There are few routine outcomes monitoring (ROM) tools available to track changes in eating-disorder (ED) symptom expression. Given that ROM is critical for providing measurement-based care, there is a pressing need to develop ROM tools for EDs. The present study developed and validated the Eating Pathology Clinical Outcomes Tracker (EPCOT). Study 1 included administering the initial EPCOT item pool to college students (N = 380). In Study 2 (Recovery Record), a revised EPCOT item pool was administered to adolescents and adults with an ED (N = 2,196). Participants were retested at 1- to 2-week (n = 964) and 1-month (n = 473) follow-up. Finally, Study 3 (Mechanical Turk sample) was a longitudinal study of community adults who were tested at baseline (N = 305), 1-week (n = 240), and 6-month (n = 172) follow-up. Analyses included exploratory and confirmatory analysis and item response theory to identify differential item functioning across weight categories and ED diagnostic groups. The final version of the EPCOT had 24 items and eight scales. The EPCOT showed evidence for moderate-to-good test-retest reliability and good-to-excellent internal consistency, discriminant and convergent validity, and criterion-related validity. Finally, in Study 3, several EPCOT scales demonstrated predictive validity for predicting general and ED-specific psychiatric impairment at 6-month follow-up. The EPCOT showed initial promise as a tool that can be used to help clinicians track progress in therapy over time and may have utility in research contexts. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
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