Is Dysphagia Under Diagnosed or is Normal Swallowing More Variable than We Think? Reported Swallowing Problems in People Aged 18-65 Years.
Paula Leslie, David G Smithard
PMID 33226473WHAT IT FOUND
Self-reported swallowing problems on the EAT-10 were common in healthy adults aged 18-65, with 17% scoring above the clinical cutoff.
However, many people with high scores reported no difficulties, while others with low scores described significant concerns. The tool often fails to match patient experience.
Key findings
0117% of the total sample scored 3 or higher on the EAT-10, which is the standard cutoff for identifying a swallowing problem.
02There was a disconnect between test scores and patient reports: some people with scores below the cutoff expressed considerable concern about their swallowing, while others with scores above the cutoff stated they had no swallowing problems.
03The authors note that recent work shows the psychometric properties of the EAT-10 are poor, limiting its reliability as a standalone diagnostic tool.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study relied on self-reported data and an online survey, which introduces volunteer bias and limits the sample to those with internet access. The EAT-10 has poor psychometric properties according to recent literature, which may affect the validity of the 'pathological' cutoff. There was no clinical verification of swallowing function (e.g., videofluoroscopy) for participants, so it is unclear which self-reported problems were genuine oropharyngeal dysphagia. The sample was geographically skewed towards North America, Europe, and Australasia, potentially limiting generalizability to other cultures.
Declared interests
The study was funded by the University of Greenwich. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that a score of 3 or higher on the EAT-10 in a healthy adult confirms a physiological swallowing disorder. The study found that many individuals with high scores reported no swallowing problems, while some with low scores described significant symptoms. The tool captures subjective concern, not necessarily clinical pathology.