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Neurogastroenterol Motil. 2016 Jan;28(1):85-90. doi: 10.1111/nmo.12700. Epub 2015 Oct 28.

Discriminant ability of the Eating Assessment Tool-10 to detect aspiration in individuals with amyotrophic lateral sclerosis.

Author information

1
Neuromotor Speech and Swallowing Restoration Laboratory, University of Florida, Gainesville, FL, USA.
2
Department of Speech, Language and Hearing Sciences, University of Florida, Gainesville, FL, USA.
3
Joy McCann Center for Swallowing Disorders, University of South Florida, Tampa, FL, USA.
4
Department of Policy and Services Research Data Center, University of South Florida, Tampa, FL, USA.
5
Department of Neurology, University of South Florida, Tampa, FL, USA.

Abstract

BACKGROUND:

Oropharyngeal dysphagia is prevalent in individuals with amyotrophic lateral sclerosis (ALS) leading to malnutrition, aspiration pneumonia, and death. These factors necessitate early detection of at-risk patients to prolong maintenance of safe oral intake and pulmonary function. This study aimed to evaluate the discriminant ability of the Eating Assessment Tool (EAT-10) to identify ALS patients with unsafe airway protection during swallowing.

METHODS:

Seventy ALS patients completed the EAT-10 survey and underwent a standardized videofluoroscopic evaluation of swallowing. Two blinded raters determined airway safety using the Penetration Aspiration Scale (PAS). A between groups anova (safe vs penetrators vs aspirators) was conducted and sensitivity, specificity, area under the curve (AUC), and likelihood ratios calculated.

KEY RESULTS:

Mean EAT-10 scores for safe swallowers, penetrators, and aspirators (SEM) were: 4.28 (0.79) vs 7.10 (1.79) vs 20.50 (3.19), respectively, with significant differences noted for aspirators vs safe swallowers and aspirators vs penetrators (p < 0.001). The EAT-10 demonstrated good discriminant ability to accurately identify ALS penetrator/aspirators (PAS ≥3) with a cut off score of 3 (AUC: 0.77, sensitivity: 88%, specificity: 57%). The EAT-10 demonstrated excellent accuracy at identifying aspirators (PAS ≥6) utilizing a cut off score of 8 (AUC: 0.88, sensitivity: 86%, specificity: 72%, likelihood ratio: 3.1, negative predictive value: 95.5%).

CONCLUSIONS & INFERENCES:

The EAT-10 differentiated safe vs unsafe swallowing in ALS patients. This patient self-report scale could represent a quick and meaningful aide to dysphagia screening in busy ALS clinics for the identification and referral of dysphagic patients for further instrumental evaluation.

KEYWORDS:

EAT-10; Eating Assessment Tool; amyotrophic lateral sclerosis; aspiration; dysphagia; screen

PMID:
26510823
PMCID:
PMC4688134
DOI:
10.1111/nmo.12700
[Indexed for MEDLINE]
Free PMC Article

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