Diagnostic accuracy of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) to estimate disability after stroke

Purpose To analyze WHODAS 2.0's diagnostic capacity and accuracy in stroke survivors. Methods Cross-sectional methodological study, in which individuals with chronic stroke were evaluated. Disability was considered the outcome variable, being evaluated by WHODAS 2.0; the modified Rankin scale (mRS) was used as the parameter variable. Disability was categorized in two levels being: "No or mild disability" (mRS 0-2) and "Moderate to severe disability" (mRS 3-5). To identify the cutoff point, a Receiver-Operating Characteristic (ROC) curve was constructed with a confidence interval (CI) of 95% and considering sensitivity and specificity. Results The cutoff point >39.62 proved acceptable for distinguishing individuals with moderate/severe disability from individuals with no or mild disability (<= 39.62 points), with 66.22% sensitivity, 72.41% specificity, positive predictive value (PPV) of 45.45%, and negative predictive value (NPV) of 84.74%. The area under the curve (AUC) was 0.747 (CI 95%: 0.65-0.83; p < 0.001). Conclusion WHODAS 2.0 demonstrated acceptable diagnostic capacity and the cutoff point of 39.62 proved suitable for distinguishing individuals with moderate/severe disability from those with no or mild disability after stroke.