Measurement Properties of the Whiplash Disability Questionnaire in Acute Whiplash-associated Disorders
Year: 2013
Type: dissertation
Study design: Observational Study
Abstract: Whiplash-associated disorders (WAD) include physical and psychological symptoms that may lead to disability. However, measuring disability following whiplash injuries is challenging because we lack valid and reliable measurement tools. The assessment of WAD-related disability relies on self-reported instruments that are specific to neck pain and do not comprehensively target the constructs associated with WAD-related disability. Designing new tools and evaluating their measurement properties is challenging because of the apparent inconsistencies in the theoretical frameworks (psychometrics and clinimetrics) used in instrument development and in reliability, validity and responsiveness evaluation. A scoping review design was used to develop a conceptual theory on the difference between clinimetrics and psychometrics in order to provide recommendations for future application. The scoping review of psychometric and clinimetric methods suggested that the two frameworks are not as divergent as reflected in the current protracted debates. Content analysis revealed that differences only exist in the scope of what is measured and in instrument development methods with no operational differences in the testing phases. Based on content analysis, I developed a new framework that bridges the two measurement schools with an overlapping informed zone between them. I designed a cohort study of 130 participants with acute WAD to assess the measurement properties of the Whiplash Disability Questionnaire (WDQ). The WDQ is a recently developed instrument designed to capture the broad construct of WAD-related disability. The WDQ measurement properties were determined in adults with WAD recruited within 21 days of their collision. My study indicates that the WDQ and its subscales are reliable and valid for clinical and research use. The WDQ can demonstrate change over time as a single scale or as the daily activities subscale. However, WDQ users should be aware of its measurement error when demonstrating change over time. Furthermore, the emotional subscale should not be used alone to demonstrate change over six weeks because it was not responsive. My thesis proposes a unified framework for studying the measurement properties of assessment tools used in clinical practice. I also demonstrated that the WDQ possesses the necessary properties to be used in patients with acute WAD.
Source: TSpace (University of Toronto)
Author: Maja Stupar
Language: English
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2691019282