About the EAT-10
The Eating Assessment Tool (EAT-10) is a brief, patient-reported symptom screen developed by Belafsky and colleagues at UC Davis and published in 2008. It consists of 10 statements about common symptoms and consequences of dysphagia — effortful swallowing of liquids, solids, or pills; coughing with meals; pain on swallowing; social and emotional impact; and weight loss. Each statement is rated on a five-point Likert scale from 0 (no problem) to 4 (severe problem), yielding a total score between 0 and 40.
Interpreting the total
In the original validation study, a total score of 3 or greater distinguished individuals with dysphagia from healthy controls with good sensitivity. Clinically, the EAT-10 is used as a rapid, low-cost screen — a score at or above the cutoff is a signal to pursue a clinical swallow evaluation, and, if indicated, an instrumental assessment such as a videofluoroscopic swallow study or a fiberoptic endoscopic evaluation of swallowing. A score below 3 does not rule out dysphagia — especially in silent aspirators or patients with limited insight into their symptoms — but it does reduce the prior probability and can be documented as part of the clinical reasoning.
Clinical context
The EAT-10 has been used across a wide variety of populations since publication: head and neck cancer survivors, stroke patients, patients with neurodegenerative disease, elective surgery patients undergoing preoperative screening, and older adults in community and long-term care settings. Its brevity (typically completed in under two minutes), strong psychometric properties in the original validation, and availability in many language translations make it one of the most widely adopted self-report dysphagia screens in practice. It is complementary to — not a substitute for — clinician rating scales such as the Functional Oral Intake Scale or the Dysphagia Outcome and Severity Scale, and to instrumental assessment.
Limitations to keep in mind
Because the EAT-10 is self-report, it requires a patient who can read (or hear) the items and reliably rate their own symptoms. It is not appropriate as a stand-alone tool in patients with significant cognitive impairment, limited health literacy without caregiver support, or in children. It also does not capture silent aspiration, in which there are no symptoms the patient perceives. As always, the total is a trigger for clinical reasoning, not a diagnosis.
Primary source: Belafsky PC, Mouadeb DA, Rees CJ, Pryor JC, Postma GN, Allen J, Leonard RJ. Validity and reliability of the Eating Assessment Tool (EAT-10). Annals of Otology, Rhinology, and Laryngology. 2008;117(12):919-924.