Cross-cultural adaptation and psychometric validation of the EAT-10pe in Peruvian adults

ABSTRACT

Purpose:  to validate the Peruvian version of the Eating Assessment Tool-10 (EAT-10pe) for assessing self-perceived dysphagia in Peruvian adults. This included translation, cultural adaptation, and evaluation of its psychometric properties in Peruvian adults with suspected or diagnosed oropharyngeal dysphagia.

Methods:  the cultural adaptation included forward and back-translation, synthesis of the translation, review by a multidisciplinary expert committee, and a pilot test with 30 Peruvian adults. Internal consistency, construct validity, concurrent validity, and test-retest reproducibility were calculated for the psychometric evaluation in a sample of 120 participants (mean age: 64.7 years; 71.67% females).

Results:  the EAT-10pe showed excellent internal consistency (Cronbach's alpha = 0.89) and a unidimensional structure that explained 58.4% of the total variance. Reproducibility was excellent, with an intraclass correlation coefficient of 0.92. It was significantly correlated with the volume-viscosity test (r = 0.67, p < 0.001) and clinical signs of aspiration (r = 0.53, p < 0.01).

Conclusion:  the translation, cultural adaptation, and psychometric evaluation of the EAT-10pe in Peruvian adults with suspected or diagnosed oropharyngeal dysphagia proved it to be a brief, reliable, and valid instrument for assessing self-perceived dysphagia in adults.

Keywords:
Dysphagia; Instrument Validation; Questionnaires; Reproducibility of Results; Patient Perception

RESUMEN

Objetivo:  validar la versión peruana del cuestionario Eating Assessment Tool-10 (EAT-10pe) para evaluar la autopercepción de disfagia en la población adulta de Perú. Incluyendo la traducción, adaptación cultural y evaluación de sus propiedades psicométricas en adultos peruanos con sospecha o diagnóstico de disfagia orofaríngea.

Métodos:  el proceso de adaptación cultural se incluyeron traducción directa e inversa, síntesis de la traducción, revisión por un comité de expertos multidisciplinario y una prueba piloto con 30 adultos peruanos. Para la evaluación psicométrica en una muestra de 120 participantes (edad media 64,7 años, 71,67% mujeres), se calculó la consistencia interna, la validez de constructo, la validez concurrente, y la reproducibilidad test-retest.

Resultados:  el EAT-10pe mostró una excelente consistencia interna (Alfa de Cronbach = 0,89) y una estructura unidimensional que explicó el 58,4% de la varianza total. La reproducibilidad fue excelente con un coeficiente de correlación intraclase de 0,92. Se encontraron correlaciones significativas con el test volumen-viscosidad (r = 0,67, p < 0,001) y signos clínicos de aspiración (r = 0,53, p < 0,01).

Conclusión:  la traducción, adaptación cultural y la valoración de sus propiedades psicométricas del Eating Assessment Tool-10 (EAT-10pe) en adultos peruanos con sospecha o diagnóstico de disfagia orofaríngea, resultó ser un instrumento breve, confiable y válido para evaluar la autopercepción de disfagia en adultos.

Descriptores:
Disfagia; Validación de Instrumentos; Cuestionarios; Estudios de Reproducibilidad; Percepción del Paciente

INTRODUCTION

Swallowing is a complex process requiring precise interaction between the central and peripheral nervous systems. When this process is impaired, significant clinical consequences can arise in both the physiological and psychosocial spheres. Physiologically, dysfunctional swallowing can lead to serious complications such as aspiration, airway obstruction, malnutrition, dehydration, and even increased mortality^1,2. Various neurological, structural, and systemic conditions can interfere with the swallowing mechanism and lead to dysphagia, although this condition is frequently overlooked or not adequately diagnosed by healthcare professionals and caregivers. Furthermore, many people, especially older adults, tend not to report symptoms consistent with dysphagia³.

From a psychosocial perspective, dysphagia negatively impacts quality of life, causing anxiety and social isolation due to embarrassment or discomfort when eating in the presence of others^2,4. The prevalence of dysphagia increases with age, posing a significant burden on healthcare systems. Epidemiological studies estimate a prevalence of up to 22% in people over 50 years old⁵, reaching figures as high as 60% in geriatric institutions^6,7.

Dysphagia research, although relatively recent, has advanced in the understanding of the pathophysiology and biomechanics of swallowing, as well as in the development of diagnostic and therapeutic methods⁷. The use of patient-centered measures, focused on self-reported symptoms and the perceived quality of life associated with this condition, has become increasingly relevant in recent years. This is especially important, considering that symptoms such as coughing, throat clearing, and drooling, associated with swallowing difficulties, generate emotional distress and can limit the individual's social participation.

Many authors have reported on the need for a patient-centered outcome measure that incorporates not only the physiological implications of dysphagia but also its consequences for the patient's quality of life^8-10. These patient-centered measures can also help clinicians evaluate the effectiveness of treatment planning. Many instruments have been used to assess quality of life in different groups of patients with dysphagia, especially those with head and neck cancer. Some of these instruments have subsets of questions that address dysphagia. However, only a few tools have been specifically designed and validated to address swallowing difficulties and the effects of dysphagia on quality of life¹¹.

In the Peruvian context, the clinical assessment of dysphagia in adults has been based primarily on non-instrumental clinical methods and the application of international scales without prior cultural validation. To date, there are no published reports demonstrating the adaptation or validation of specific self-report questionnaires for Peruvian adults with dysphagia. Although some local clinical studies have used observational scales and screening tests developed in other countries, their use has not considered a systematic process of cross-cultural adaptation, which limits their applicability and diagnostic accuracy in clinical practice.

In response to this need, various instruments have been proposed internationally to assess dysphagia-related quality of life. Some tools, such as SWAL-QOL and SWAL-CARE, evaluate the physical and psychosocial effects of swallowing disorders from the patient's perspective¹². However, the length of these instruments, especially SWAL-QOL with its 44 items, limits their applicability in high-demand clinical settings. Other tools, such as MDADI, SDQ, and the Sydney Swallow Questionnaire (SSQ), have been designed for specific populations, such as patients with head and neck cancer or Parkinson's disease^13-15.

Although instrumental techniques such as videofluoroscopy (VFSS) and fiberoptic endoscopy of swallowing (FEES) are the gold standard in the diagnosis of oropharyngeal dysphagia (OD), their widespread use is limited due to their cost and availability¹⁶. Clinical screening methods such as the volume-viscosity test (V-VST)¹⁷ and the 3-ounce water swallow test (3Oz WST)¹⁸ have proven to be effective alternatives for detecting dysphagia in clinical settings. However, the need for brief, valid, and easy-to-administer instruments has driven the development of tools such as the Eating Assessment Tool-10 (EAT-10).

The EAT-10, developed by Belafsky et al.¹⁹, is a self-administered questionnaire that assesses the severity of dysphagia symptoms, their impact on quality of life, and the effectiveness of treatment. It consists of 10 items, takes approximately 2 minutes to complete, and yields a total score. A score above 3 indicates a significant perception of dysphagia. Due to its ease of use, it has been validated in several languages, including Italian and Spanish^11,20. However, its validity and reliability must be evaluated in each new cultural and linguistic context, as a simple translation does not guarantee semantic equivalence or clinical applicability.

The EAT-10 symptom survey, developed by Belafsky et al.¹⁹, assesses functional health status related to dysphagia in English-speaking patients. This tool is easy to administer and interpret in patients with dysphagia of any etiology. The EAT-10 measures the severity of dysphagia symptoms and evaluates the patient's perception of the treatment they have received^19,20. The EAT-10 has been translated and validated in several languages, including Turkish²¹, Italian²², Portuguese^23,24, and Spanish from Spain (EAT-10spa)²⁰; in Latin America, only in Colombia²⁵. However, to apply EAT-10spa in Latin America, further cultural adaptations are needed depending on the country, given the diversity of the population in these countries, besides assessing its psychometric properties²⁶. Furthermore, the sensitivity of the EAT-10 to change has been evaluated almost exclusively in patients with esophageal dysphagia, and more research is needed on OD. In fact, a recent systematic review highlighted the need for a comprehensive evaluation of the EAT-10 using the recommended validation tests^27-29. Because there is no validated symptom survey to quantify dysphagia symptoms in Peruvian Spanish, we conducted a study to validate the EAT-10spa adapted to Peruvian culture and its psychometric properties.

Hence, this study aimed to validate the Peruvian version of the EAT-10 (EAT-10pe) to assess self-perceived dysphagia in Peruvian adults. This included translation, cultural adaptation, and evaluation of its psychometric properties in Peruvian adults with suspected or diagnosed OD.

METHODS

Design and type of study

This study is part of a multicenter research project, approved by the Human Research Ethics Committee of the Research Department of the Center for Orofacial Myofunctional Therapy - CeMOF (Resolution R. No-25-2024-CEI-CeMOF), in accordance with the national health research formats and regulations of Peru through Ministerial Resolution No. 233-2020-MINSA (Supreme Decree No. 021-2017-SA)³⁰, which approves the technical document of ethical considerations for human health research.

This cross-sectional, instrumental study aimed to translate, culturally adapt, and validate the EAT-10 in a Peruvian adult population (EAT-10pe) with suspected or diagnosed OD.

Participants

The study included 180 adults over 18 years old, of both sexes, with suspected or confirmed dysphagia. They were recruited from outpatient clinics and inpatient services at healthcare institutions in Metropolitan Lima. It excluded 60 patients with severe cognitive impairment or psychiatric disorders that limited their understanding of the instrument. All participants signed an informed consent form. The sample size for factor analysis was estimated considering at least 12 subjects per item of the instrument (n = 120).

Translation and cultural adaptation process

The translation and cultural adaptation of an instrument such as EAT-10 requires a systematic approach to ensure that the questionnaire maintains semantic, idiomatic, conceptual, and cultural equivalence with the original instrument. The study followed the guidelines proposed by Beaton et al.³¹ and recommended by the International Society for Pharmacoeconomics and Outcomes Research (ISPOR)³² for the cross-cultural adaptation of health measurement instruments, as well as the international guidelines of the Task Force for Translation and Cultural Adaptation³² and the World Health Organization (WHO), which include the following steps:

Step 1: Forward translation: Two bilingual translators whose native language is Peruvian Spanish independently translated the original EAT-10 from English to Spanish. One of them had experience in medical terminology, and the other was an expert translator in the clinical field, which allowed them to capture both the technical meaning and the colloquial language of the instrument³¹.

Step 2: Translation Summary: The two versions were compared to generate a consensus version through discussion between the translators and a committee of experts in dysphagia and methodology, preserving semantic and cultural equivalence.

Step 3: Back translation: Two native English-speaking translators with no prior knowledge of the original instrument back-translated the consensus version into English. The purpose was to verify conceptual fidelity to the original instrument and to detect any possible semantic or cultural deviations.

Step 4: Review by expert committee: A multidisciplinary panel of experts, composed of speech-language-hearing pathologists, rehabilitation physicians, linguists, and methodologists, reviewed all previous versions. They evaluated the semantic, idiomatic, conceptual, and cultural equivalence of each item, according to criteria proposed by Guillemin et al.³³. They made minor adjustments to the language to ensure comprehension by the Peruvian population, especially in terms such as “líquidos espesos” (thick liquids) and expressions like “toser mientras come” (coughing while eating).

Step 5: Pilot test: The preliminary version of the EAT-10pe was administered to a group of 30 Peruvian adults (with and without a history of dysphagia) to assess comprehension, clarity, and acceptance. Think-aloud cognitive interviews were used to explore how participants interpreted each item. Modifications were made based on the results to generate the final version.

Psychometric assessment

Once the adaptation process was completed, the instrument was subjected to a series of psychometric tests to evaluate its reliability and validity in the Peruvian adult population:

• Internal consistency: Cronbach's alpha was calculated to determine the internal homogeneity of the items. An α value ≥ 0.70 was considered acceptable³³.

• Construct validity: An exploratory factor analysis (EFA) was performed using principal component extraction with varimax rotation to examine the dimensionality of the instrument. A factor loading ≥ 0.40 and an eigenvalue > 1 were considered adequate.

• Criterion validity (concurrent): Concurrent validity was assessed by correlating EAT-10pe scores with the results of standardized clinical tests such as the volume-viscosity test (V-VST) and the presence of clinical signs of aspiration (cough, wet voice, desaturation), using Spearman's rho coefficient.

• Reproducibility (temporal stability, test-retest): Temporal reliability was assessed by administering the questionnaire at two points in time, with an interval of 7 to 10 days, to a subgroup of participants (n = 30). The intraclass correlation coefficient (ICC) was used, with values ≥ 0.80 considered adequate³⁴.

Statistical analysis

Statistical analysis was performed using IBM SPSS Statistics, version 28.0. Various statistical procedures were applied to evaluate the psychometric properties of the Peruvian version of the EAT-10 (EAT-10pe), according to international recommendations for instrument validation studies³¹. The instrument's internal consistency was assessed using Cronbach's alpha coefficient. An α value ≥ 0.70 was considered acceptable, while values greater than 0.80 indicated good internal reliability. Additionally, alpha-if-item-removed values were analyzed to determine each item’s impact on the overall consistency of the questionnaire.

Temporal stability (test-retest reliability) was determined in a subgroup of participants (n = 30) by administering the EAT-10pe at intervals of 7 to 10 days. ICC was used with a mixed-effects model and an absolute measure type. An ICC ≥ 0.75 was interpreted as good temporal reliability³⁴.

An EFA with varimax rotation was performed for construct validity. Data adequacy was assessed using the Kaiser-Meyer-Olkin (KMO) index and Bartlett's test of sphericity. A KMO ≥ 0.60 and a p-value < 0.05 in Bartlett's test were considered adequate. Factors with eigenvalues ​​≥ 1.0 were retained, and factor loadings were assessed to determine item grouping.

Discriminant validity was examined by comparing the total EAT-10pe scores between the clinical group (patients with a medical diagnosis consistent with OD) and the control group (without symptoms or a history of dysphagia) using the Mann-Whitney U test. Statistical significance was assumed for p-values < 0.05.

The effect size was calculated using Rosenthal's r coefficient to assess the magnitude of the differences between groups.

To explore the EAT-10pe's capacity as a clinical screening tool, the area under the receiver operating characteristic (ROC) curve was calculated to identify the optimal cutoff for discriminating between subjects with and without perceived dysphagia. Sensitivity, specificity, predictive values, and likelihood ratios were determined for different cutoffs. An AUC ≥ 0.80 was considered indicative of good discriminative capacity³⁵.

RESULTS

The study included 120 participants, with a mean age of 64.7 years (SD = 13.2); 71.67% were females, and 81.7% had a medical diagnosis of OD, while 18.3% presented suggestive symptoms without a confirmed diagnosis at the time of the study (Table 1).

Table 1
Descriptive indicators of sociodemographic and clinical variables

		Number	%
Sex	Males	34	28.33
	Females	86	71.67
Age	40-65	14	11.67
	66-75	23	19.17
	76-85	43	35.8
	Over 85	40	33.3
Education	Illiterate	10	8.33
	Primary	26	21.67
	Secondary	55	45.83
	Higher	29	24.17
Marital status	Single	12	10
	Married	88	73.33
	Divorced	8	6.67
	Widow(er)	12	10
Diagnosis	Stroke	89	90.8
	Multiple sclerosis	8	8.16
	Amyotrophic lateral sclerosis	9	9.18
	Myasthenia gravis	2	2.04
	Parkinson’s disease	14	14.29
	Not confirmed	22	18.30
Comorbidities	High blood pressure	37	30.83
	Chronic obstructive pulmonary disease	18	15
	Diabetes mellitus	9	7.5
	Heart failure	9	7.5
	Autoimmune disease	8	6.67
	Chronic kidney disease	7	5.83
	Sleep apnea	4	3.33
	Osteoporosis	4	3.33
	Epilepsia	2	1.67
	Liver disease	2	1.67
	None	20	10.67

The preliminary version of the EAT-10pe, applied as a pilot test to 30 individuals, resulted in a cognitive information session, whose "cultural and/or semantic adjustment notes" we have included for your information. This led to the final version, according to the consensus of the researchers (Table 2).

Table 2
Semantic equivalences of the original version, cultural adjustments, and the final version of the EAT-10pe

Original item (English)	Initial translation 1	Initial translation 2	Consensus version (final)	Cultural/semantic adjustment notes
1. My swallowing problem has caused me to lose weight.	Mi problema al tragar me ha hecho perder peso.	He bajado de peso por problemas al tragar.	Mi problema al tragar me ha hecho perder peso.	A formal and direct structure was maintained; both were understandable.
2. My swallowing problem interferes with my ability to go out for meals.	Mi problema al tragar interfiere con mi capacidad de salir a comer.	No puedo salir a comer por mi problema al tragar.	Mi problema al tragar interfiere con mi capacidad para salir a comer.	The original structure was maintained for clinical accuracy.
3. Swallowing liquids takes extra effort.	Tragar líquidos requiere un esfuerzo adicional.	Me cuesta más trabajo tragar líquidos.	Tragar líquidos requiere un esfuerzo adicional.	A formal version was chosen to maintain semantic equivalence; it was validated as understandable.
4. Swallowing solids takes extra effort.	Tragar sólidos requiere esfuerzo extra.	Me cuesta más trabajo tragar sólidos.	Tragar sólidos requiere un esfuerzo adicional.	Minimum adjustment to maintain parallelism with item 3.
5. Swallowing pills takes extra effort.	Tragar pastillas requiere esfuerzo adicional.	Me cuesta tragar pastillas.	Tragar pastillas requiere un esfuerzo adicional.	Formality and clarity were maintained for the clinical environment.
6. Swallowing is painful.	Tragar es doloroso.	Me duele al tragar.	Tragar es doloroso.	It was kept literal because it was widely understandable.
7. The pleasure of eating is affected by my swallowing.	El placer de comer se ve afectado por mi forma de tragar.	Comer ya no es placentero por mis problemas al tragar.	El placer de comer se ve afectado por mis problemas al tragar.	A slightly clearer wording was preferred without losing fidelity.
8. When I swallow food sticks in my throat.	Cuando trago, la comida se queda atascada en mi garganta.	Siento que la comida se me queda en la garganta al tragar.	Al tragar, siento que la comida se queda atorada en la garganta.	The order was adjusted for better fluency in Peruvian Spanish.
9. I cough when I eat.	Toso cuando como.	Me da tos al comer.	Toso cuando como.	The most accurate and clinically used version was chosen.
10. Swallowing is stressful.	Tragar es estresante.	Me estresa tragar.	Tragar es estresante.	The literal version was clear and valid for self-reporting.

Internal consistency

The Peruvian version of the EAT-10pe showed high internal consistency with a Cronbach's alpha coefficient of 0.89, indicating adequate homogeneity between items (Table 3).

Factor analysis

An EFA was performed using principal component extraction and varimax rotation. A unidimensional structure was identified, with a single factor explaining 58.4% of the total variance. All items had factor loadings greater than 0.60 (Table 3).

Table 3
Reliability and validity analysis of the EAT-10pe (Peruvian version)

Item	Mean (SD)	Corrected item-total correlation	Factor loading
1	1.9 (1.1)	0.63	0.71
2	1.4 (1.2)	0.61	0.69
3	1.8 (1.0)	0.64	0.73
4	1.2 (1.3)	0.58	0.65
5	1.6 (1.0)	0.67	0.76
6	1.5 (1.1)	0.60	0.71
7	1.3 (1.2)	0.59	0.67
8	1.7 (1.1)	0.66	0.74
9	1.0 (1.4)	0.52	0.61
10	1.6 (1.1)	0.65	0.72
Total Cronbach's alpha	-	0.89	-

• Extraction method: principal components; rotation: The analysis revealed a Varimax one-factor structure; total variance explained: 58.4%, similar to previous studies in other populations^36,37.

Reproducibility (Test-retest)

The EAT-10pe was administered at two time points separated by an interval of 7 to 10 days to a subsample of 30 stable patients. The ICC was 0.92 (95% CI: 0.88-0.96), indicating excellent temporal stability (Table 4).

Concurrent validity

The total scores of the EAT-10pe were significantly correlated with the V-VST clinical findings (r = 0.67, p < 0.001) and the presence of clinical signs of aspiration documented by the treating professional (r = 0.53, p < 0.01), which supports the criterion validity of the instrument (Table 4).

Table 4
Reproducibility and concurrent validity of the EAT-10pe

Analysis	Statistics	Value	Confidence interval (95 %)
Test-retest (ICC)	Intraclass correlation coefficient	0.92	0.88 - 0.96
Concurrent validity with V-VST	Spearman’s correlation	0.67	p < 0.001
Concurrent validity with clinical signs of aspiration	Spearman’s correlation	0.53	p < 0.01

DISCUSSION

This study aimed to validate the Peruvian version of the EAT-10 (EAT-10pe) for assessing self-perceived dysphagia in adults. The results indicate that this adapted version maintains adequate psychometric properties, including high internal consistency, a clear unifactorial structure, excellent temporal stability, and good concurrent validity.

The internal consistency obtained (α = 0.89) is comparable to that of previous versions of the instrument. For example, Belafsky et al.¹⁹, in their original study, reported a Cronbach's alpha of 0.96, while Spanish¹⁶ and Italian²² adaptation studies reported values ​​between 0.87 and 0.93. This high reliability suggests that the Peruvian EAT-10pe items are consistent with each other and measure the same underlying dimension related to the perception of dysphagia symptoms.

EFA revealed a unidimensional structure that explained 58.4% of the total variance. This supports the original theoretical model by Belafsky et al.¹⁹, which proposed the EAT-10pe as a unifactorial tool focused on the perception of swallowing impairment. Furthermore, the factor loadings of all items exceeded the recommended threshold of 0.60^36,37, indicating adequate representativeness of each item with respect to the construct being assessed.

Regarding temporal stability, the high ICC (0.92) confirms that the instrument exhibits excellent reproducibility in clinically stable patients³⁴, which is essential for its use in longitudinal follow-up and in the evaluation of therapeutic interventions.

Concurrent validity analyses showed statistically significant correlations between EAT-10pe scores and objective clinical measures, such as the V-VST and the presence of clinical signs of aspiration. These correlations indicate that the EAT-10pe accurately reflects the severity of dysphagia symptoms, reinforcing its value as a screening tool in primary and specialized care settings.

From a clinical perspective, adapting the EAT-10pe to Peruvian Spanish is highly useful, as it provides a brief (less than 2 minutes to apply), easy-to-administer and interpret, and culturally appropriate tool. Having a reliable self-report questionnaire in the Peruvian context, where resources for instrumental tests such as VFSS are limited and concentrated in large urban centers, is an effective alternative for the initial identification of suspected dysphagia cases.

A significant contribution of this validation is the semantic adaptation of the EAT-10pe items to common expressions in Peruvian Spanish, which facilitates patient comprehension. As previously documented, dialectal differences can affect the validity of standardized instruments if rigorous cultural adaptation is not performed. Our study used a systematic translation-back-translation approach and expert evaluation, followed by a pilot test, to ensure conceptual equivalence.

The limitations of this study include the non-probabilistic sample, with participants recruited primarily from urban areas of Lima. This could limit the generalizability of the results to other regions of the country with different socioeconomic levels, particularly rural or indigenous areas of Peru, where native languages ​​such as Quechua or Aymara are prevalent, potentially overlooking linguistic or cultural variations specific to these communities. Furthermore, although the sample was representative in terms of age and sex, it would be advisable to expand the study to include pediatric populations and individuals with low functional literacy.

Despite these limitations, the study findings have important clinical implications. The Peruvian version of the EAT-10pe proved to be a brief, easy-to-administer, and reliable instrument for the subjective detection of dysphagia symptoms in adults. Its use can facilitate early screening in primary care settings, general hospitals, and rehabilitation services, contributing to the timely identification of at-risk patients.

Furthermore, as a self-administered questionnaire focused on the patient's experience, the EAT-10pe incorporates the subjective perspective of symptoms, which is key for planning individualized treatment and monitoring its effectiveness. Its application can reduce the underdiagnosis of dysphagia, especially in populations with limited access to instrumental diagnostic methods such as VFSS or FEES.

The EAT-10pe can become a useful tool for healthcare professionals such as speech-language-hearing pathologists, internists, geriatricians, and nursing staff in hospital and community settings, as part of routine clinical protocols for the early detection of dysphagia. It can also be used in future research aimed at evaluating the response to rehabilitation treatments or changes in patients' quality of life. Its clinical application can facilitate early detection of swallowing difficulties and improve patients' quality of life through timely intervention. This is supported by the results from other countries^11,19-25, which likewise obtained satisfactory validity and reliability results.

Finally, its validation in the Peruvian context represents a relevant step to strengthen the clinical approach to dysphagia in Latin America, promoting practices based on culturally and linguistically validated instruments.

CONCLUSION

This study translated and culturally adapted the EAT-10 for the Peruvian adult population, ensuring its linguistic and conceptual equivalence. Furthermore, the Peruvian version (EAT-10pe) demonstrated adequate levels of validity and reliability for assessing self-perceived OD in Peruvian adults. Therefore, the EAT-10pe is a useful and reliable tool for clinical practice and research in the Peruvian context.

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• A multicentric study conducted at the Centros de terapias de la deglución, Lima, Peru.
• Financial support
  Nothing to declare
• Data sharing statement
  Individual data of unidentified participants will not be shared. The methodology, statistics, and analysis plan used will be available immediately after publication and will remain available indefinitely to anyone who wishes to access the data. For any further information, please contact the corresponding author at [e-mail].

Edited by

• Chief Editor
  Hilton da Silva

• Associate Editor
  Célia Santini

Data availability

Individual data of unidentified participants will not be shared. The methodology, statistics, and analysis plan used will be available immediately after publication and will remain available indefinitely to anyone who wishes to access the data. For any further information, please contact the corresponding author at [e-mail].

Publication Dates

• Publication in this collection
  18 May 2026
• Date of issue
  2026

History

• Received
  26 June 2025
• Reviewed
  26 Sept 2025
• Accepted
  25 Feb 2026