Construct validity of the Eating Assessment Tool (EAT-10).
Janina Wilmskoetter, Heather Bonilha, Ickpyo Hong and 3 others
PMID 29117726WHAT IT FOUND
The EAT-10 mostly reflects one swallowing-symptom pattern and patients use its 0-4 ratings as expected, but two items did not behave as expected and scores correlate only weakly with aspiration and diet findings.
Use it for patient-reported symptoms, not to replace swallow testing.
Key findings
01The EAT-10 largely measured one swallowing-symptom pattern, but two items appeared to measure something different.
02Two items, 'I cough when I eat' and 'My swallowing problem has caused me to lose weight', did not fit the expected response pattern, and two other items behaved differently depending on aspiration or diet status.
03EAT-10 scores had only weak associations with observed aspiration severity and diet restriction.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample had rather mild swallowing problems (median PAS score 2 and median FOIS score 7), so results may not apply to patients with severe dysphagia. Patients had heterogeneous diagnoses, which may have influenced the measurement results. The study was cross-sectional, so it cannot show whether the EAT-10 detects change after treatment. Seven patients had no PAS data and two had no FOIS data for the correlation analyses. Patients who could not complete the EAT-10 independently were assisted by a speech-language pathologist or caregiver, which may have affected responses.
Declared interests
The patient records came from an ongoing NIH-funded study, and all authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that the EAT-10 can identify aspiration risk or diet safety on its own. It correlated only weakly with observed aspiration and oral intake scores, and two items did not fit the measurement pattern.