Validation of the World Health Organization Disability Assessment Schedule II (WHODAS-II) in patients with multiple sclerosis

Magistrale, Giuseppe; Pisani, Valerio; Argento, Ornella; Incerti, Chiara Concetta; Bozzali, Marco; Cadavid, Diego; Caltagirone, Carlo; Medori, Rossella; DeLuca, John; Nocentini, Ugo

doi:10.1177/1352458514543732

Cited by 37 publications

(36 citation statements)

References 24 publications

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“…Physician scored and patient‐reported disability measures were assessed including both physician‐derived EDSS and patient‐reported telephone EDSS score adapted for digital questionnaire use . For potentially more patient‐focused real‐life outcomes we used the WHODAS 2.0, which includes six domains of function: cognition, mobility, self‐care, interacting with other people, life activities, and participating in community activities …”

Section: Methodsmentioning

confidence: 99%

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Novel MS vital sign: multi‐sensor captures upper and lower limb dysfunction

Akhbardeh

Arjona

Krysko

et al. 2020

Ann Clin Transl Neurol

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Objective To create a novel neurological vital sign and reliably capture MS‐related limb disability in less than 5 min. Methods Consecutive patients meeting the 2010 MS diagnostic criteria and healthy controls were offered enrollment. Participants completed finger and foot taps wearing the MYO‐band© (accelerometer, gyroscope, and surface electromyogram sensors). Signal processing was performed to extract spatiotemporal features from raw sensor data. Intraclass correlation coefficients (ICC) assessed intertest reproducibility. Spearman correlation and multivariable regression methods compared extracted features to physician‐ and patient‐reported disability outcomes. Partial least squares regression identified the most informative extracted textural features. Results Baseline data for 117 participants with MS (EDSS 1.0–7.0) and 30 healthy controls were analyzed. ICCs for final selected features ranged from 0.80 to 0.87. Time‐based features distinguished cases from controls (P = 0.002). The most informative combination of extracted features from all three sensors strongly correlated with physician EDSS (finger taps rs = 0.77, P < 0.0001; foot taps rs = 0.82, P < 0.0001) and had equally strong associations with patient‐reported outcomes (WHODAS, finger taps rs = 0.82, P < 0.0001; foot taps rs = 0.82, P < 0.0001). Associations remained with multivariable modeling adjusted for age and sex. Conclusions Extracted features from the multi‐sensor demonstrate striking correlations with gold standard outcomes. Ideal for future generalizability, the assessments take only a few minutes, can be performed by nonclinical personnel, and wearing the band is nondisruptive to routine practice. This novel paradigm holds promise as a new neurological vital sign.

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Section: Methodsmentioning

confidence: 99%

“…3 For potentially more patient-focused real-life outcomes we used the WHODAS 2.0, which includes six domains of function: cognition, mobility, self-care, interacting with other people, life activities, and participating in community activities. 4…”

Section: Clinical Measurementsmentioning

confidence: 99%

Novel MS vital sign: multi‐sensor captures upper and lower limb dysfunction

Akhbardeh

Arjona

Krysko

et al. 2020

Ann Clin Transl Neurol

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“…The WHODAS questionnaire showed suitable internal consistency to be used with DM patients in almost all domains, as other studies with similar Cronbach alpha coefficients have shown 18,19 . The only exception was in the Good relationship with people domain, in which, as other studies demonstrate [20][21][22] , the sexual activities question decreased the internal consistency of the domains. Therefore, the use of this question is debatable, as its advantages and disadvantages should be considered for the questionnaire's internal consistency.…”

Section: Discussionmentioning

confidence: 67%

Validation of the Brazilian version of the World Health Organization Disability Assessment Schedule in individuals with diabetes mellitus

et al. 2019

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To evaluate the functioning of individuals with diabetes mellitus (DM) using a biopsychosocial model, recommended by the World Health Organization and sustained in the theoretical-conceptual framework of the International Classification of Functioning, Disability and Health (ICF), this study proposed validating the Brazilian version of WHODAS 2.0 (World Health Organization Disability Assessment Schedule). The 36-item version of WHODAS 2.0 was applied to 100 participants with DM as validation procedures, using the measurement of Diabetes Quality of Life Measure (DQOL-Brazil) and a dynamometry. The psychometric properties analyzed were internal consistency (Cronbach Alpha coefficient) and convergent and divergent external validity (Spearman correlation coefficient). The internal consistency analysis was appropriate, except for the “having a good relationship with people” domain in the alpha Cronbach coefficient. External validity analysis confirmed the convergence hypothesis between the correlate domains of the different tools. The exception was the “life activities” domain (WHODAS) with the left-hand dynamometry. The Brazilian version of the WHODAS 2.0 instrument is a valid instrument to assess the functioning of these individuals.

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“…17 The WHODAS-II was also translated and validated for the Italian healthy population. 18 More recently, its validity has been confirmed with modern Rasch model analyses in MS. 19 The WHODAS-II covers six domains of functioning: cognition (understanding and communicating), mobility (moving and getting around), self-care (hygiene, dressing, eating and staying alone), getting along (interacting with other people), life activities (domestic responsibilities, leisure, work and school) and participation (joining in community activities). Seven scales can be derived from the six domains of functioning: understanding and communicating (six items), getting around (five items), self-care (four items), getting along with others (five items), life activities: household (four items), life activities: work/school (eight items) and participation in society (eight items).…”

Section: Methodsmentioning

confidence: 84%

Assessing clinical correlates of self-rated disability in patients with multiple sclerosis

Magistrale

Medori

Cadavid

et al. 2015

Multiple Sclerosis Journal - Experimental, Translational and Cl

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BackgroundMultiple sclerosis (MS) is associated with significant impairment.ObjectiveThe objective of this article is to identify and compare clinical measures that can predict self-rated disability in patients with MS using the World Health Organization Disability Assessment Schedule II (WHODAS-II).MethodsPatients with MS and healthy controls were consecutively recruited at one center. Patients were evaluated for cognitive function assessment, neurological status, perceived disability, mood, fatigue and disease duration. Controls underwent neuropsychological evaluation only. Data were analyzed using multivariate regression.ResultsWHODAS-II total score was predicted by fatigue (p < 0.001) and neurological status (p < 0.05). Student’s t test comparisons between published WHODAS-II normative data and the enrolled cohort of patients with MS showed significantly worse (p < 0.05) scores for patients on mobility, self-care, life activities, participation and total score domains, but not in cognition. Group differences between patients with MS (n = 61) and controls (n = 61) were significant in all cognitive measures except one verbal memory test subscale. Memory function correlated best with the social participation domain of the WHODAS-II.ConclusionsSelf-reported disability in patients with MS was most strongly influenced by fatigue and to a lesser extent by physical disability. Although cognitive function does affect self-assessment of disability, this is not captured by patients on the WHODAS-II cognitive domain.

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Validation of the World Health Organization Disability Assessment Schedule II (WHODAS-II) in patients with multiple sclerosis

Abstract: The WHODAS-II is a reliable and valid instrument for the assessment of patient-reported disability in MS, with some limitations including some item redundancy and questionable reliability of some subscales.

Cited by 37 publications

References 24 publications

Novel MS vital sign: multi‐sensor captures upper and lower limb dysfunction

Novel MS vital sign: multi‐sensor captures upper and lower limb dysfunction

Validation of the Brazilian version of the World Health Organization Disability Assessment Schedule in individuals with diabetes mellitus

Assessing clinical correlates of self-rated disability in patients with multiple sclerosis

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