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Title: Measurement of disability-free survival after surgery
Epworth Authors: Ponsford, Jennie
Other Authors: Shulman, Mark
Myles, Paul
Chan, Matthew
McIIroy, David
Wallace, Sophie
Keywords: World Health Organization Disability Assessment Schedule 2.0
Postoperative Disability
Patient-Centered Outcomes
Monash-Epworth Rehabilitation Research Centre, Richmond, Victoria, Australia.
Issue Date: Mar-2015
Publisher: Lippincott Williams and Wilkins
Citation: Anesthesiology. 2015 Mar;122(3):524-36
Abstract: Survival and freedom from disability are arguably the most important patient-centered outcomes after surgery, but it is unclear how postoperative disability should be measured. The authors thus evaluated the World Health Organization Disability Assessment Schedule 2.0 in a surgical population. The authors examined the psychometric properties of World Health Organization Disability Assessment Schedule 2.0 in a diverse cohort of 510 surgical patients. The authors assessed clinical acceptability, validity, reliability, and responsiveness up to 12 months after surgery. Criterion and convergent validity of World Health Organization Disability Assessment Schedule 2.0 were supported by good correlation with the 40-item quality of recovery scale at 30 days after surgery (r = -0.70) and at 3, 6, and 12 months after surgery with physical functioning (The Katz index of independence in Activities of Daily Living; r = -0.70, r = -0.60, and rho = -0.47); quality of life (EQ-5D; r = -0.57, -0.60, and -0.52); and pain interference scores (modified Brief Pain Inventory Short Form; r = 0.72, 0.74, and 0.81) (all P < 0.0005). Construct validity was supported by increased hospital stay (6.9 vs. 5.3 days, P = 0.008) and increased day 30 complications (20% vs. 11%, P = 0.042) in patients with new disability. There was excellent internal consistency with Cronbach's α and split-half coefficients greater than 0.90 at all time points (all P < 0.0005). Responsiveness was excellent with effect sizes of 3.4, 3.0, and 1.0 at 3, 6, and 12 months after surgery, respectively. World Health Organization Disability Assessment Schedule 2.0 is a clinically acceptable, valid, reliable, and responsive instrument for measuring postoperative disability in a diverse surgical population. Its use as an endpoint in future perioperative studies can provide outcome data that are meaningful to clinicians and patients alike.
DOI: 10.1097/ALN.0000000000000586
PubMed URL:
ISSN: 0003-3022
Journal Title: Anesthesiology
Type: Journal Article
Affiliated Organisations: Department of Anaesthesia and Perioperative Medicine, Alfred Hospital and Monash University, Melbourne, Victoria, Australia
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong Special Administrative Region
Type of Clinical Study or Trial: Validation Study
Appears in Collections:Rehabilitation

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