This page is part of the MII Implementation Guide PRO (v2027.0.0-ballot.1: 2027 Ballot 5) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

WHODAS 2.0

Clinical Context

The WHODAS 2.0 (WHO Disability Assessment Schedule 2.0) is the WHO's generic instrument for assessing functioning and disability across all conditions, methodologically aligned with the ICF (International Classification of Functioning, Disability and Health). This implementation uses the 12-item short form (self-report).

The 12 items cover six ICF domains: cognition, mobility, self-care, getting along with people, life activities and participation. They capture impairment over the past 30 days on a five-point scale (0 = none, 1 = mild, 2 = moderate, 3 = severe, 4 = extreme or cannot do).

Scoring and interpretation (sum score 0–48):

• Simple scoring (WHO "simple scoring"): the sum of the 12 item values (0–4 each), range 0–48.
• Higher values = greater impairment (a limitation score).
• The complex, IRT-based WHO scoring (0–100) is not yet represented in this version (follow-up work).

Placement in the MII PRO module: PCOR-MII lists WHODAS-12 under the domain "Generic Health" / category "Generic Health Status" together with PROMIS Global Health. A planned conversion of the WHODAS sum score onto the PROMIS Generic/Global Health scale (ConceptMap/CQL) is envisaged as follow-up work.

FHIR Implementation

Language strategy: English as the primary language (the original instrument), German texts as translations/designations. The German item wording follows the validated PCOR-MII Item Level Dictionary.

Canonical URL: https://www.medizininformatik-initiative.de/fhir/ext/modul-pro/Questionnaire/mii-qst-pro-whodas-whodas12

Implementation notes:

• linkIds whodas-whodas12-q01 … whodas-whodas12-q12.
• Answer scale via answerValueSet (mii-vs-pro-whodas-12-answer-list); ordinal weights (0–4) as a property on the CodeSystem concepts (mii-cs-pro-whodas-12).
• Automatic score calculation via FHIRPath (.weight().sum()). Note: resolving .weight() from an answerValueSet is engine-dependent; robust scoring via CQL/server.

Score representation:

• ObservationDefinition: mii-obsdef-pro-score-whodas12-simple-sum — value range 0–48, SNOMED 715823002, MII score catalogue whodas12-simple-sum, direction: higher = greater impairment.

License

Important: WHODAS 2.0 is © World Health Organization 2010 (Measuring Health and Disability: Manual for WHODAS 2.0, ISBN 9789241547598).

• The WHO permits clinicians to reproduce WHODAS 2.0 for use with their own patients — free of charge and without separate permission.
• Any other use — in particular embedding it in electronic data capture systems (such as this IG) — requires a WHO licence agreement via the WHO Classifications licensing process. This is free for non-commercial users and requires online acceptance of a usage agreement.
• Translations additionally require WHO approval.
• Only the MII's own FHIR content (profiles, codes, scoring logic) is under CC0; the WHODAS 2.0 item text remains © WHO.

These terms are recorded machine-readably in the copyright element of the Questionnaire and CodeSystem resources.

Sources

• World Health Organization. Measuring Health and Disability: Manual for WHO Disability Assessment Schedule (WHODAS 2.0). Geneva: WHO; 2010. ISBN 9789241547598.
• Kirchberger I, et al. Validation of the WHODAS 2.0 in a population-based sample (MONICA/KORA). Population Health Metrics 2014;12:27. doi:10.1186/s12963-014-0027-8
• Saltychev M, et al. Psychometric properties of the WHODAS 2.0 — systematic review. PMID 31335215.

Example response: WHODAS-12 QuestionnaireResponse