World health organization disability assessment schedule versus functional independence measure in traumatic brain injury

Objective: In patients with traumatic brain injury, to compare functioning measured using the 12-item patient and proxy World Health Organization Disa-bility Assessment Schedule (WHODAS-12) with assessments made by professionals. Patients and methods: At discharge from rehabilita-tion, 89 consecutive patients with traumatic brain injury (10 mild, 36 moderate, 43 severe) and their proxies completed the WHODAS-12. Professionals assessed functioning simultaneously using the WHO minimal generic set of domains of functioning and health and Functional Independence Measure (FIM). Results: From mild to severe traumatic brain injury, increasing disability was found in: sum, component and item scores of patient and proxy WHODAS, except for emotional functions in patients' ratings; in sum and item scores of the WHO minimal generic data-set, except for pain; and in FIM total score and sub-scores. The WHODAS participation component was more impaired than activities. Although prox-ies rated functioning more impaired than patients, the correlation between patient and proxy WHO-DAS was strong (0.74). The correlation between patient/proxy WHODAS and FIM was also strong (-0.56 and -0.78, respectively). Proxy WHODAS differentiated mild and moderate traumatic brain injury more accurately than the other assessments. Conclusion: We recommend using the WHODAS-12 when planning patient-and family-oriented rehabi-litation services after traumatic brain injury.