Abstract
Objective
We conducted a systematic review to determine measurement properties and minimal important
change (MIC) of World Health Organization Disability Assessment Schedule 2.0 (WHODAS
2.0) short (12 questions) and full (36 questions) versions in persons with non-specific
LBP.
Data Sources
MEDLINE, Embase, CINAHL, APA-PsycInfo, CENTRAL (inception-May 2021).
Study Selection, Data Extraction
Eligible studies assessed measurement properties or MIC of WHODAS 2.0 in persons with
LBP. Paired reviewers screened articles, extracted data, and assessed risk-of-bias
using COnsensus-based Standards for selection of health-Measurement INstruments (COSMIN)
and COSMIN-Outcome Measures in Rheumatology checklists.
Data Synthesis
We descriptively synthesized results stratified by measurement property and LBP duration
(subacute: 6 weeks-3 months; chronic: ≥3 months).
Results
We screened 297 citations and included 14 studies (reported in 15 articles). Methodological
quality of studies was very good for internal consistency, varied between very good
and doubtful for construct validity, doubtful for responsiveness, and adequate for
all other properties assessed. Evidence suggests that WHODAS 2.0 full version has
adequate content validity (2 studies); WHODAS 2.0 short and full versions have adequate
structural validity (3 studies), but construct validity is indeterminate (9 studies).
WHODAS 2.0 short and full versions have adequate internal consistency (10 studies),
and the full version has adequate test-retest and inter-rater reliability (3 studies)
in persons with LBP. Minimal detectable change (MDC) was 10.45-13.99/100 for the full
version and 8.6/48 for the short version in persons with LBP (4 studies). WHODAS 2.0
full version has no floor or ceiling effects, but the short version has potential
floor effects in persons with chronic LBP (3 studies). One study estimated MIC for
the full version as 4.87/100 or 9.74/100 (corresponding to 1- and 2-point change on
0-10cm visual-analogue-scale for pain, respectively), and one study estimated 3.09-4.68/48
for the short version.
Conclusions
In persons with LBP, WHODAS 2.0 full version has adequate content validity, structural
validity, internal consistency, and reliability. WHODAS 2.0 short version has adequate
structural validity and internal consistency. Construct validity of the short and
full versions is indeterminate. Since MDC is estimated to be larger than MIC, knowledge
users may consider both MIC and MDC thresholds to measure change in functioning for
LBP.
Key words
List of abbreviations:
COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments), ICC (intraclass correlation coefficient), ICF (International Classification of Functioning, Disability and Health), LBP (low back pain), MIC (minimal important change), MDC (minimal detectable change), OMERACT (Outcome Measures in Rheumatology), WHO (World Health Organization), WHODAS 2.0 (World Health Organization Disability Assessment Schedule 2.0)To read this article in full you will need to make a payment
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Article Info
Publication History
Accepted:
June 7,
2022
Received in revised form:
May 19,
2022
Received:
February 1,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Protocol registration: OSF Registries (https://osf.io/sxtgk)
Identification
Copyright
© 2022 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
