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Measuring disability in amyotrophic lateral sclerosis/motor neuron disease: the WHODAS 2.0-36, WHODAS 2.0-32, and WHODAS 2.0-12.

Authors :
Young CA
Ealing J
McDermott CJ
Williams TL
Al-Chalabi A
Majeed T
Talbot K
Harrower T
Faull C
Malaspina A
Annadale J
Mills RJ
Tennant A
Source :
Amyotrophic lateral sclerosis & frontotemporal degeneration [Amyotroph Lateral Scler Frontotemporal Degener] 2023 Feb; Vol. 24 (1-2), pp. 63-70. Date of Electronic Publication: 2022 Jul 23.
Publication Year :
2023

Abstract

Aim: To investigate whether the World Health Organization Disability Assessment Schedule 2.0 (WHODAS) can provide interval level measurement of disability in Amyotrophic Lateral Sclerosis (ALS), allowing parametric analyses. Methods : Data on the WHODAS 12, 32, and 36-item versions, from 1120 patients studied at one or more time points, were fit to the Rasch model and comparisons made against ALSFRS-R, King's staging, and mortality. Trajectory modeling was undertaken for a newly diagnosed (≤6 months) cohort of 454 individuals. Results : Total scores for WHODAS 32 and 36-item versions can be converted to interval level measurement suitable for individual clinical use, and the 12-item WHODAS total for group use. The 36-item version is shown to be equivalent to the 32-item version. Expected correlations were seen with King's staging, ALSFRS-R, and EQ-5D-5L. Trajectory analysis of disability (WHODAS 2.0) showed three clearly demarcated groups with differences in King's staging, depressive symptomatology and mortality, but not age. Conclusions : The WHODAS 2.0 is a brief patient reported outcome measure which can be used to measure disability in ALS. Provided the patient answers all 36 (32 if not working) items, the conversion table produces an interval level estimate for parametric analyses. The different trajectories demonstrated from diagnosis support the concept of a prodromal period, and suggest the WHODAS 2.0 could be used for surveillance of at risk populations, such as those with genetic predisposition.

Details

Language :
English
ISSN :
2167-9223
Volume :
24
Issue :
1-2
Database :
MEDLINE
Journal :
Amyotrophic lateral sclerosis & frontotemporal degeneration
Publication Type :
Academic Journal
Accession number :
35876069
Full Text :
https://doi.org/10.1080/21678421.2022.2102926