Developing the World Health Organization Disability Assessment Schedule 2.0

Abstract

Objective: To describe the development of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for measuring functioning and disability in accordance with the International Classification of Functioning, Disability and Health. WHODAS 2.0 is a standard metric for ensuring scientific comparability across different populations.

Methods: A series of studies was carried out globally. Over 65,000 respondents drawn from the general population and from specific patient populations were interviewed by trained interviewers who applied the WHODAS 2.0 (with 36 items in its full version and 12 items in a shortened version).

Findings: The WHODAS 2.0 was found to have high internal consistency (Cronbach's alpha, α: 0.86), a stable factor structure; high test-retest reliability (intraclass correlation coefficient: 0.98); good concurrent validity in patient classification when compared with other recognized disability measurement instruments; conformity to Rasch scaling properties across populations, and good responsiveness (i.e. sensitivity to change). Effect sizes ranged from 0.44 to 1.38 for different health interventions targeting various health conditions.

Conclusion: The WHODAS 2.0 meets the need for a robust instrument that can be easily administered to measure the impact of health conditions, monitor the effectiveness of interventions and estimate the burden of both mental and physical disorders across different populations.

Figures

Fig. 1

Factor structure of the World Health Organization Disability Assessment Schedule 2.0, 36-item version, in formative field studies

Fig. 2

Test–retest reliability of the World Health Organization Disability Assessment Schedule 2.0, 36-item versiona

Fig. 3

World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0): domain profile by subgroup

Fig. 4

Population distribution of scores on the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), 36-item version

Fig. 5

Responsiveness (sensitivity to change) of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), 36-item version (SF 36), as noted in the case of treatment for depression