Reliability and validity of the Eating Assessment Tool-10 (Greek adaptation) in neurogenic and head and neck cancer-related oropharyngeal dysphagia

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.