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The ability of the eating assessment tool-10 to detect penetration and aspiration in Parkinson’s disease

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A Letter to the Editor to this article was published on 16 February 2021

Abstract

Purpose

Dysphagia is common in patients with Parkinson’s disease (PD) and often leads to pneumonia, malnutrition, and reduced quality of life. This study investigates the ability of the Eating Assessment Tool-10 (EAT-10), an established, easy self-administered screening tool, to detect aspiration in PD patients. This study aims to validate the ability of the EAT-10 to detect FEES-proven aspiration in patients with PD.

Methods

In a controlled prospective cross-sectional study, a total of 50 PD patients completed the EAT-10 and, subsequently, were examined by Flexible Endoscopic Evaluation of Swallowing (FEES) to determine the swallowing status. The results were rated through the Penetration-Aspiration Scale (PAS) and data were analyzed retrospectively.

Results

PAS and EAT-10 did not correlate significantly. Selected items of the EAT-10 could not predict aspiration or residues. 19 (38%) out of 50 patients with either penetration or aspiration were not detected by the EAT-10. The diagnostic accuracy was established at only a sufficient level (AUC 0.65). An optimal cut-off value of ≥ 6 presented a sensitivity of 58% and specificity of 82%.

Conclusions

The EAT-10 is not suited for the detection of penetration and aspiration in PD patients. Therefore, it cannot be used as a screening method in this patient population. There is still a need for a valid, simple, and efficient screening tool to assist physicians in their daily diagnostics and to avoid clinical complications.

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Availability of data and material

The datasets generated during and/ or analyzed during this study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Acknowledgements

We would like to thank Beate Schönwald, Julia Radtke, Almut Nießen, and Till Flügel for the acquisition of data and the department's team for all the assistance they provided.

Funding

No funding.

Author information

Author notes

  1. Ole Schlickewei and Julie Cläre Nienstedt authors have contributed equally to this work.

Authors and Affiliations

  1. Department of Voice, Speech and Hearing Disorders, Center for Clinical Neurosciences, University Medical Center Hamburg‐Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany

    Ole Schlickewei, Julie Cläre Nienstedt, Frank Müller, Jana-Christiane Koseki & Christina Pflug

  2. Department of Linguistics, Swallowing Research Lab, University of Potsdam, Potsdam, Germany

    Ulrike Frank

  3. Department of Neurology, Center for Clinical Neurosciences, University Medical Center Hamburg‐Eppendorf, 20246, Hamburg, Germany

    Odette Fründt, Monika Pötter-Nerger, Christian Gerloff & Carsten Buhmann

  4. Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg‐Eppendorf, 20246, Hamburg, Germany

    Susanne Lezius

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  1. Ole Schlickewei
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Contributions

Ole Schlickewei: Acquisition of data, analysis and interpretation of data, and drafting/revising manuscript, including medical writing for content. Julie Cläre Nienstedt: Study concept and design, acquisition of data, interpretation of data, drafting/revising manuscript, including medical writing for content, and study supervision. Ulrike Frank: Study concept, Acquisition of data, and reading and approving the final manuscript. Odette Fründt: Acquisition of data, and reading and approving the final manuscript. Monika Pötter-Nerger: Revising manuscript, including medical writing for content. Christian Gerloff: Revising manuscript, including medical writing for content. Carsten Buhmann: Acquisition of data and revising manuscript, including medical writing for content. Frank Müller: Analysis of data, statistical analysis, and reading and approving the final manuscript. Susanne Lezius: Analysis of data, statistical analysis, and reading and approving the final manuscript. Jana-Christiane Koseki: Acquisition of data, and reading and approving the final manuscript. Christina Pflug: Study concept and design, acquisition of data, interpretation of data, drafting/revising manuscript, including medical writing for content, and study supervision.

Corresponding author

Correspondence to Julie Cläre Nienstedt.

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The authors have no conflict of interest to report.

Ethical standards

The study was approved by the local ethics committee of the Medical Council Hamburg (trial number PV5089) and has, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Schlickewei, O., Nienstedt, J.C., Frank, U. et al. The ability of the eating assessment tool-10 to detect penetration and aspiration in Parkinson’s disease. Eur Arch Otorhinolaryngol 278, 1661–1668 (2021). https://doi.org/10.1007/s00405-020-06377-x

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