Skip to main content
SpringerLink
Log in

Relationship Between the Eating Assessment Tool-10 and Objective Clinical Ratings of Swallowing Function in Individuals with Head and Neck Cancer

  • Original Article
  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

The Eating Assessment Tool-10 (EAT-10) represents a validated, easy to administer patient report dysphagia severity scale. Although its ability to detect swallowing impairment has been investigated in other patient populations, the utility of this instrument in individuals with head and neck cancer (HNC) has not been studied. The aim of the current investigation was to determine the relationship between patient ratings of swallowing impairment (EAT-10) and objective clinical ratings of swallow physiology in individuals with HNC. Forty-four HNC participants completed the EAT-10 and a standardized videofluoroscopy swallow study. Blinded raters determined airway safety using the penetration–aspiration scale (PAS) and swallowing function using the modified barium swallow impairment profile (MBSImP™©). Participants were stratified into three groups (pre-treatment through 1 year post-treatment, 1–5 years post-treatment, and >5 years post-treatment). Independent t tests, Pearson’s and Spearman’s Rho correlations, and a Bonferroni correction for multiple comparisons were performed. EAT-10 scores were significantly higher in HNC patients with unsafe swallowing (M 24.45, SD 8.32) compared to those with safe swallowing (M 16.20, SD 12.14), t(21) = −2.36, p  < 0.04. Significant correlations were revealed between EAT-10 scores and the MBSImP™© (pharyngeal composite), and PAS scores (p < 0.05) for the pre-treatment to within 1 year post-treatment group. No associations, however, were observed for HNC patients in the time groups representing greater than 1-year post cancer treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Murphy BA, Gilbert J. Dysphagia in head and neck cancer patients treated with radiation: assessment, sequelae, and rehabilitation. Semin In Radiat Oncol. 2009;19(1):35–42. doi:10.1016/j.semradonc.2008.09.

    Article  Google Scholar 

  2. Arrese LC, Lazarus CL. Special groups: head and neck cancer. Otolaryngol Clin N Am. 2013;46(6):1123–36.

    Article  Google Scholar 

  3. Stenson KM, MacCracken E, List M, Haraf DJ, Brockstein B, Weichselbaum R, Vokes EE. Swallowing function in patients with head and neck cancer prior to treatment. Arch Otolaryngol-Head Neck Surg. 2000;126(3):371–7.

    Article  CAS  PubMed  Google Scholar 

  4. Huchenson KA, Lewin JS, Holsinger FC, et al. Long-term functional survival outcomes after induction chemotherapy and risk-based definitve therapy for locally advanced squamous cell carcinoma of the head and neck. Head Neck. 2014;36(4):474–80.

    Article  Google Scholar 

  5. Caudell JJ, Schaner PE, Meredith RF, et al. Factors associated with long-term dysphagia after definitive radiotherapy for locally advanced head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2009;73(2):410–5.

    Article  PubMed  Google Scholar 

  6. Francis DO, Weymuller EA Jr, Parvathaneni U, Merati AL, Yueh B. Dysphagia, stricture, and pneumonia in head and neck cancer patients: does treatment modality matter? Ann Otol Rhinol Laryngol. 2010;119(6):391–7.

    PubMed  Google Scholar 

  7. Deschler DG, Richmon JD, Khariwala SS, Ferris RL, Wang MB. The “New” head and neck cancer patient-young, nonsmoker, nondrinker, and HPV positive: evaluation. Otolaryngol – Head Neck Surg. 2014;151(3):375–80.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Chaturvedi AK, Engels EA, Anderson WF, Gillison ML. Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol. 2008;26(4):612–9. doi:10.1200/JCO.2007.14.1713.

    Article  PubMed  Google Scholar 

  9. Fakhry C, Westra WH, Li S, Cmelak A, Ridge JA, Pinto H, Forastiere A, Gillison ML. Improved survival of patients with human papillomavirus-positive head and neck squamous cell carcinoma in a prospective clinical trial. J Natl Cancer Inst. 2008;100(4):261–9. doi:10.1093/jnci/djn011.

    Article  CAS  PubMed  Google Scholar 

  10. Kendall KA, Kosek SR, Tanner K. Quality-of-life scores compared to objective measures of swallowing after oropharyngeal chemoradiation. Laryngoscope. 2014;124(3):682–7. doi:10.1002/lary.24344.

    Article  PubMed  Google Scholar 

  11. Pauloski BR, Rademaker AW, Logemann JA, Lazarus CL, Newman L, Hamner A, MacCracken E, Gaziano J, Stachowiak L. Swallow function and perception of dysphagia in patients with head and neck cancer. Head Neck. 2002;24(6):555–65. doi:10.1002/hed.10092.

    Article  PubMed  Google Scholar 

  12. Rogus-Pulia NM, Pierce MC, Mittal BB, Zecker SG, Logemann JA. Changes in swallowing physiology and patient perception of swallowing function following chemoradiation for head and neck cancer. Dysphagia. 2014;29(2):223–33. doi:10.1007/s00455-013-9500-y.

    Article  PubMed  Google Scholar 

  13. Chen AY, Frankowski R, Bishop-Leone J, Herbert T, Leyk S, Lewin J, Goepfert H. The development and validation of a dysphagia-specific quality-of-life questionnaire for patients with head and neck cancer: the M.D. Anderson dysphagia inventory. Arch Otolaryngol Head Neck Surg. 2001;127:870–6.

    CAS  PubMed  Google Scholar 

  14. Weymuller EA, Alsarrag R, Yueh B, Deleyiannis FWB, Coltrera MD. Analysis of the performance characteristics of the university of Washington quality of life instrument and its modification (UW-QOL-R). Arch Otolaryngol Head Neck Surg. 2001;127:489–93.

    Article  PubMed  Google Scholar 

  15. Hutcheson KA, Barrow MP, Lisec A, Barringer DA, Gries K, Lewin JS. What is a clinically relevant difference in MDADI scores between groups of head and neck cancer patients? Laryngoscope. 2016;126(5):1108–12.

    Article  PubMed  Google Scholar 

  16. Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and reliability of the eating assessment tool (EAT-10). Ann Otol Rhinol Laryngol. 2008;117(12):919–24.

    Article  PubMed  Google Scholar 

  17. Cheney DM, Siddiqui MT, Litts JK, Kuhn MA, Belafsky PC. The ability of the 10-item eating assessment tool (EAT-10) to predict aspiration risk in persons with dysphagia. Ann Otol Rhinol Laryngol. 2015;124(5):351–4.

    Article  PubMed  Google Scholar 

  18. Rofes L, Arreola V, Mukherjee R, Clavé P. Sensitivity and specificity of the eating assessment tool and the volume-viscosity swallow test for clinical evaluation of oropharyngeal dysphagia. Neurogastroenterol Motil. 2014;26(9):1256–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Plowman EK, Tabor LC, Robison R, Gaziano J, Dion C, Watts SA, Vu T, Gooch C. Discriminant ability of the eating assessment tool-10 to detect aspiration in individuals with amyotrophic lateral sclerosis. Neurogastroenterol Motil. 2015;28(1):85–90.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Logemann J. A manual for videofluoroscopic swallow studies. 2nd ed. Austin: Pro-Ed; 1993.

    Google Scholar 

  21. Rosenbek JC, Robbins JA, Roecker EB, Coyle JL, Wood JL. A penetration-aspiration scale. Dysphagia. 1996;11(2):93–8.

    Article  CAS  PubMed  Google Scholar 

  22. Martin-Harris B, Brodsky MB, Michel Y, Castell DO, Schleicher M, Sandidge J, Maxwell R, Blair J. MBS measurement tool for swallow impairment–MBSImp: establishing a standard. Dysphagia. 2008;23(4):392–405. doi:10.1007/s00455-008-9185-9.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Logemann JA, Pauloski BR, Rademaker AW, Lazarus CL, Gaziano J, Stachowiak L, Newman L, MacCracken E, Santa D, Mittal B. Swallowing disorders in the first year after radiation and chemoradiation. Head Neck. 2008;30(2):148–58.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Hutcheson KA, Yuk MM, Holsinger FC, Gunn GB, Lewin JS. Late radiation-associated dysphagia with lower cranial neuropathy in long-term oropharyngeal cancer survivors: video case reports. Head Neck. 2015;37(4):56–62.

    Article  Google Scholar 

  25. Portney LG, Watkins MP. Foundations of clinical research: applications to practice. 2nd ed. Upper Saddle River, NJ: Prentice Hall Health; 2000.

    Google Scholar 

Download references

Acknowledgments

The authors would like to thank Meredith Hunt, MA, CCC-SLP and Jennifer Graham, MS, CCC-SLP for their assistance with data collection.

Author information

Authors and Affiliations

  1. Department of Otolaryngology – Head and Neck Surgery, The Ohio State University Wexner Medical Center, 460 W. 10th Ave, Columbus, OH, 43210, USA

    Loni C. Arrese & Ricardo Carrau

  2. Department of Speech, Language and Hearing Sciences, Neuromotor Speech and Swallowing Restoration Laboratory, University of Florida, 1225 Center Drive, Room 2141, Gainesville, FL, 32610, USA

    Emily K. Plowman

Authors
  1. Loni C. Arrese
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ricardo Carrau
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Emily K. Plowman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Loni C. Arrese.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arrese, L.C., Carrau, R. & Plowman, E.K. Relationship Between the Eating Assessment Tool-10 and Objective Clinical Ratings of Swallowing Function in Individuals with Head and Neck Cancer. Dysphagia 32, 83–89 (2017). https://doi.org/10.1007/s00455-016-9741-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00455-016-9741-7

Keywords

Search

Navigation