{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:00:27Z","timestamp":1792602027316,"version":"4.5.0"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:00:00Z","timestamp":1683763200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess: (1) the Eating Assessment Tool (EAT\u201010) with item response theory (IRT) to determine which individual items provide the most information, (2) the extent to which dysphagia is measured with subsets of items while maintaining precise score estimates, and (3) if 5\u2010item scales have the differing discriminatory ability, as compared to the parent 10\u2010item instrument.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospectively collected data from 2,339 patients who completed the EAT\u201010 questionnaire during evaluation at a tertiary care otolaryngology clinic were utilized. IRT analyses provided discrimination and location parameters associated with individual questions. Residual item correlations were also assessed for redundant information. Based on these results, three 5\u2010item subsets were further evaluated using item information function curves. Areas under receiver\u2010operator characteristic curves (ROC\u2010AUC) were also calculated to evaluate the discriminatory ability for dysphagia\u2010related clinical diagnoses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Item discrimination parameter estimates ranged from 1.71 to 5.46, with higher values indicating more information. Residual item correlations were determined within item pairs, and location parameters were calculated. Based on these data, in combination with clinical utility, three 5\u2010item subsets were proposed and assessed. ROC\u2010AUC analyses demonstrated no significant difference between the EAT\u20105\u2010Alpha subset and the original 10\u2010item instrument for discriminating dysphagia as a primary diagnosis (0.88, 0.88). The EAT\u20105\u2010Clinical subset outperformed the original 10 instruments in ROC\u2010AUC for aspiration. The EAT\u20105\u2010Range subset was significantly associated with problems with thin liquids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>IRT analyses distinguished three proposed 5\u2010item subsets of the EAT\u201010 instrument, supporting shorter survey options, while still reflecting the impact of dysphagia without significant loss of discrimination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 (Diagnostic testing with consistently applied reference standards, partial blinding). <jats:italic>Laryngoscope<\/jats:italic>, 133:3327\u20133333, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30732","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T11:33:51Z","timestamp":1683804831000},"page":"3327-3333","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Can <scp>EAT<\/scp>\u201010 Become <scp>EAT<\/scp>\u20105? Improving Measurement Efficiency of Dysphagia with Item Response Theory"],"prefix":"10.1002","volume":"133","author":[{"given":"Adaobi","family":"Ahanotu","sequence":"first","affiliation":[{"name":"University of Maryland School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7034-9238","authenticated-orcid":false,"given":"Elliana Kirsh","family":"DeVore","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5666-2482","authenticated-orcid":false,"given":"Thomas L.","family":"Carroll","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Edelen","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Morcos","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Willard","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina W.","family":"Zhao","sequence":"additional","affiliation":[{"name":"University of California  Davis California USA"},{"name":"University Hospitals Cleveland Medical Center  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Belafsky","sequence":"additional","affiliation":[{"name":"University of California  Davis California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9741-8491","authenticated-orcid":false,"given":"Jennifer J.","family":"Shin","sequence":"additional","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"},{"name":"Center for Surgery and Public Health Brigham and Women's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,11]]},"reference":[{"key":"e_1_2_6_2_1","volume-title":"American Speech\u2010Language\u2010Hearing Association","author":"Adult Dysphagia"},{"issue":"2","key":"e_1_2_6_3_1","first-page":"97","article-title":"Dysphagia: evaluation and collaborative management","volume":"103","author":"Wilkinson JM","year":"2021","journal-title":"Am Fam Physician"},{"issue":"2","key":"e_1_2_6_4_1","first-page":"235","article-title":"Multidisciplinary management of dysphagia","volume":"48","author":"Logemann JA","year":"1994","journal-title":"Acta Otorhinolaryngol Belg"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940811701210"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599818760528"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/01945998211018383"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817731759"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.30177"},{"key":"e_1_2_6_10_1","unstructured":"IRTPRO.Mathematical software\u2010swMATH. 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