Validation of tele-assessment of disability and health after stroke using WHODAS 2.0 through video call in a middle-income country.

Background: The validity, reliability, and accuracy of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for face-to-face assessment in the stroke population are well established. However, the validity and reliability of WHODAS 2.0 through tele-assessment remain uncertain. OBJECTIVE: To assess the reliability, agreement, internal consistency, criterion and discriminant validity of WHODAS 2.0 when administered through video calls.

Methods: A longitudinal methodological study included fifty individuals with chronic stroke. Both in-person and video call assessments were conducted, and their sequence was randomized. The reliability was determined using the Intraclass Correlation Coefficient (ICC2,1). Measurement errors were assessed using the standard error of measurement (SEM) and smallest detectable change (SDC). Internal consistency was assessed using Cronbach's α. Criterion validity was determined by conducting Pearson's correlation coefficient analysis between in-person and video call assessments. Discriminant validity was examined using the Receiver Operating Characteristic (ROC) curve to distinguish disability levels, with the Modified Rankin Scale as the reference standard.

Results: The participants had a mean age of 56.10 ± 10.8 years, with an equal distribution of genders. Adequate reliability was observed between the two methods (ICC2,1 = 0.88; 95% CI = 0.79-0.93; p < 0.001), and internal consistency was also adequate (Cronbach's α = 0.88). The criterion validity revealed a strong correlation (r = 0.78; p < 0.001). Discriminant validity demonstrated satisfactory accuracy in distinguishing disability levels via video call (AUC = 0.67; p = 0.04).

Discussion: This study offers evidence supporting the validity and reliability of the WHODAS 2.0 assessment through video call. Teleassessment using WHODAS 2.0 proves suitable for individuals who have had a stroke, enabling remote evaluation and care.