10.1007/s12603-023-1950-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 03/31/2023] [Indexed: 09/14/2023]
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.
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Affiliation(s)
- A Schindler
- William Gildardo Robles-Rodriguez FUCS: Fundacion Universitaria de Ciencias de la Salud, Colombia,
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Abstract
BACKGROUND The oropharyngeal dysphagia is an underestimated symptom with various causes in the geriatric population. Clinical presentation is often insidious and dysphagia symptoms are seldomly mentioned by elderly patients although causing many life-threatening complications. The aim of this work was to introduce an easy applicable tool to be used by the caregivers and general practitioners for screening of dysphagia in geriatrics for early detection of at risk individuals. METHODS A sample of 200 Egyptian Arabic-speaking elderly patients (65 years or older) not complaining of dysphagia was recruited from nursing homes in Greater Cairo Area. They or their caregivers completed the designed screening tool, including; the designed questionnaires of dysphagia manifestations and eating habits. General, oral motor and bedside evaluation were also performed. In addition to filling in the EAT10 questionnaire and FEES that was performed for only suspected cases for the purpose of validation of the screening tool. RESULTS The dysphagia manifestations questionnaire was significantly correlated with EAT 10 with p value of 0.001. It was correlated in some of its aspects with FEES showing quite reliability with p values' range between 0.012 and 0.044. The Questionnaire of eating habits reliability of r- value of 0.568 slightly exceeding EAT10 reliability of r -value of 0.721 in the subjects under study. The cutoff point of total score of the dysphagia manifestations was > 5, with a sensitivity of 17.65% & a specificity of 94.20%. The cutoff point of total score of the bedside evaluation was ≤ 1 with a sensitivity of 66.9% & a specificity of 56.9%. CONCLUSION the use of this easy applicable screening tool managed to suspect and later on diagnose cases with oropharyngeal dysphagia in non-complaining aging subjects.
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Ghelichi L, Hashemian M, Nakhostin Ansari N, Tarameshlu M. Cross-cultural Adaption, Validation and Factor Analysis of the Persian Version of the Eating Assessment Tool: EAT-10. Dysphagia 2022; 37:1511-1518. [PMID: 35132473 DOI: 10.1007/s00455-021-10405-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 12/28/2021] [Indexed: 02/05/2023]
Abstract
The eating assessment tool (EAT-10) is a self-reported questionnaire to assess the patient's perception of swallowing difficulties. The aim of this study was to cross-culturally adapt and determine validity and reliability of the Persian version of the EAT-10 (P-EAT-10) in patients with oropharyngeal dysphagia. The EAT-10 was translated into Persian language and cross-culturally adapted. One hundred patients with dysphagia (mean age ± SD = 44.44 ± 14.69 years) participated. The test-retest reliability (time interval = 7 days) was assessed in 50 patients. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and smallest detectable change (SDC) were analyzed. The Persian version of functional oral intake scale (FOIS-P) was also recorded to assess construct validity. One hundred healthy subjects completed the P-EAT-10 for clinical validity. Factor analysis was performed to determine the P-EAT-10 structure. There were no missing responses and floor or ceiling effects. Internal consistency was high (Cronbach's α 0.91). Item-total correlations exceeded acceptable standard of 0.3 for the all items (0.62-0.83). The test-retest reliability was excellent [(ICC)agreement 0.96]. The SEM and SDC were 2.61 and 7.23, respectively. Construct validity was confirmed by a significant correlation between the P-EAT-10 and FOIS-P scores (r = 0.84). Clinical validity was supported by a significant discrimination between patients and healthy subjects (t = 29.97, P < 0.001). Factor analysis indicated 2 components for the P-EAT-10. The P-EAT-10 is a valid and reliable tool and can be used in clinic and research for the assessment of oropharyngeal dysphagia in Persian-speaking patients.
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Affiliation(s)
- Leila Ghelichi
- Department of Speech and Language Pathology, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohadeseh Hashemian
- Department of Speech and Language Pathology, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Tarameshlu
- Department of Speech and Language Pathology, Rehabilitation Research Center, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
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Donohue C, Tabor Gray L, Anderson A, DiBiase L, Chapin J, Wymer JP, Plowman EK. Discriminant Ability of the Eating Assessment Tool-10 to Detect Swallowing Safety and Efficiency Impairments. Laryngoscope 2022; 132:2319-2326. [PMID: 35137963 DOI: 10.1002/lary.30043] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/07/2022] [Accepted: 01/21/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVES/HYPOTHESIS Quick, sensitive dysphagia screening tools are necessary to identify high-risk patients for further evaluation in busy multidisciplinary amyotrophic lateral sclerosis (ALS) clinics. We examined the relationship between self-perceived dysphagia using the validated Eating Assessment Tool-10 (EAT-10) and videofluoroscopic analysis of swallowing safety and efficiency. STUDY DESIGN Prospective, observational, longitudinal study. METHODS Individuals with ALS completed the EAT-10 and a videofluoroscopic swallowing study. Duplicate, independent, blinded analyses of the validated Dynamic Imaging Grade of Swallowing Toxicity (DIGEST) scale were performed to index swallowing safety and efficiency (mild dysphagia: DIGEST ≥ 1, moderate dysphagia: DIGEST ≥ 2). A between-groups analysis of variance with Games-Howell test for post-hoc pairwise comparisons was performed to examine EAT-10 scores across dysphagia severity levels. Receiver operator characteristic curve analysis, area under the curve (AUC), sensitivity, specificity, positive-negative predictive values (PPV, NPV), and odds ratios (OR) were derived. RESULTS Four hundred and thirty five paired EAT-10 and DIGEST scores were analyzed. Mean EAT-10 score was 8.48 (95% confidence interval [CI]: 7.63-9.33). Individuals with dysphagia demonstrated higher EAT-10 scores (mild: 4.1 vs. 11.3, moderate: 6.0 vs. 17.5, P < .001). Mean EAT-10 scores increased across DIGEST levels (D0: 4.1, D1: 7.9, D2: 15.1, D3: 20.4, D4: 39.0). For mild dysphagia, an EAT-10 cut score of 3 was optimal: AUC 0.74 (95% CI: 0.69-0.78; sensitivity: 77%; specificity: 53%; PPV: 71%; NPV: 60%; OR: 3.5). An EAT-10 cut score of 7 optimized detection of moderate dysphagia: AUC 0.83 (95% CI: 0.78-0.87; sensitivity: 81%; specificity: 66%; PPV: 39%; NPV: 93%; OR: 8.1). CONCLUSION The EAT-10 is an easy-to-administer dysphagia screening tool with good discriminant ability for use in ALS clinics. LEVEL OF EVIDENCE 2 Laryngoscope, 132:2319-2326, 2022.
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Affiliation(s)
- Cara Donohue
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A.,Breathing Research and Therapeutics Center, University of Florida, Gainesville, Florida, U.S.A
| | - Lauren Tabor Gray
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A.,Breathing Research and Therapeutics Center, University of Florida, Gainesville, Florida, U.S.A
| | - Amber Anderson
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A
| | - Lauren DiBiase
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A
| | - Jennifer Chapin
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A
| | - James P Wymer
- Department of Neurology, University of Florida, Gainesville, Florida, U.S.A
| | - Emily K Plowman
- Aerodigestive Research Core Laboratory, University of Florida, Gainesville, Florida, U.S.A.,Department of Speech, Language, and Hearing Sciences, University of Florida, Gainesville, Florida, U.S.A.,Breathing Research and Therapeutics Center, University of Florida, Gainesville, Florida, U.S.A.,Department of Neurology, University of Florida, Gainesville, Florida, U.S.A.,Department of Surgery, University of Florida, Gainesville, Florida, U.S.A
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Slovak Translation and Cross-Cultural Validation of the Eating Assessment Tool (EAT10 ®). J Clin Med 2022; 11:jcm11195966. [PMID: 36233831 PMCID: PMC9570619 DOI: 10.3390/jcm11195966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/21/2022] [Accepted: 09/26/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: The objective of the study was the language adaptation and verification of psychometric properties of the Slovak version of the EAT10® questionnaire. Methods: The original English version of the questionnaire was translated into the Slovak language. The research group included 136 control participants and 51 dysphagic patients. Test−retest reliability, item analysis, internal consistency, construct and clinical validity, and Receiver Operating Characteristic (ROC) analysis were performed to verify the psychometric properties of the Slovak EAT10®. Results: The internal consistency assessed with Cronbach’s alpha is excellent (α = 0.94). Statistical analysis of the Slovak version of EAT10® showed excellent reliability (0.91, p < 0.001) in the test−retest. Through item-to-total correlation, we found out that all items significantly correlated with the overall score in EAT10®. Factor analysis proved a high construct validity. The EAT10® questionnaire was able to reveal a latent variable: a swallowing disorder, which was affecting a group of patients. The clinical validity results confirmed statistically significant differences in the mean scores of the control and dysphagic groups (z = −10.30; p < 0.001). By dividing the dysphagic group into four subgroups (Head and Neck Cancer, Extraesophageal Reflux, Iatrogenic, and Neurological) there were nonsignificant differences in the mean scores of the subgroups. The cut-off value for the Slovak EAT10® is three points. Conclusion: The Slovak EAT10® is a valid and reliable tool designed for the subjective assessment of oropharyngeal dysphagia in patients.
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Self-perceived dysphagia in non-invasively ventilated COVID-19 patients. Eur Arch Otorhinolaryngol 2022; 279:5929-5937. [PMID: 35947148 PMCID: PMC9363266 DOI: 10.1007/s00405-022-07557-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 07/12/2022] [Indexed: 01/04/2023]
Abstract
PURPOSE COVID-19 is known to present with a wide range of clinical symptoms. COVID-19-related dysphagia has been frequently investigated in patients who were critically ill and mechanically ventilated, but not in those with less severe presentations. This study aims to identify the frequency, characteristics, and severity of self-perceived oropharyngeal dysphagia in non-intubated COVID-19 patients. METHODS In this cross-sectional study, data were collected from patients using a self-administered questionnaire that included the Eating Assessment Tool (EAT-10). RESULTS The study included 359 participants with a median age of 34 (range: 18-65) years. Self-perceived dysphagia (EAT-10 total score > 2) was identified in 64.62%, and their median EAT-10 total score was 13 (range 3-40). The most prevalent symptoms were painful swallowing, affected pleasure of eating, stressful swallowing, and coughing while eating. Age, gender, and hospitalization were not statistically significantly associated with the presence of dysphagia, while re-infection, duration, and severity of COVID-19 diagnosis were. The EAT-10 total score was higher in moderate and severe COVID-19 cases as compared to mild cases, and showed a statistically significant inverse correlation with the duration of COVID-19 (r = - 0.267). CONCLUSION Self-perceived dysphagia was prevalent in non-intubated COVID-19 patients. Its severity was related to that of COVID-19 and its duration.
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Adel SM, Gaafar AH, Fasseeh N, Abdou RM, Hamouda NH. Validation and Cultural Adaptation of an Arabic Version of Pediatric Eating Assessment Tool (Pedi-EAT-10 Arabic). Dysphagia 2022; 37:1440-1450. [PMID: 35018485 PMCID: PMC8752037 DOI: 10.1007/s00455-021-10404-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 12/28/2021] [Indexed: 12/16/2022]
Abstract
Pediatric eating assessment tool (Pedi-EAT-10Arabic) is a validated and reliable caregiver administered outcome instrument designed for detection of children at high risk of penetration/aspiration. The objective of this study is to translate and validate the Arabic version of Pedi-EAT-10 and to correlate its results with pharyngeal residue and aspiration on fiber optic endoscopic examination of swallowing (FEES). A cross-sectional study including 202 children selected randomly from those attending the swallowing clinic in phoniatrics unit, Otorhinolaryngology department (ORL) at main university hospital between February 2019 and October 2020 complaining of dysphagia. For test-retest reliability, one hundred caregivers refilled the Pedi-EAT-10Arabic after a 2-week period following their first visit. Validity was established by comparing the scores of dysphagia patients to healthy controls. Internal consistency of Pedi-EAT-10Arabic was high (Cronbach's alpha 0.986). Intra class correlation showed excellent test-retest reliability (r = 0.968). The median Pedi-EAT 10Arabic score was significantly higher in dysphagia group compared to healthy controls. (Median 27 IQR 21-34 for cases compared to median zero IQR 0-2 points for healthy controls, P less than 0.001). A strong correlation was found between Pedi-EAT 10Arabic scores and PAS scores with Spearman's correlation coefficient r = 0.803 and P < 0.001. The ROC for evaluating the discriminatory capacity of Pedi-EAT 10 for aspiration showed an AUC of 0.92 (95% CI of 0.89 to 0.96). Conclusion: Pedi-EAT 10Arabic was found to be a valid and reliable screening tool for further instrumental assessment of risk of dysphagia in pediatric population.
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Affiliation(s)
- Sally M. Adel
- Phoniatrics Unit, Oto-Rhino-Laryngology Department, Faculty of Medicine, Alexandria University, Champollion Street, Alexandria Main University Hospital, El Sultan Hussein, Egypt
| | - Alaa H. Gaafar
- Otorhinolaryngology Department, Faculty of Medicine, Alexandria University, Alexandria Main University Hospital, Champollion Street, El Sultan Hussein, Egypt
| | - Nader Fasseeh
- Respiratory and Allergy Unit, Pediatrics Department, Faculty of Medicine, Alexandria University, Champollion Street, Alexandria Main University Hospital, El Sultan Hussein, Egypt
| | - Rania M. Abdou
- Phoniatrics Unit, Oto-Rhino-Laryngology Department, Faculty of Medicine, Alexandria University, Champollion Street, Alexandria Main University Hospital, El Sultan Hussein, Egypt
| | - Nesrine Hazem Hamouda
- Phoniatrics Unit, Oto-Rhino-Laryngology Department, Faculty of Medicine, Alexandria University, Champollion Street, Alexandria Main University Hospital, El Sultan Hussein, Egypt
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Järvenpää P, Kuuskoski J, Pietarinen P, Markkanen-Leppänen M, Freiberg H, Ruuskanen M, Rekola J, Ilmarinen T, Kinnari TJ, Autio TJ, Penttilä E, Muttilainen MS, Laaksonen A, Oksanen L, Geneid A, Aaltonen LM. Finnish Version of the Eating Assessment Tool (F-EAT-10): A Valid and Reliable Patient-reported Outcome Measure for Dysphagia Evaluation. Dysphagia 2021; 37:995-1007. [PMID: 34518933 PMCID: PMC9345834 DOI: 10.1007/s00455-021-10362-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/30/2021] [Indexed: 12/25/2022]
Abstract
Our aim was to validate a Finnish version of the Eating Assessment Tool (F-EAT-10) for clinical use and to test its reliability and validity in a multicenter nationwide study. Normative data were acquired from 180 non-dysphagic participants (median age 57.0 years, 62.2% female). Dysphagia patients (n = 117, median age 69.7 years, 53.0% female) referred to fiberoptic endoscopic evaluation of swallowing (FEES) completed F-EAT-10 before the examination and after 2 weeks. Patients underwent the 100-ml water swallow test (WST) and FEES was evaluated using the following three scales: the Yale Pharyngeal Residue Severity Rating Scale, Penetration-Aspiration Scale, and the Dysphagia Outcome Severity Scale. An operative cohort of 19 patients (median age 75.8 years, 57.9% female) underwent an endoscopic operation on Zenker's diverticulum, tight cricopharyngeal muscle diagnosed in videofluorography, or both. Patients completed the F-EAT-10 preoperatively and 3 months postoperatively. The cut-off score for controls was < 3 (sensitivity 94.0%, specificity 96.1%) suggesting that ≥ 3 is abnormal. Re-questionnaires for test-retest reliability analysis were available from 92 FEES patients and 123 controls. The intraclass correlation coefficient was excellent for the total F-EAT-10 score (0.93, 95% confidence interval 0.91-0.95). Pearson correlation coefficients were strong (p < 0.001) for each of the questions and the total score. Internal consistency as assessed by Cronbach's alpha was excellent (0.95). Some correlations between findings in FEES and 100-ml WST with F-EAT-10 were observed. The change in subjective symptoms of operative patients paralleled the change in F-EAT-10. F-EAT-10 is a reliable, valid, and symptom-specific patient-reported outcome measure for assessing dysphagia among Finnish speakers.
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Affiliation(s)
- Pia Järvenpää
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland.
| | - Jonna Kuuskoski
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Petra Pietarinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland
| | - Mari Markkanen-Leppänen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland
| | - Hanna Freiberg
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Miia Ruuskanen
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Jami Rekola
- Department of Otorhinolaryngology - Head and Neck Surgery, Turku University Hospital and University of Turku, Turku, Finland
| | - Taru Ilmarinen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland
| | - Teemu J Kinnari
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland
| | - Timo J Autio
- Department of Otorhinolaryngology - Head and Neck Surgery, Oulu University Hospital, Oulu, Finland.,PEDEGO Research Unit, University of Oulu, Oulu, Finland.,Medical Research Center Oulu, Oulu, Finland
| | - Elina Penttilä
- Department of Otorhinolaryngology - Head and Neck Surgery, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - Marika S Muttilainen
- Department of Rehabilitation and Psychosocial Support, Tampere University Hospital and Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Annika Laaksonen
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University, Hospital and University of Helsinki, Helsinki, Finland
| | - Lotta Oksanen
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University, Hospital and University of Helsinki, Helsinki, Finland
| | - Ahmed Geneid
- Department of Otorhinolaryngology and Phoniatrics - Head and Neck Surgery, Helsinki University, Hospital and University of Helsinki, Helsinki, Finland
| | - Leena-Maija Aaltonen
- Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, P.O. Box 263, FI-00029, Finland
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Yang L, Zhang Z, Gao H, Wu Y, Wei H, Kong J, Wang R, Cheng J, Tian J. Cultural Adaptation and Validation of Questionnaires for Evaluation of Health-Related Quality of Life with Dysphagia in Different Countries: A Systematic Review. Dysphagia 2021; 37:812-823. [PMID: 34181064 DOI: 10.1007/s00455-021-10330-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 06/09/2021] [Indexed: 11/26/2022]
Abstract
Dysphagia can have devastating and long-lasting effects on the patient's health-related quality of life (HRQoL). In recent years, a number of questionnaires for the evaluation of the HRQoL of patients with dysphagia have been developed and have been adapted for use in different countries and cultures. However, problems may arise in the process of cultural adaptation and validation, which can affect the quality of the questionnaires and their measurements. This study was conducted to systematically summarize the cultural adaptation and validation of questionnaires for the evaluation of dysphagia-related HRQoL in different countries, assessing the varieties, measurement properties, and qualities of these questionnaires, with the aim of identifying the status of their adaptation and validation and ways in which they might be improved. Four databases were searched, and relevant articles were screened, with data from eligible reports extracted and reviewed. The methodological quality of the included articles was evaluated using the QualSyst critical appraisal tool. The HRQoL questionnaires for patients with dysphagia were assessed using the quality criteria for the measurement properties of health status questionnaires proposed by Terwee et al. and Timmerman et al. 29 studies published between 2008 and 2020 were included. The questionnaires described in these 29 studies were translated into 19 languages and culturally adapted to 21 countries. The adapted questionnaires were based on the Swallowing quality of life questionnaire (SWAL-QOL) by Mchorney et al., the Dysphagia Handicap Index (DHI) by Silbergleit et al., the M.D. Anderson Dysphagia Inventory (MDADI) by Chen et al., and the Eating Assessment Tool-10 (EAT-10) by Belafsky et al. It was found that the questionnaires were reliable and valid instruments for the assessment of dysphagia-related HRQoL, but the quality criteria for cultural adaptation and validation were not strictly followed, especially in the categories of criterion validity, agreement, responsiveness, and interpretability. In conclusion, although the questionnaires were found to be both reliable and valid, the quality criteria should be considered and strictly followed in the cultural adaptation and validation process in the future.
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Affiliation(s)
- Lin Yang
- The First Hospital of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Zhigang Zhang
- The First Hospital of Lanzhou University, Lanzhou, China.
- School of Nursing, Lanzhou University, Lanzhou, China.
| | - Huiya Gao
- The First Hospital of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Yuchen Wu
- The First Hospital of Lanzhou University, Lanzhou, China
| | - Huaping Wei
- The First Hospital of Lanzhou University, Lanzhou, China
| | - Jiajia Kong
- The First Hospital of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Rui Wang
- The First Hospital of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Jie Cheng
- The First Hospital of Lanzhou University, Lanzhou, China
- School of Nursing, Lanzhou University, Lanzhou, China
| | - Jinhui Tian
- Evidence-Based Medicine Center, Lanzhou University, Lanzhou, China
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Schlickewei O, Nienstedt JC, Frank U, Fründt O, Pötter-Nerger M, Gerloff C, Buhmann C, Müller F, Lezius S, Koseki JC, Pflug C. The ability of the eating assessment tool-10 to detect penetration and aspiration in Parkinson's disease. Eur Arch Otorhinolaryngol 2020; 278:1661-1668. [PMID: 32978686 DOI: 10.1007/s00405-020-06377-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/13/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Dysphagia is common in patients with Parkinson's disease (PD) and often leads to pneumonia, malnutrition, and reduced quality of life. This study investigates the ability of the Eating Assessment Tool-10 (EAT-10), an established, easy self-administered screening tool, to detect aspiration in PD patients. This study aims to validate the ability of the EAT-10 to detect FEES-proven aspiration in patients with PD. METHODS In a controlled prospective cross-sectional study, a total of 50 PD patients completed the EAT-10 and, subsequently, were examined by Flexible Endoscopic Evaluation of Swallowing (FEES) to determine the swallowing status. The results were rated through the Penetration-Aspiration Scale (PAS) and data were analyzed retrospectively. RESULTS PAS and EAT-10 did not correlate significantly. Selected items of the EAT-10 could not predict aspiration or residues. 19 (38%) out of 50 patients with either penetration or aspiration were not detected by the EAT-10. The diagnostic accuracy was established at only a sufficient level (AUC 0.65). An optimal cut-off value of ≥ 6 presented a sensitivity of 58% and specificity of 82%. CONCLUSIONS The EAT-10 is not suited for the detection of penetration and aspiration in PD patients. Therefore, it cannot be used as a screening method in this patient population. There is still a need for a valid, simple, and efficient screening tool to assist physicians in their daily diagnostics and to avoid clinical complications.
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Affiliation(s)
- Ole Schlickewei
- Department of Voice, Speech and Hearing Disorders, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Julie Cläre Nienstedt
- Department of Voice, Speech and Hearing Disorders, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
| | - Ulrike Frank
- Department of Linguistics, Swallowing Research Lab, University of Potsdam, Potsdam, Germany
| | - Odette Fründt
- Department of Neurology, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Monika Pötter-Nerger
- Department of Neurology, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Christian Gerloff
- Department of Neurology, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Carsten Buhmann
- Department of Neurology, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Frank Müller
- Department of Voice, Speech and Hearing Disorders, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Susanne Lezius
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - Jana-Christiane Koseki
- Department of Voice, Speech and Hearing Disorders, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Christina Pflug
- Department of Voice, Speech and Hearing Disorders, Center for Clinical Neurosciences, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
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Self-reported Swallowing and Nutrition Status in Community-Living Older Adults. Dysphagia 2020; 36:198-206. [PMID: 32385694 DOI: 10.1007/s00455-020-10125-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/29/2020] [Indexed: 10/24/2022]
Abstract
More New Zealanders are forecast to grow older in the community, ranging in levels of abilities and needs. Many health conditions can affect swallowing function or nutrition status in older age. However, older adults may not be aware of risk factors and when to seek help. A nationwide survey was conducted of self-reported swallowing ability and nutrition status in community-living New Zealanders aged 65 years and older to assess whether undisclosed swallowing and nutrition problems exist. Respondents completed an amalgamated questionnaire including two validated screening tools: Eating Assessment Tool (EAT-10) and Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN-II). A convenience sample of 1020 adults aged 65-96 years old was obtained. Mean EAT-10 score was 2.15 (SD = 4.3); 22.1% scored above the normative score (3 or more). Mean SCREEN-II score was 48.50 (SD = 6.5); 46.9% scored below normal (< 50 for adults under 85 years old, < 49 for adults over 84 years old). EAT-10 scores significantly correlated with SCREEN-II scores (p < 0.001). Scores did not correlate with age or differ between age groups. Significantly more respondents with medical history associated with dysphagia disclosed swallowing and nutrition problems (p < 0.001). This data suggest increased prevalence of swallowing difficulties in older age is attributed to health conditions and medications, rather than ageing itself. Swallowing complaints from community-living older adults should not be ignored or attributed to the normal ageing process. This study supports routine nutrition screening in older adults.
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Batista AO, Nascimento WV, Cassiani RA, Silva ACV, Alves LMT, Alves DC, Dantas RO. Prevalence of non-obstructive dysphagia in patients with heartburn and regurgitation. Clinics (Sao Paulo) 2020; 75:e1556. [PMID: 31994617 PMCID: PMC6970278 DOI: 10.6061/clinics/2020/e1556] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 12/09/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Heartburn and regurgitation are the most common gastroesophageal reflux symptoms, and dysphagia could be a possible symptom. This investigation aimed to evaluate the prevalence of non-obstructive dysphagia in patients with heartburn and regurgitation. METHODS A total of 147 patients (age, 20-70 years; women, 72%) complaining of heartburn and regurgitation, without esophageal stricture, previous esophageal surgery, or other diseases, were evaluated. Twenty-seven patients had esophagitis. The Eating Assessment Tool (EAT-10) was employed to screen for dysphagia; EAT-10 is composed of 10 items, and the patients rate each item from 0 to 4 (0, no problems; 4, most severe symptom). Results of the 147 patients were compared with those of 417 healthy volunteers (women, 62%; control group) aged 20-68 years. RESULTS In the control group, only two (0.5%) had an EAT-10 score ≥5, which was chosen as the threshold to define dysphagia. EAT-10 scores ≥5 were found in 71 (48.3%) patients and in 55% of the patients with esophagitis and 47% of the patients without esophagitis. This finding indicates a relatively higher prevalence of perceived dysphagia in patients with heartburn and regurgitation and in patients with esophagitis. We also found a positive correlation between EAT-10 scores and the severity of gastroesophageal reflux symptoms based on the Velanovich scale. CONCLUSION In patients with heartburn and regurgitation symptoms, the prevalence of dysphagia was at least 48%, and has a positive correlation with the overall symptoms of gastroesophageal reflux.
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Affiliation(s)
| | | | - Rachel Aguiar Cassiani
- Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Ribeirao Preto SP, BR
| | | | | | - Dauana Cássia Alves
- Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo, Ribeirao Preto SP, BR
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Lechien JR, Cavelier G, Thill MP, Huet K, Harmegnies B, Bousard L, Blecic S, Vanderwegen J, Rodriguez A, Dequanter D. Validity and reliability of the French version of Eating Assessment Tool (EAT-10). Eur Arch Otorhinolaryngol 2019; 276:1727-1736. [PMID: 31006058 DOI: 10.1007/s00405-019-05429-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Accepted: 04/11/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To develop a French version of the Eating Assessment Tool (Fr EAT-10) and to assess its internal consistency, reliability and clinical validity. METHODS Fifty-six patients referred in the Swallowing Clinics of CHU Saint-Pierre Hospital (Brussels) and EpiCURA hospital (Ath, Belgium) for dysphagia were enrolled and completed fiberoptic endoscopic evaluation of swallowing and videofluoroscopy. Seventy-three asymptomatic subjects were included in the study. To assess reliability, Fr-EAT-10 was completed twice within a 7-day period. Validity was assessed by comparing Fr-EAT-10 scores with the scores of dysphagia handicap index (DHI) in all individuals. Normative value of EAT-10 was calculated and the receiver operating characteristic (ROC) curve was used to determine the best Fr-EAT-10 threshold associated with aspiration. RESULTS Fifty-two patients completed the study. Cronbach's alpha was 0.95 indicating a high internal consistency. Test-retest reliability was high in the entire cohort (rs = 0.921). The correlation between Fr-EAT-10 total scores and DHI was high (rs = 0.827) indicating a high external validity. Patients had a significant higher score of Fr-EAT-10 than the controls (p < 0.001) exhibiting a high internal validity. The analysis of normative data reported that a score of Fr-EAT-10 > 3 should be considered as abnormal. The correlation between Fr-EAT-10 and the occurrence of aspiration is significant (rs = 0.327, p < 0.05). According to the ROC curve; aspirations need to be highly suspected for patients with Fr-EAT-10 ≥ 17. CONCLUSION The Fr-EAT-10 developed in this study is a reliable and valid self-administered tool in the evaluation of dysphagia in French-speaking patients.
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Affiliation(s)
- Jérôme R Lechien
- Research Committee of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.
- Laboratory of Human Anatomy and Experimental Oncology, School of Medicine, Research Institute for Health Sciences and Technology, University of Mons (UMons), Avenue du Champ de mars, 6, 7000, Mons, Belgium.
- Department of Otolaryngology-Head & Neck Surgery, CHU Saint-Pierre (CHU de Bruxelles), Université Libre de Bruxelles, Brussels, Belgium.
| | - Gaëtan Cavelier
- Department of Otolaryngology-Head & Neck Surgery, CHU Saint-Pierre (CHU de Bruxelles), Université Libre de Bruxelles, Brussels, Belgium
| | - Marie-Paule Thill
- Department of Otolaryngology-Head & Neck Surgery, CHU Saint-Pierre (CHU de Bruxelles), Université Libre de Bruxelles, Brussels, Belgium
| | - Kathy Huet
- Laboratory of Phonetics, Psychology School, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Bernard Harmegnies
- Laboratory of Phonetics, Psychology School, Research Institute for Language Sciences and Technology, University of Mons (UMons), Mons, Belgium
| | - Laura Bousard
- Department of Neurology, EpiCURA Hospital, Baudour, Belgium
| | - Serge Blecic
- Department of Neurology, EpiCURA Hospital, Baudour, Belgium
| | - Jan Vanderwegen
- Department of Otolaryngology-Head & Neck Surgery, CHU Saint-Pierre (CHU de Bruxelles), Université Libre de Bruxelles, Brussels, Belgium
| | - Alexandra Rodriguez
- Department of Otolaryngology-Head & Neck Surgery, CHU Saint-Pierre (CHU de Bruxelles), Université Libre de Bruxelles, Brussels, Belgium
| | - Didier Dequanter
- Department of Otolaryngology-Head & Neck Surgery, CHU Saint-Pierre (CHU de Bruxelles), Université Libre de Bruxelles, Brussels, Belgium
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Shapira-Galitz Y, Yousovich R, Halperin D, Wolf M, Lahav Y, Drendel M. Does the Hebrew Eating Assessment Tool-10 Correlate with Pharyngeal Residue, Penetration and Aspiration on Fiberoptic Endoscopic Examination of Swallowing? Dysphagia 2019; 34:372-381. [DOI: 10.1007/s00455-018-9964-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 11/14/2018] [Indexed: 12/12/2022]
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Zakaria DA, Bekhet MM, Khodeir MS, Bassiouny SS, Saleh MM. Oropharyngeal Dysphagia and Diabetes Mellitus: Screening of 200 Type 1 and Type 2 Patients in Cairo, Egypt. Folia Phoniatr Logop 2018; 70:134-137. [PMID: 30089310 DOI: 10.1159/000491079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 06/19/2018] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Although diabetes mellitus is a well-researched systemic endocrinal disease, literature is scarce addressing the co-occurrence of oropharyngeal dysphagia with diabetes. OBJECTIVE The aim of this work was to screen Egyptian diabetic patients for symptoms suggestive of oropharyngeal dysphagia using the validated Arabic version of the Eating Assessment Tool (A-EAT-10). PARTICIPANTS AND METHODS 200 Egyptian adult diabetic patients, aged from 18 to 59 years participated in the study. The inclusion criteria were being diabetic patients of type 1 or type 2. Patients were asked to complete the A-EAT-10 questionnaire. RESULTS Age progression and being female were found to be risk factors for dysphagia among diabetic patients participating in this study. The most common symptom among diabetic patients who complained of dysphagia was "I cough when I eat." CONCLUSION The present study suggests the presence of oropharyngeal swallowing problems among patients with diabetes mellitus.
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Affiliation(s)
- Donia Ayman Zakaria
- Unit of Phoniatrics, Department of Otolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Meram M Bekhet
- Endocrinology and Diabetes Mellitus Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mona S Khodeir
- Unit of Phoniatrics, Department of Otolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Samia S Bassiouny
- Unit of Phoniatrics, Department of Otolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Marwa M Saleh
- Unit of Phoniatrics, Department of Otolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Printza A, Kyrgidis A, Pavlidou E, Triaridis S, Constantinidis J. Reliability and validity of the Eating Assessment Tool-10 (Greek adaptation) in neurogenic and head and neck cancer-related oropharyngeal dysphagia. Eur Arch Otorhinolaryngol 2018; 275:1861-1868. [PMID: 29770876 DOI: 10.1007/s00405-018-5001-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/14/2018] [Indexed: 12/27/2022]
Abstract
PURPOSE Dysphagia is a symptom associated with significant morbidity and mortality, with profound impact on physical ability and quality of life. Many questionnaires have been used to assess patient-reported dysphagia, but issues related to developmental and measurement properties affect their wide applicability. The purpose of this study was to assess the validity and reliability of the Eating Assessment Tool-10 (EAT-10, Greek adaptation) in neurogenic and head and neck cancer-related dysphagia. METHODS The study consisted of: item generation in the Greek language, internal consistency and reliability analysis, normative data generation, and validity analysis. Data were collected prospectively from 421 participants: 144 asymptomatic subjects, 146 patients with dysphagia, and 131 patients with dysphagia-related diagnoses. Validity was assessed by comparing scores of healthy and dysphagic participants, by comparing pre- and post-treatment scores, and by correlating the Greek-EAT-10 with fibreoptic endoscopic evaluation of swallowing (FEES). RESULTS The mean participants' age was 52.85 years (ranging from 18 to 85 years). All questionnaires were completed in less than 3 min. The overall internal consistency (assessed with Cronbach's alpha) was 0.963. The test-retest reliability was excellent with Spearman's rho ranging from 0.937 to 1. Dysphagic patients had a significantly higher score compared to healthy participants (p < 0.001). The mean EAT-10 improved significantly after treatment (Wilcoxon signed rank, p < 0.001). The Greek-EAT-10 and FEES scores were significantly correlated (Spearman's rho = 0.69). CONCLUSIONS The EAT-10 is a valid, reliable, symptom-specific tool for the assessment of dysphagia, easily self-administered, and practical for clinical use.
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Affiliation(s)
- Athanasia Printza
- 1st Otolaryngology Department, Medical Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
| | - Athanasios Kyrgidis
- 1st Otolaryngology Department, Medical Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Elena Pavlidou
- 1st Otolaryngology Department, Medical Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Stefanos Triaridis
- 1st Otolaryngology Department, Medical Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Jannis Constantinidis
- 1st Otolaryngology Department, Medical Department, School of Health Sciences, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
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Abu-Ghanem S, Schechter M, Flesh-Eyni H, Litwin L, Makai E, Oestreicher-Kedem Y, Yehuda M. Validation of the Hebrew Version of the Eating Assessment Tool-10 (H-EAT-10). Folia Phoniatr Logop 2017; 68:261-267. [PMID: 29232666 DOI: 10.1159/000484557] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 10/23/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Dysphagia is a common disability with different etiologies. In order to measure dysphagia symptom severity and effects on quality of life, the Eating Assessment Tool (EAT-10) was developed and validated in the English language. We aimed to develop a Hebrew version of the EAT-10 and to evaluate its internal consistency, test-retest reliability, and validity in Hebrew-speaking adults with dysphagia. SUBJECTS AND METHODS The Hebrew EAT-10 (H-EAT-10) questionnaire was completed by 132 patients: 56 patients with dysphagia and 76 controls. Internal consistency analysis was calculated using Cronbach α, and test-retest reliability was calculated using intraclass correlation coefficient in order to assess clinical validity. RESULTS Internal consistency and test-retest reliability were found to be high in the H-EAT-10 (Cronbach α = 0.955 and intraclass correla tion = 0.98). In addition, H-EAT-10 scores in the dysphagia group were found to be significantly higher than those in the control group (p < 0.001). CONCLUSION This study demonstrated that H-EAT-10 is a reliable and valid tool that may be implemented for clinical practice and research on dysphagia in a Hebrew-speaking population.
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Wilmskoetter J, Bonilha H, Hong I, Hazelwood RJ, Martin-Harris B, Velozo C. Construct validity of the Eating Assessment Tool (EAT-10). Disabil Rehabil 2017; 41:549-559. [PMID: 29117726 DOI: 10.1080/09638288.2017.1398787] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
PURPOSE We aimed to evaluate the construct validity of the Eating Assessment Tool (EAT-10) by determining its dimensionality, rating scale integrity, item-person match, precision and relationship with the degree of airway invasion and functional oral intake. METHODS We conducted a retrospective analysis of patients' EAT-10 scores. We used the Rasch rating scale model. We investigated correlations between the EAT-10 and scores on the Penetration-Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS). RESULTS The median score of the EAT-10 from 127 patients was 16 of 40 (range 0-40). Confirmatory factor analysis supported unidimensionality. The 5-point rating scale categories met published criteria. Two items misfit the Rasch model and two other items displayed differential item functioning. Rasch person reliability was 0.79. Our patient cohort was divided into three person-strata. Correlations between the EAT-10 and the PAS and FOIS were weak to moderate in strength (respectively: r = 0.26, p = 0.0036; r = -0.27, p = 0.0027). CONCLUSIONS Our analyses identified deficits in the construct validity of the EAT-10 suggestive of a need to improve the EAT-10 to support its frequent use in clinical practice and research. Implications for Rehabilitation Swallowing disorders are associated with severe complications, such as pneumonia and malnutrition, and impose both social and psychological burdens on patients. The Eating Assessment Tool is a self-report instrument developed to estimate initial dysphagia severity and monitor change in patient-reported dysphagia symptoms as a response to treatment. This study shows that the Eating Assessment Tool has deficits in its construct validity and a need to improve the instrument to support its frequent use in clinical practice and research.
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Affiliation(s)
- Janina Wilmskoetter
- a Department of Health Sciences and Research , College of Health Professions, Medical University of South Carolina , Charleston , SC , USA
| | - Heather Bonilha
- a Department of Health Sciences and Research , College of Health Professions, Medical University of South Carolina , Charleston , SC , USA.,b Department of Otolaryngology - Head and Neck Surgery , Medical University of South Carolina , Charleston , SC , USA
| | - Ickpyo Hong
- c Department of Occupational Therapy , School of Health Professions, University of Texas Medical Branch , Galveston , TX , USA
| | - R Jordan Hazelwood
- d Department of Communication Sciences and Disorders , Beaver College of Health Sciences, Appalachian State University , Boone , NC , USA
| | - Bonnie Martin-Harris
- e Roxelyn and Richard Pepper Department of Communication Sciences and Disorders , School of Communication, Northwestern University , Evanston , IL , USA
| | - Craig Velozo
- f Division of Occupational Therapy, Department of Health Professions , College of Health Professions, Medical University of South Carolina , Charleston , SC , USA
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Cordier R, Joosten A, Clavé P, Schindler A, Bülow M, Demir N, Arslan SS, Speyer R. Evaluating the Psychometric Properties of the Eating Assessment Tool (EAT-10) Using Rasch Analysis. Dysphagia 2016. [PMID: 27873090 DOI: 10.1007/s00455-016-9754-2.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Early and reliable screening for oropharyngeal dysphagia (OD) symptoms in at-risk populations is important and a crucial first stage in effective OD management. The Eating Assessment Tool (EAT-10) is a commonly utilized screening and outcome measure. To date, studies using classic test theory methodologies report good psychometric properties, but the EAT-10 has not been evaluated using item response theory (e.g., Rasch analysis). The aim of this multisite study was to evaluate the internal consistency and structural validity and conduct a preliminary investigation of the cross-cultural validity of the EAT-10; floor and ceiling effects were also checked. Participants involved 636 patients deemed at risk of OD, from outpatient clinics in Spain, Turkey, Sweden, and Italy. The EAT-10 and videofluoroscopic and/or fiberoptic endoscopic evaluation of swallowing were used to confirm OD diagnosis. Patients with esophageal dysphagia were excluded to ensure a homogenous sample. Rasch analysis was used to investigate person and item fit statistics, response scale, dimensionality of the scale, differential item functioning (DIF), and floor and ceiling effect. The results indicate that the EAT-10 has significant weaknesses in structural validity and internal consistency. There are both item redundancy and lack of easy and difficult items. The thresholds of the rating scale categories were disordered and gender, confirmed OD, and language, and comorbid diagnosis showed DIF on a number of items. DIF analysis of language showed preliminary evidence of problems with cross-cultural validation, and the measure showed a clear floor effect. The authors recommend redevelopment of the EAT-10 using Rasch analysis.
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Affiliation(s)
- R Cordier
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia. .,College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia.
| | - A Joosten
- School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia
| | - P Clavé
- Unitat d'Exploracions Funcionals Digestives, Department of Surgery, Hospital de Mataró, Universitat Autònoma de Barcelona, Mataró, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Barcelona, Spain
| | - A Schindler
- Phoniatric Unit, Department of Biomedical and Clinical Sciences "L. Sacco", Università degli Studi di Milano, Milan, Italy
| | - M Bülow
- Diagnostic Centre of Imaging and Functional Medicine, Malmö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden.,Skane University Hospital Malmö, Malmö, Sweden
| | - N Demir
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - S Serel Arslan
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - R Speyer
- College of Healthcare Sciences, James Cook University, Townsville, QLD, Australia.,Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands
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Evaluating the Psychometric Properties of the Eating Assessment Tool (EAT-10) Using Rasch Analysis. Dysphagia 2016; 32:250-260. [DOI: 10.1007/s00455-016-9754-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 10/18/2016] [Indexed: 12/15/2022]
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