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Evaluating Behavioural Interventions for Oropharyngeal Dysphagia in Adults: A Systematic Review and Meta-Analysis of Swallowing Manoeuvres, Exercises, and Postural Techniques.

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Evaluating the Psychometric Properties of the Eating Assessment Tool (EAT-10) Using Rasch Analysis.

R Cordier1,2, A Joosten3, P Clavé4,5

  • 1School of Occupational Therapy and Social Work, Curtin University, Perth, WA, Australia. reinie.cordier@curtin.edu.au.

Dysphagia
|November 23, 2016
PubMed
Summary
This summary is machine-generated.

The Eating Assessment Tool (EAT-10) shows significant weaknesses in screening for oropharyngeal dysphagia (OD). Rasch analysis revealed issues with validity, internal consistency, and cross-cultural application, suggesting a need for redevelopment.

Keywords:
Classic test theoryDeglutitionDeglutition disordersItem response theoryMeasurementOropharyngeal dysphagiaReliabilityValidity

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Area of Science:

  • Swallowing Disorders
  • Clinical Measurement
  • Psychometrics

Background:

  • Early screening for oropharyngeal dysphagia (OD) is vital for management.
  • The Eating Assessment Tool (EAT-10) is a common screening tool, but its psychometric properties require further investigation using modern methods.
  • Item response theory (IRT), specifically Rasch analysis, offers a robust framework for evaluating measurement tools.

Purpose of the Study:

  • To evaluate the internal consistency and structural validity of the EAT-10 using Rasch analysis.
  • To conduct a preliminary investigation of the EAT-10's cross-cultural validity across different countries.
  • To assess floor and ceiling effects of the EAT-10 in at-risk populations.

Main Methods:

  • A multisite study involving 636 patients at risk of OD from Spain, Turkey, Sweden, and Italy.
  • Rasch analysis was employed to examine person and item fit, response scale properties, dimensionality, differential item functioning (DIF), and floor/ceiling effects.
  • The EAT-10 was used alongside videofluoroscopic and/or fiberoptic endoscopic evaluation of swallowing for OD diagnosis confirmation.

Main Results:

  • The EAT-10 demonstrated significant weaknesses in structural validity and internal consistency.
  • Analysis revealed item redundancy, a lack of sufficiently easy and difficult items, and disordered rating scale thresholds.
  • Differential item functioning (DIF) was observed for gender, confirmed OD, language, and comorbid diagnosis, indicating potential cross-cultural validation issues and a clear floor effect.

Conclusions:

  • The EAT-10 exhibits significant psychometric limitations that impact its reliability and validity.
  • The observed DIF across language suggests challenges in its cross-cultural application.
  • Redevelopment of the EAT-10, guided by Rasch analysis, is recommended to improve its measurement properties for OD screening.