The Optimal Cut-off Point of the Children’s Eating Attitudes Test (ChEAT-26) Among a Prepubertal Population in Taiwan: a Primary-school-based Study

Abstract

Background:It is proposed that for each population a culturally appropriate cut-off point should be defined when using scales or questionnaires in quantitative cross-cultural research.The purpose of this study was to identify the best cut-off point of the Children’s Eating Attitudes Test (ChEAT) in a Taiwanese prepubertal population. Methods. A two-stage design for the recruitment of the participants was used. During the first stage, fifth- and sixth-graders from three elementary schools in Taiwan were purposively selected, and a total of 1,195 valid questionnaires were obtained using the ChEAT. During the second stage, 280 students were chosen using a stratified random sampling method; among them, 205 students received a diagnostic interview for any eating disorder. The differences between the clinical diagnoses and the ChEAT scores of all study samples were compared to determine the best cut-off point. Results. Using the psychiatrist’s clinical diagnosis as the golden standard, it was found that when the cut-off point was set at 21.5, the ChEAT yielded the highest discriminant value with the area under the curve (AUC-ROC) of 0.723, showing good sensitivity and specificity. Conclusions. The optimal cut-off point for the ChEAT among prepubertal students in Taiwan was 21.5. Limitations of this present study and suggestions for future research were also addressed.