Reliability and validity of the Eating Assessment Tool-10 (Greek adaptation) in neurogenic and head and neck cancer-related oropharyngeal dysphagia
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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.
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).
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).
The EAT-10 is a valid, reliable, symptom-specific tool for the assessment of dysphagia, easily self-administered, and practical for clinical use.
KeywordsDysphagia Swallowing Self-assessment questionnaire Validity Outcome Quality of life
The authors thank for assistance with data collection Professors Nikolaos Grigoriadis, MD, Multiple Sclerosis Clinic, Evaggelos Pavlou, MD, Neuromuscular Disorders Unit, and Vasilios Liakopoulos, MD, Chronic Kidney Failure Unit. Professor Athanasia Printza, MD, PhD had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Compliance with ethical standards
Conflict of interest
The authors Athanasia Printza, MD, MSc, PhD, Athanasios Kyrgidis, MD, MSc, PhD, Elena Pavlidou, MSc, Stefanos Triaridis, MD, MSc, PhD, and Jannis Constantinidis, MD, PhD, declare that there is no conflict of interest related to this paper.
This study was performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments.
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