Psychometric evaluation of the Swedish self-rated 36-item version of WHODAS 2.0 for use in psychiatric populations – using classical test theory

Midhage, Robin; Hermansson, Liselotte; Söderberg, Per; Tungström, Stefan; Nordenskjöld, Axel; Svanborg, Cecilia; Ginsberg, Ylva; Ramklint, Mia

doi:10.1080/08039488.2021.1897162

Cited by 12 publications

(14 citation statements)

References 31 publications

(45 reference statements)

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“…The instrument’s psychometric properties contributed satisfactorily to the evidence for validity at the level of the total score. This is in line with the results of a CTT study of the Swedish version of the WHODAS 2.0 in patients with mental disorders [ 21 ]. The analyses between different methods of calculating overall scores demonstrated a high linear correlation.…”

Section: Discussionsupporting

confidence: 89%

“…Moreover, the disattenuated correlation confirmed the unidimensionality even at the domain level, which may suggest that measurement error was the cause of the explained variance under the recommended value [ 37 ]. The confirmatory factor analysis in the CTT study of the Swedish version of WHODAS 2.0 indicated one general disability factor [ 21 ], which confirms the acceptable unidimensionality of the WHODAS 2.0 reported in the current study.…”

Section: Discussionsupporting

confidence: 84%

“…The use of both CTT and IRT has been suggested to be more informative than the use of only one of these methods [ 20 ]. Midhage et al performed CTT analyses on WHODAS 2.0 data from Swedish patients with mental disorders [ 21 ]. The results showed good reliability (Cronbach’s alpha values for domains were between 0.70–0.90, and test–retest reliability of the total score was ICC 0.83) and convergent validity (Pearson correlation coefficient of 0.77 between the WHODAS 2.0 and the Sheehan Disability Scale).…”

Section: Introductionmentioning

confidence: 99%

“…The results showed good reliability (Cronbach’s alpha values for domains were between 0.70–0.90, and test–retest reliability of the total score was ICC 0.83) and convergent validity (Pearson correlation coefficient of 0.77 between the WHODAS 2.0 and the Sheehan Disability Scale). However, this study provided no information about other psychometric properties such as item fit, bias or rating scale functioning [ 21 , 22 ]. Therefore, further investigation of these properties by Rasch analysis on the Swedish version of the WHODAS 2.0 in patients with mental disorders is important.…”

Section: Introductionmentioning

confidence: 99%

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Evidence for validity of the Swedish self-rated 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in patients with mental disorders: a multi-centre cross-sectional study using Rasch analysis

Svanborg

Amer

Nordenskjöld

et al. 2022

J Patient Rep Outcomes

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Background The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a generic instrument for the assessment of functioning in six domains, resulting in a total health-related disability score. The aim of this study was to investigate the psychometric properties of the Swedish-language version of the self-rated 36-item version in psychiatric outpatients with various common psychiatric diagnoses using Rasch analysis. A secondary aim was to explore the correlation between two methods of calculating overall scores to guide clinical practice: the WHODAS simple (summative) model and the WHODAS complex (weighted) model. Methods Cross-sectional data from 780 Swedish patients with various mental disorders were evaluated by Rasch analysis according to the partial credit model. Bivariate Pearson correlations between the two methods of calculating overall scores were explored. Results Of the 36 items, 97% (35 items) were within the recommended range of infit mean square; only item D4.5 (Sexual activities) indicated misfit (infit mean square 1.54 logits). Rating scale analysis showed a short distance between severity levels and disordered thresholds. The two methods of calculating overall scores were highly correlated (0.89–0.99). Conclusions The self-administered WHODAS 2.0 fulfilled several aspects of validity according to Rasch analysis and has the potential to be a useful tool for the assessment of functioning in psychiatric outpatients. The internal structure of the instrument was satisfactorily valid and reliable at the level of the total score but demonstrated problems at the domain level. We suggest rephrasing the item Sexual activities and revising the rating scale categories. The WHODAS simple model is easier to use in clinical practice and our results indicate that it can differentiate function among patients with moderate psychiatric disability, whereas Rasch scaled scores are psychometrically more precise even at low disability levels. Further investigations of different scoring models are warranted.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Evidence for validity of the Swedish self-rated 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in patients with mental disorders: a multi-centre cross-sectional study using Rasch analysis

Svanborg

Amer

Nordenskjöld

et al. 2022

J Patient Rep Outcomes

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“…Although examining the clinical utility of WHODAS 2.0 in a population of older patients at the ED is new, its utility in other populations has been examined extensively in the recent years ( 42 – 44 ). The WHODAS 2.0 was found a useful measure of disability in a population with chronic pain ( 42 ) and for stroke survivors ( 43 ) were WHODAS 2.0 showed good reliability and validity.…”

Section: Discussionmentioning

confidence: 99%

Construct Validity and Clinical Utility of World Health Organization Disability Assessment Schedule 2.0 in Older Patients Discharged From Emergency Departments

Nielsen

Oestergaard

Kirkegaard

et al. 2021

Front. Rehabilit. Sci.

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Introduction: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is designed to measure functioning and disability in six domains. It is included in the International Classification of Diseases 11th revision (ICD-11). The objective of the study was to examine the construct validity of WHODAS 2.0 and describe its clinical utility for the assessment of functioning and disability among older patients discharged from emergency departments (EDs).Material and Methods: This cross-sectional study is based on data from 129 older patients. Patients completed the 36-item version of WHODAS 2.0 together with the Barthel-20, the Assessment of Motor and Process Skills (AMPS), Timed Up and Go (TUG), and the 30-Second Chair Stand Test (30 s-CST). Construct validity was examined through hypothesis testing by correlating the WHODAS with the other instruments and specifically the mobility domain in WHODAS 2.0 with the TUG and 30 s-CST tests. The clinical utility of WHODAS 2.0 was explored through floor/ceiling effect and missing item responses.Results: WHODAS 2.0 correlated fair with Barthel-20 (r = −0.49), AMPS process skills (r = −0.26) and TUG (r=0.30) and correlated moderate with AMPS motor skills (r = −0.58) and 30s-CST (r = −0.52). The WHODAS 2.0 mobility domain correlated fair with TUG (r = 0.33) and moderate with 30s-CST (r = −0.60). Four domains demonstrated floor effect: D1 “Cognition,” D3 “Self-care,” D4 “Getting along,” and D5 “Household.” Ceiling effect was not identified. The highest proportion of missing item responses were present for Item 3.4 (Staying by yourself for a few days), Item 4.4 (Making new friends), and Item 4.5 (Sexual activities).Conclusion: WHODAS 2.0 had fair-to-moderate correlations with Barthel-20, AMPS, TUG, and 30s-CST and provides additional aspects of disability compared with commonly used instruments. However, the clinical utility of WHODAS 2.0 applied to older patients discharged from EDs poses some challenges due to floor effect and missing item responses. Accordingly, patient and health professional perspectives need further investigation.

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Comparison of the 12‐item and 36‐item versions of the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 using longitudinal data from community mental health outreach service users

Iwanaga,

Yamaguchi,

Sato

et al. 2024

Neuropsychopharm Rep

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AimThis study aimed to compare the 12‐item and 36‐item versions of the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 using longitudinal data from community mental health outreach service users.MethodsUsing data from Tokorozawa City mental health outreach service users in Japan, total and domain WHODAS‐12 and WHODAS‐36 scores were compared. First, we examined score‐change differences by domain at the start of outreach services (T1) and 1 year later (T2) for each version. Next, we compared differences between the two versions using Pearson's correlation, Wilcoxon signed‐rank test, and Bland–Altman analysis.ResultsAmong 20 participants, total scores and scores of some domains (i.e., cognition, getting along, life activities, and participation) were significantly lower at T2 than at T1 on both versions (p < 0.010). WHODAS‐36 scores were significantly lower at T2 than at T1 for the self‐care domain (p = 0.018). Except for self‐care, strong correlations were found between scores from the two versions (p < 0.001). In the Wilcoxon signed‐rank test and Bland–Altman analysis, we found significant differences between the scores of the two versions in the mobility, self‐care, and participation domains. There were no significant differences in the distribution or systematic errors between the two versions in scores for the other domains or total score.ConclusionWe found strong positive correlations between WHODAS‐12 and WHODAS‐36 total scores with no statistical differences between them. For some domains, differences in distribution and systematic errors were found.

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Psychometric evaluation of the Swedish self-rated 36-item version of WHODAS 2.0 for use in psychiatric populations – using classical test theory

Cited by 12 publications

References 31 publications

Evidence for validity of the Swedish self-rated 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in patients with mental disorders: a multi-centre cross-sectional study using Rasch analysis

Evidence for validity of the Swedish self-rated 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in patients with mental disorders: a multi-centre cross-sectional study using Rasch analysis

Construct Validity and Clinical Utility of World Health Organization Disability Assessment Schedule 2.0 in Older Patients Discharged From Emergency Departments

Comparison of the 12‐item and 36‐item versions of the World Health Organization Disability Assessment Schedule (WHODAS) 2.0 using longitudinal data from community mental health outreach service users

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