Measuring disability: An agreement study between two disability measures.


Journal

Disability and health journal
ISSN: 1876-7583
Titre abrégé: Disabil Health J
Pays: United States
ID NLM: 101306633

Informations de publication

Date de publication:
04 2021
Historique:
received: 05 06 2020
revised: 04 09 2020
accepted: 08 09 2020
pubmed: 26 9 2020
medline: 25 8 2021
entrez: 25 9 2020
Statut: ppublish

Résumé

The Washington Group Short Set (WGSS) is increasingly being included in surveys worldwide to improve the quality and comparability of disability data within and between nations. However, compared to commonly employed binary impairment measures, the WGSS appears to have a relatively high threshold for disability indication. Empirical evidence is required to quantify this potential difference and its impact. To determine the agreement between a binary disability question (BDQ) and the WGSS measure administered concurrently in a large representative survey of adults. Two WGSS indication scenarios were considered: one using the recommended threshold to indicate disability (WGSS1); and another using a lower threshold (WGSS2). A cross-sectional agreement study nested within the 2018 Canterbury Wellbeing Survey of randomly selected adults aged ≥18 years resident in the greater Christchurch region. From 2807 valid observations, 493 (17.6%), 259 (9.1%), and 822 (28.7%) participants were identified as having a disability by the BDQ, WGSS1 and WGSS2 measures, respectively. While concordance was high between BDQ and WGSS1 measures (85.3%), agreement was only fair (κ = 0.37) and discordance was significantly asymmetrical (p < 0.001). Participants were more likely to be indicated as 'disabled' using the BDQ but not indicated using the WGSS1 than vice versa. Different WGSS thresholds produce widely varying disability estimates, and the recommended WGSS1 resulted in an importantly reduced disability prevalence compared to a binary impairment measure when administered concurrently. This has profound implications for inclusivity and policy for people living with disability.

Sections du résumé

BACKGROUND
The Washington Group Short Set (WGSS) is increasingly being included in surveys worldwide to improve the quality and comparability of disability data within and between nations. However, compared to commonly employed binary impairment measures, the WGSS appears to have a relatively high threshold for disability indication. Empirical evidence is required to quantify this potential difference and its impact.
OBJECTIVE
To determine the agreement between a binary disability question (BDQ) and the WGSS measure administered concurrently in a large representative survey of adults. Two WGSS indication scenarios were considered: one using the recommended threshold to indicate disability (WGSS1); and another using a lower threshold (WGSS2).
METHODS
A cross-sectional agreement study nested within the 2018 Canterbury Wellbeing Survey of randomly selected adults aged ≥18 years resident in the greater Christchurch region.
RESULTS
From 2807 valid observations, 493 (17.6%), 259 (9.1%), and 822 (28.7%) participants were identified as having a disability by the BDQ, WGSS1 and WGSS2 measures, respectively. While concordance was high between BDQ and WGSS1 measures (85.3%), agreement was only fair (κ = 0.37) and discordance was significantly asymmetrical (p < 0.001). Participants were more likely to be indicated as 'disabled' using the BDQ but not indicated using the WGSS1 than vice versa.
CONCLUSIONS
Different WGSS thresholds produce widely varying disability estimates, and the recommended WGSS1 resulted in an importantly reduced disability prevalence compared to a binary impairment measure when administered concurrently. This has profound implications for inclusivity and policy for people living with disability.

Identifiants

pubmed: 32972900
pii: S1936-6574(20)30127-8
doi: 10.1016/j.dhjo.2020.100995
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

100995

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

John A Bourke (JA)

Burwood Academy of Independent Living, Private Bag 4708, Christchurch, 8140, New Zealand; Menzies Health Institute, Griffith University, Queensland, 4222, Australia; Preventive and Social Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. Electronic address: johnny.bourke@burwood.org.nz.

Allison Nichols-Dunsmuir (A)

Community & Public Health, Te Mana Ora, Canterbury District Health Board, PO Box 1475, Christchurch, 8140, New Zealand. Electronic address: allison.nichols-dunsmuir@cdhb.health.nz.

Annabel Begg (A)

Community & Public Health, Te Mana Ora, Canterbury District Health Board, PO Box 1475, Christchurch, 8140, New Zealand. Electronic address: annabel.begg@cdhb.health.nz.

Hongfang Dong (H)

Community & Public Health, Te Mana Ora, Canterbury District Health Board, PO Box 1475, Christchurch, 8140, New Zealand. Electronic address: hongfang.dong@cdhb.health.nz.

Philip J Schluter (PJ)

School of Health Sciences, University of Canterbury - Te Whare Wānanga o Waitaha, Private Bag 4800, Christchurch, 8140, New Zealand; School of Clinical Medicine - Primary Care Clinical Unit, The University of Queensland, 4072, Brisbane, Australia. Electronic address: philip.schluter@canterbury.ac.nz.

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