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Measurement properties of the WHO Disability Assessment Schedule 2.0 for evaluating functional status after inpatient surgery
BJS (British Journal of Surgery) Pub Date : 2022-10-05 , DOI: 10.1093/bjs/znac263
Julian F Daza 1, 2 , Brian H Cuthbertson 2, 3, 4 , Paul S Myles 5 , Mark A Shulman 5 , Duminda N Wijeysundera 2, 3, 6 ,
Affiliation  

Abstract Background Expert recommendations propose the WHO Disability Assessment Schedule (WHODAS) 2.0 as a core outcome measure in surgical studies, yet data on its long-term measurement properties remain limited. These were evaluated in a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) prospective cohort. Methods Participants were adults (40 years of age or older) who underwent inpatient non-cardiac surgery. The 12-item WHODAS and EQ-5DTM-3L questionnaires were administered preoperatively (in person) and 1 year postoperatively (by telephone). Responsiveness was characterized using standardized response means (SRMs) and correlation coefficients between change scores. Construct validity was evaluated using correlation coefficients between 1-year scores and comparisons of WHODAS scores across clinically relevant subgroups. Results The analysis included 546 patients. There was moderate correlation between changes in WHODAS and various EQ-5DTM subscales. The strongest correlation was between changes in WHODAS and changes in the functional domains of the EQ-5D-3L—for example, mobility (Spearman’s rho 0.40, 95 per cent confidence interval [c.i.] 0.32 to 0.48) and usual activities (rho 0.45, 95 per cent c.i. 0.30 to 0.52). When compared across quartiles of EQ-5D index change, median WHODAS scores followed expected patterns of change. In subgroups with expected functional status changes, the WHODAS SRMs ranged from ‘small’ to ‘large’ in the expected directions of change. At 1 year, the WHODAS demonstrated convergence with the EQ-5D-3L functional domains, and good discrimination between patients with expected differences in functional status. Conclusion The WHODAS questionnaire has construct validity and responsiveness as a measure of functional status at 1 year after major surgery.

中文翻译:

WHO 残疾评估表 2.0 用于评估住院手术后功能状态的测量特性

摘要 背景专家建议建议将世界卫生组织残疾评估表(WHODAS)2.0作为外科研究的核心结果衡量标准,但其长期衡量特性的数据仍然有限。这些在术前运动耐量测量 (METS) 前瞻性队列的二次分析中进行了评估。 方法参与者是接受住院非心脏手术的成年人(40 岁或以上)。术前(亲自)和术后 1 年(通过电话)进行了 12 项 WHODAS 和 EQ-5DTM-3L 问卷调查。使用标准化响应平均值 (SRM) 和变化分数之间的相关系数来表征响应性。使用 1 年评分之间的相关系数和临床相关亚组的 WHODAS 评分比较来评估结构效度。 结果该分析包括 546 名患者。WHODAS 和各种 EQ-5DTM 分量表的变化之间存在中等相关性。最强的相关性是 WHODAS 的变化与 EQ-5D-3L 功能域的变化之间的关系,例如,流动性(Spearman 的 rho 0.40,95% 置信区间 [ci] 0.32 至 0.48)和日常活动(rho 0.45, 95% CI 0.30 至 0.52)。当比较 EQ-5D 指数变化的四分位数时,WHODAS 得分中位数遵循预期的变化模式。在具有预期功能状态变化的亚组中,WHODAS SRM 在预期变化方向上范围从“小”到“大”。1 年时,WHODAS 表现出与 EQ-5D-3L 功能域的趋同性,并且能够很好地区分具有预期功能状态差异的患者。 结论WHODAS 问卷具有结构有效性和响应性,可作为大手术后 1 年功能状态的衡量标准。
更新日期:2022-10-05
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