WaLIDD score, a new tool to diagnose dysmenorrhea and predict medical leave in university students

Abstract

BackgroundDysmenorrhea is a frequent and misdiagnosed symptom affecting the quality of life in young women. A working ability, location, intensity, days of pain, dysmenorrhea (WaLIDD) score was designed to diagnose dysmenorrhea and to predict medical leave.MethodsThis cross-sectional design included young medical students, who completed a self-administered questionnaire that contained the verbal rating score (VRS; pain and drug subscales) and WaLIDD scales. The correlation between scales was established through Spearman test. The area under the receiver operating characteristic (ROC) curve, sensitivity, specificity, and likelihood ratio (LR +/−) were evaluated to diagnose students availing medical leave due to dysmenorrhea; moreover, to predict medical leave in students with dysmenorrhea, a binary logistic regression was performed.ResultsIn all, 585 students, with a mean age of 21 years and menarche at 12 years, participated. Most of them had regular cycles, 5 days of menstrual blood flow and 1–2 days of lower abdominal pain. The WaLIDD scale presented an adequate internal consistency and strong correlation with VRS subscales. With a cutoff of >6 for WaLIDD and 2 for VRS subscales (drug subscale and pain subscale) to identify students with dysmenorrhea, these scales presented an area under the curve (AUC) ROC of 0.82, 0.62, and 0.67, respectively. To identify students taking medical leave due to dysmenorrhea, WaLIDD (cutoff >9) and VRS subscales (cutoff >2) presented an AUC ROC of 0.97, 0.68, and 0.81; moreover, the WaLIDD scale showed a good LR +14.2 (95% CI, 13.5–14.9), LR −0.00 (95% CI, undefined), and predictive risk (OR 5.38; 95% CI, 1.78–16.2).ConclusionThis research allowed a comparison between two multidimensional scales regarding their capabilities, one previously validated and a new one, to discriminate among the general population of medical students, among those with dysmenorrhea or those availing medical leave secondary to dysmenorrhea. WaLIDD score showed a larger effect size than the pain and drug score in the students. In addition, this study demonstrated the ability to predict this combination of events.

Prevalence of premenstrual syndrome and dysmenorrhea among medical students and its impact on their college absenteeism

“…The WaLIDD score contained three frequently used criteria identified in the definitions of dysmenorrhea present in the literature: days of pain (D), work ability (Wa), and anatomical region of pain location (L). 11 Study reported that about 16% of the students had symptoms which were severe enough for them to be absent from college.…”

Use of complementary and alternative therapies for the treatment of dysmenorrhea among undergraduate pharmacy students in Malaysia: a cross sectional study

“…The results for the prevalence of dysmenorrhea and its effect on academic activities will be published elsewhere. The severity of dysmenorrhea was assessed using WaLIDD scale [ 20 ]. WaLIDD score measures the severity of dysmenorrhea on a scale of 0–12 with scores 0, 1–4, 5–7, and 8–12 representing no, mild, moderate and severe dysmenorrhea, respectively [ 20 ].…”

“…The severity of dysmenorrhea was assessed using WaLIDD scale [ 20 ]. WaLIDD score measures the severity of dysmenorrhea on a scale of 0–12 with scores 0, 1–4, 5–7, and 8–12 representing no, mild, moderate and severe dysmenorrhea, respectively [ 20 ]. A five-point Likert scale was used to assess the student’s perceptions towards analgesics and CATs.…”

“…The questionnaire was developed in the English language after the review of relevant previous literatures on dysmenorrhea and the usage of CAT as well as analgesics [16][17][18][19][20][21][22][23][24]. The initial questionnaire was validated by three senior lecturers in the Department of Pharmacy Practice and the questionnaire was revised based on the comments and suggestions of the reviewers.…”

Development and Testing of the Dysmenorrhea Symptom Interference (DSI) Scale

“…Other measures of dysmenorrhea pain have not fully captured symptom interference. For example, one measure assessed "working ability" as the only dysmenorrhea impact (Teheran et al, 2018), while another only assessed impact on "things the person usually does" without asking what specific aspects of life are affected (Wyrwich et al, 2018). Pain interference with daily activities has been acknowledged as a core outcome in pain research, especially in clinical trials (Dworkin et al, 2005).…”