The reliability and construct validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) were examined in individuals with Huntington disease (HD).
We examined factor structure (confirmatory factor analysis), internal consistency reliability (Cronbach’s alpha), floor and ceiling effects, convergent validity (Pearson correlations), and known-groups validity (multivariate analysis).
Results of a confirmatory factor analysis replicated the six-factor latent model that reflects the six separate scales within the WHODAS 2.0 (understanding and communicating; getting around; self-care; getting along with others; life activities; participation). Cronbach’s alpha for the scale was 0.94, suggesting good internal consistency reliability. The WHODAS demonstrated a ceiling effect for 19.5 % of participants; there were no floor effects. There was evidence for convergent validity; the WHODAS demonstrated moderate significant correlations with other general measures of health-related quality of life (HRQOL; i.e., RAND-12, EQ5D). Multivariate analyses indicated that late-stage HD participants indicated poorer HRQOL than both early-stage HD and prodromal HD participants for all HRQOL measures.
Findings provide support for both the reliability and validity of the WHODAS 2.0 in individuals with HD.
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Work on this manuscript was supported by the National Institutes of Health (NIH), National Institute of Neurological Disorders and Stroke (1R01NS077946, 5R01NS040068, 1R01NS077946), the National Center for Advancing Translational Sciences (UL1TR000114), the CHDI Foundation awards to the University of Iowa, and the NIH support of the phenotyping performed by CIDR. We thank the University of Iowa, the Investigators and Coordinators of the Huntington Study Group, the study participants, the National Research Roster for Huntington Disease Patients and Families, and the Huntington’s Disease Society of America. We acknowledge the assistance of Jeffrey D. Long, Hans J. Johnson, and Jeremy H. Bockholt. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. HDQLIFE Site Investigators and Coordinators: Praveen Dayalu, Amy Austin (University of Michigan, Ann Arbor, MI); Courtney Shadrick, Amanda Miller (University of Iowa, Iowa City, IA); Kimberly Quaid, Melissa Wesson (Indiana University, Indianapolis, IN); Christopher Ross, Gregory Churchill, Mary Jane Ong (Johns Hopkins University, Baltimore, MD); Susan Perlman, Brian Clemente (University of California-Los Angeles, Los Angeles, CA); Michael McCormack, Humberto Marin, Allison Dicke (Rutgers University, Piscataway, NJ); Joel Perlmutter, Stacey Barton, Shineeka Smith (Washington University, St. Louis, MO); Martha Nance, Pat Ede (Struthers Parkinson’s Center); Anwar Ahmed, Christine Reece, Lyla Mourany (Cleveland Clinic Foundation, Cleveland, OH); Michael Geschwind, Joseph Winer (University of California-San Francisco, San Francisco, CA).
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Carlozzi, N.E., Kratz, A.L., Downing, N.R. et al. Validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in individuals with Huntington disease (HD). Qual Life Res 24, 1963–1971 (2015). https://doi.org/10.1007/s11136-015-0930-x