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

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.

[Translation and validation of the Spanish version of the EAT-10 (Eating Assessment Tool-10) for the screening of dysphagia]

RATIONALE

The Eating Assessment Tool-10 (EAT-10) is a self-administered, analogical, direct-scoring screening tool for dysphagia.

OBJECTIVE

To translate and adapt the EAT-10 into Spanish, and to evaluate its psychometric properties.

METHODS

After the translation and back-translation process of the EAT-10 ES, a prospective study was performed in adult patients with preserved cognitive and functional abilities. Patients in 3 clinical situations, diagnosed with dysphagia (DD), patients at risk of dysphagia (RD), and patients not at risk of dysphagia (SRD) were recruited from 3 settings: a hospital Nutritional Support Unit (USN), a nursing home (RG) and primary care centre (CAP). Patients completed the EAT-10 ES during a single visit. Both patients and researchers completed a specific questionnaire regarding EAT-10 ES' comprehension.

RESULTS

65 patients were included (age 75 ± 9.1 y), 52.3% women. Mean time of administration was 3.8 ± 1.7 minutes. 95.4% of patients considered that all tool items were comprehensible and 72.3% found it easy to assign scores. EAT-10 ES' internal consistency, Cronbach's Alpha coefficient was 0.87. A high correlation was observed between all tool items and global scores (p < 0.001). Mean score for patients in group DD was 15 ± 8.9 points, 6.7 ± 7.7 points in group RD, and 2 ± 3.1 points in group SRD. Male patients, previously diagnosed of dysphagia or patients from the NSU showed significantly higher scores on the EAT-10 ES (p < 0.001).

CONCLUSION

EAT-10 ES has proven to be reliable, valid and to have internal consistency. Is it an easy-to-understand tool that can be completed quickly, making it useful for the screening of dysphagia in routine clinical practice.

[Translation and validation of the Spanish version of the EAT-10 (Eating Assessment Tool-10) for the screening of dysphagia]

RATIONALE

The Eating Assessment Tool-10 (EAT-10) is a self-administered, analogical, direct-scoring screening tool for dysphagia.

OBJECTIVE

To translate and adapt the EAT-10 into Spanish, and to evaluate its psychometric properties.

METHODS

After the translation and back-translation process of the EAT-10 ES, a prospective study was performed in adult patients with preserved cognitive and functional abilities. Patients in 3 clinical situations, diagnosed with dysphagia (DD), patients at risk of dysphagia (RD), and patients not at risk of dysphagia (SRD) were recruited from 3 settings: a hospital Nutritional Support Unit (USN), a nursing home (RG) and primary care centre (CAP). Patients completed the EAT-10 ES during a single visit. Both patients and researchers completed a specific questionnaire regarding EAT-10 ES' comprehension.

RESULTS

65 patients were included (age 75 ± 9.1 y), 52.3% women. Mean time of administration was 3.8 ± 1.7 minutes. 95.4% of patients considered that all tool items were comprehensible and 72.3% found it easy to assign scores. EAT-10 ES' internal consistency, Cronbach's Alpha coefficient was 0.87. A high correlation was observed between all tool items and global scores (p < 0.001). Mean score for patients in group DD was 15 ± 8.9 points, 6.7 ± 7.7 points in group RD, and 2 ± 3.1 points in group SRD. Male patients, previously diagnosed of dysphagia or patients from the NSU showed significantly higher scores on the EAT-10 ES (p < 0.001).

CONCLUSION

EAT-10 ES has proven to be reliable, valid and to have internal consistency. Is it an easy-to-understand tool that can be completed quickly, making it useful for the screening of dysphagia in routine clinical practice.