The use of the Washington Group on Disability Statistics questionnaires to identify hearing disability: a systematic review

Moreno, Jennifer Dantas; Bennett, Larissa Hellen Viégas; Ferrite, Silvia

Jennifer Dantas Moreno

Departamento de Fonoaudiologia, Universidade Federal da Bahia – UFBA - Salvador (BA), Brasil.

https://orcid.org/0000-0003-3157-3496

Larissa Hellen Viégas Bennett

College of Health Professions, School of Audiology, Pacific University - Hillsboro (OR), USA.

https://orcid.org/0000-0003-1767-6923

Silvia Ferrite

Departamento de Fonoaudiologia, Universidade Federal da Bahia – UFBA - Salvador (BA), Brasil.

https://orcid.org/0000-0001-5344-3751

Conflict of interests: nothing to declare.

Correspondence addres: Jennifer Dantas Moreno Departamento de Fonoaudiologia, Universidade Federal da Bahia – UFBA R. Basílio da Gama, s/n - Canela, Salvador - BA, 40110-040, Brazil. E-mail: jennifer.danntas@hotmail.com

Author contributions

JDM participated in the study design, the collection, analysis and interpretation of data and the drafting of the article. LHVB participated in the study as the second reviewer for the collection and analysis of articles included in the synthesis and the critical review of the article. SF participated as supervisor of the study design, the analysis and interpretation of data and the drafting and critical review of the article.

Figures (1)
Tables (6)

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Figure 1
Flowchart mapping the search and selection of scientific works for a systematic review of the use of the Washington Group on Disability Statistics hearing disability question, using PRISMA* criteria

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PUBMED SCOPUS SCIENCE DIRECT WEB OF SCIENCE LILACS Search (((“washington group”) OR (((“short set” OR “extended set”)) AND question))) AND (((((“washington group”) OR (((“short set” OR “extended set”)) AND question)) OR (((“washington questionnaire”) OR module disability) OR “do you have difficulty”))) AND (((((((((domain) OR function) OR disability) OR impairment) OR disorder) OR “health survey”[MeSH Terms]) OR hearing) OR “hearing loss”) OR difficulty)) ((TITLE-ABSKEY (“washington group”)) OR (((TITLE-ABS KEY (“short set”) OR TITLE-ABS-KEY (“extended set”))) AND (TITLE-ABS-KEY (question))) OR ((TITLE-ABS-KEY (“Washington question”)OR TITLE-ABS-KEY (“Washington module disability”) OR TITLE-ABS-KEY ({do you have difficulty})))) AND ((TITLE-ABS KEY (function) OR TITLE-ABS-KEY (domain) OR TITLE-ABS-KEY (disability) OR TITLE-ABS-KEY (impairment) OR TITLE-ABS-KEY (disorder) OR TITLE-ABS-KEY (“health survey”) OR TITLE-ABS-KEY (hearing) OR TITLE-ABS-KEY (“hearing loss”) OR TITLE-ABS-KEY (difficulty)) (((“washington group W/2 disability”) or (“washington group”)) OR ((({short set?}) or ({extended set?})) AND ({question?}))) AND (((hearing) OR (“hearing loss”) OR (difficulty)) AND ((function) OR (domain) OR (disability) OR (impairment) OR (disorder))) Tópico: (function) OR Tópico: (domain) OR Tópico: (difficulty) OR Tópico: (hearing) OR Tópico: (“hearing loss”) OR Tópico: (“health survey”) OR Tópico: (impairment) OR Tópico: (disorder*) OR Tópico: (disability)AND Tópico: (“Washington question*”) OR Tópico: (“do you have difficulty”) OR Tópico: (“washington module”) OR (“short set” OR “extended set”) OR (“Washington group”) (tw:(“washington group” OR “short set” OR “extended set”)) AND (tw:((tw:(domain)) OR (tw:(function)) OR (tw:(disability)) OR (tw:(impairment)) OR (tw:(disorder)) OR (mh:(“health survey”)) OR (tw:(hearing)) OR (tw:(“hearing loss”)) OR (tw:(difficulty))))

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Table 1
Characteristics of studies selected in the review of literature about the use of the Washington Group on Disability Statistics’ tools to identify hearing disability, 2017

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Table 2
Distribution of studies that used one of the Washington Group modules, by health region and country (N=65)

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Table 3
Studies which contained data about the prevalence of hearing disability according to type of Washington Group module used

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Table 4
Distribution of studies that presented accuracy measures for hearing disability obtained from the Washington Group hearing module compared to pure tone audiometry

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PUBMED SCOPUS SCIENCE DIRECT WEB OF SCIENCE LILACS Search (((“washington group”) OR (((“short set” OR “extended set”)) AND question))) AND (((((“washington group”) OR (((“short set” OR “extended set”)) AND question)) OR (((“washington questionnaire”) OR module disability) OR “do you have difficulty”))) AND (((((((((domain) OR function) OR disability) OR impairment) OR disorder) OR “health survey”[MeSH Terms]) OR hearing) OR “hearing loss”) OR difficulty)) ((TITLE-ABSKEY (“washington group”)) OR (((TITLE-ABS KEY (“short set”) OR TITLE-ABS-KEY (“extended set”))) AND (TITLE-ABS-KEY (question))) OR ((TITLE-ABS-KEY (“Washington question”)OR TITLE-ABS-KEY (“Washington module disability”) OR TITLE-ABS-KEY ({do you have difficulty})))) AND ((TITLE-ABS KEY (function) OR TITLE-ABS-KEY (domain) OR TITLE-ABS-KEY (disability) OR TITLE-ABS-KEY (impairment) OR TITLE-ABS-KEY (disorder) OR TITLE-ABS-KEY (“health survey”) OR TITLE-ABS-KEY (hearing) OR TITLE-ABS-KEY (“hearing loss”) OR TITLE-ABS-KEY (difficulty)) (((“washington group W/2 disability”) or (“washington group”)) OR ((({short set?}) or ({extended set?})) AND ({question?}))) AND (((hearing) OR (“hearing loss”) OR (difficulty)) AND ((function) OR (domain) OR (disability) OR (impairment) OR (disorder))) Topic: (function) OR Topic: (domain) OR Topic: (difficulty) OR Topic: (hearing) OR Topic: (“hearing loss”) OR Topic: (“health survey”) OR Topic: (impairment) OR Topic: (disorder*) OR Topic: (disability)AND Topic: (“Washington question*”) OR Topic: (“do you have difficulty”) OR Topic: (“washington module”) OR (“short set” OR “extended set”) OR (“Washington group”) (tw:(“washington group” OR “short set” OR “extended set”)) AND (tw:((tw:(domain)) OR (tw:(function)) OR (tw:(disability)) OR (tw:(impairment)) OR (tw:(disorder)) OR (mh:(“health survey”)) OR (tw:(hearing)) OR (tw:(“hearing loss”)) OR (tw:(difficulty))))

Variables	N=65	%
Type of Study
Article	53	81.5
Report/Official Document	12	18.5
Journal ^* * Journals from which more than one study was selected for the review (IF; H)
Plos One (IF:1.16; H:241)	7	10.8
Bio Med Central (IF:1.34; H:103)	6	9.2
Disability and Rehabilitation (IF:0.8; H:92)	4	6.2
ALTER - European Journal of Disability Research (IF:0.3; H:11)	3	4.6
BMJ Open (IF: 1.01; H:24)	3	4.6
Disability and Health Journal (IF:1.95; H:24)	3	4.6
Population Health Metrics (IF:1.95; H:40)	2	3.1
Tropical Medicine & International Health (IF: 1.73; H:97)	2	3.1
World Development (IF: 2.12; H:140)	2	3.1
Others	33	50.8
Study Year
2001 - 2004	3	4.6
2005 - 2008	14	21.5
2009 - 2012	26	40.0
2013 - 2016	22	33.8
Objectives
To estimate prevalence	16	24.6
To investigate factors associated with disability	40	61.5
Instrument validation studies	1	1.5
Comparison between instruments	8	12.3
Module
WG Short Set	53	81.5
WG Extended Set	4	6.2
WG/UNICEF Children Disability	6	9.2
WG Extended Set and WG/UNICEF Children Disability	2	3.1

REGION ^* * Regions defined according to the World Health Organization	COUNTRY	NUMBER OF STUDIES
AFRICA	Cameroon	7
	South Africa	6
	Uganda	5
	Zambia	3
	Ethiopia	2
	Burkina Faso	1
	Ghana	1
	Lesotho	1
	Kenya	1
	Sierra Leone	1
	Tanzania	1
THE AMERICAS	Mexico	3
	United States	2
	Peru	2
	Guyana	1
	Haiti	1
EUROPE	Portugal	2
WESTERN MEDITERRANEAN	Palestine	1
WESTERN PACIFIC	Vietnam	5
	Fiji	2
	Philippines	2
	Cambodia	1
	Malaysia	1
	Mongolia	1
SOUTHEAST ASIA	India	7
	Bangladesh	6
	Indonesia	2
	Nepal	2
	Myanmar	1
	Sri Lanka	1

Study	Country	Year	Population	Prevalence of hearing disability
				Binary response (yes) for difficulty	Most of the time	Some difficulty or worse	A lot of difficulty or worse ^* * Washington Group recommended cut-off point	Cannot do at all
SHORT SET
Ahmad et al.⁽⁷²72 Ahmad NA, Mohamad Kasim N, Mahmud NA, Mohd Yusof Y, Othman S, Chan YY, et al. Prevalence and determinants of disability among adults in Malaysia: results from the National Health and Morbidity Survey (NHMS) 2015. BMC Public Health. 2017;17(1):756. http://dx.doi.org/10.1186/s12889-017-4793-7. PMid:28962562. http://dx.doi.org/10.1186/s12889-017-479... ⁾	Malaysia	2015	19,959 individuals 18-30 years (35%) to > 60 years (11.2%)			5.5%
Ramachandra et al.⁽⁷³73 Ramachandra SS, Allagh KP, Kumar H, Grills N, Marella M, Pant H, et al. Prevalence of disability among adults using Rapid Assessment of Disability tool in a rural district of South India. Disabil Health J. 2016;9(4):624-31. http://dx.doi.org/10.1016/j.dhjo.2016.05.010. PMid:27343046. http://dx.doi.org/10.1016/j.dhjo.2016.05... ⁾	India	2014	4,000 adults 18-28 years (22.2%) to >70 years (7.6%)		1.60%
Ferrite et al.⁽⁷⁴74 Ferrite S, Mactaggart I, Kuper H, Oye J, Polack S. Prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon. Trop Med Int Health. 2017;22(4):485-92. http://dx.doi.org/10.1111/tmi.12840. PMid:28102004. http://dx.doi.org/10.1111/tmi.12840... ⁾	Cameroon	2013	4,104 individuals 0-9 years (34.7%) to >80 years (2.5%)			14.10%	1.10%
Danquah et al.⁽⁷⁵75 Danquah L, Polack S, Brus A, Mactaggart I, Houdon CP, Senia P, et al. Disability in post-earthquake Haiti: prevalence and inequality in access to services. Disabil Rehabil. 2015;37(12):1082-9. http://dx.doi.org/10.3109/09638288.2014.956186. PMid:25178862. http://dx.doi.org/10.3109/09638288.2014.... ⁾	Haiti	2012	3,132 individuals 0-16 years (21%) to >16 years (79%)			1.4%	0.20%	0.04%
Islam et al.⁽⁷⁶76 Islam FMA, Bhowmik JL, Islam SZ, Renzaho AMN, Hiller JE. Factors associated with disability in rural Bangladesh: Bangladesh Population-Based Diabetes and Eye Study (BPDES). PLoS One. 2016;11(12):e0165625. http://dx.doi.org/10.1371/journal.pone.0165625. PMid:27936096. http://dx.doi.org/10.1371/journal.pone.0... ⁾	Bangladesh	2012	3,104 individuals 30-35 years (7.7%) to > 65 years (14.7%)	16.50%
				12.6% M
				18.5% F
Wandera et al.⁽⁷¹71 Wandera SO, Ntozi J, Kwagala B. Prevalence and correlates of disability among older Ugandans: evidence from the Uganda National Household Survey. Glob Health Action. 2014;7(1):25686. http://dx.doi.org/10.3402/gha.v7.25686. PMid:25413721. http://dx.doi.org/10.3402/gha.v7.25686... ⁾	Uganda	2010	2,628 old people (>50 years)			10.7% M	1.5%M
	Uganda	2010	2,628 old people (>50 years)			15.9% F	2.2% F
Tareque et al.⁽⁷⁰70 Tareque MI, Tiedt AD, Islam TM, Begum S, Saito Y. Gender differences in functional disability and self-care among seniors in Bangladesh. BMC Geriatr. 2017;17(1):177. http://dx.doi.org/10.1186/s12877-017-0577-2. PMid:28789638. http://dx.doi.org/10.1186/s12877-017-057... ⁾	Bangladesh	2010	4,176 old people (>60 years)			10.32%	2.16%	0.26%
						9% M	2% M	0.19% M
						11.7% F	2.31% F	0.34% F
Marella et al.⁽⁷⁷77 Marella M, Huq NL, Devine A, Baker SM, Quaiyum MA, Keeffe JE. Prevalence and correlates of disability in Bogra district of Bangladesh using the rapid assessment of disability survey. BMC Public Health. 2015;15(1):867. http://dx.doi.org/10.1186/s12889-015-2202-7. PMid:26346063. http://dx.doi.org/10.1186/s12889-015-220... ⁾	Bangladesh	2010	2,315 adults 18 -24 years (23.8%) to > 50 years		2.30%
Bachani et al.⁽¹⁹19 Bachani AM, Galiwango E, Kadobera D, Bentley JA, Bishai D, Wegener S, et al. A new screening instrument for disability in low-income and middle-income settings: application at the Iganga-Mayuge Demographic Surveillance System (IM-DSS), Uganda. BMJ Open. 2014;4(12):e005795. http://dx.doi.org/10.1136/bmjopen-2014-005795. PMid:25526793. http://dx.doi.org/10.1136/bmjopen-2014-0... ⁾	Uganda	2009	5,247 individuals 0-14 years (39%) to >60 years (6%)			2.6% M
	Uganda	2009	5,247 individuals 0-14 years (39%) to >60 years (6%)			3.2% F
Loeb et al.⁽⁷⁸78 Loeb ME, Eide AH, Mont D. Approaching the measurement of disability prevalence: the case of Zambia. Alter. 2008;2(1):32-43. http://dx.doi.org/10.1016/j.alter.2007.06.001. http://dx.doi.org/10.1016/j.alter.2007.0... ⁾	Zambia	2006	28,010 individuals (all ages)			3.70%	2.30%	0.50%
Seager and Tamasane⁽⁴⁹49 Seager JR, Tamasane T. Health and well-being of the homeless in South African cities and towns. Dev South Afr. 2010;27(1):63-83. http://dx.doi.org/10.1080/03768350903519358. http://dx.doi.org/10.1080/03768350903519... ⁾	South Africa	2005	942 street-dwelling adults and 305 children (12-73 years). Answered by key informants			5.9% (child)	3.0%(children)	0%(children)
	South Africa	2005				10.4% (adult)	1.7%(adults)	1.7%(adults)
EXTENDED SET
Moniruzzaman et al.⁽⁷⁹79 Moniruzzaman M, Zaman MM, Mashreky SR, Rahman AKMF. Prevalence of disability in Manikganj district of Bangladesh: results from a large-scale cross-sectional survey. BMJ Open. 2016;6(7):e010207. http://dx.doi.org/10.1136/bmjopen-2015-010207. PMid:27431897. http://dx.doi.org/10.1136/bmjopen-2015-0... ⁾	Bangladesh	2009	37,030 individuals (all ages)				1.00%	0.40%
WG/UNICEF
Rojas-Martínez et al.⁽⁶⁹69 Rojas-Martínez R, Castro F, Villalobos A, Romero M, Allen B, Hubert C, et al. Population profiles associated with severe functioning difficulties and disability among two to four years old children in Mexico. Salud Publica Mex. 2017;59(4):361-9. http://dx.doi.org/10.21149/8485. PMid:29211256. http://dx.doi.org/10.21149/8485... ⁾	Mexico	2015	5,010 children (2-4 years)				0.16%
							0.22%M
							0.1% F
Geda et al.⁽⁵²52 Geda B, Berhane Y, Assefa N, Worku A. School Enrollment among children with disability in rural eastern Ethiopia: a community-based survey. J Commun Disord Deaf Stud Hear Aids. 2017;04(4):1000166. http://dx.doi.org/10.4172/2375-4427.1000166. http://dx.doi.org/10.4172/2375-4427.1000... ⁾	Ethiopia	2014	21,572 children (0-14 years)				1.94%
							2.14%M
							1.71% F

Study	Questionnaire/Instrument	Population/Domain analysed		Sensitivity		Specificity		Positive Predictive Value		Negative Predictive Value
Study	Questionnaire/Instrument	Population/Domain analysed		Some difficulty or worse	A lot of difficulty or worse	Some difficulty or worse	A lot of difficulty or worse	Some difficulty or worse	A lot of difficulty or worse	Some difficulty or worse	A lot of difficulty or worse
Sprunt et al.⁽^⁶⁵65 Sprunt B, Hoq M, Sharma U, Marella M. Validating the UNICEF/Washington Group Child Functioning Module for Fijian schools to identify seeing, hearing and walking difficulties. Disabil Rehabil. 2019;41(2):201-1. http://dx.doi.org/10.1080/09638288.2017.1378929. PMid:28931311. http://dx.doi.org/10.1080/09638288.2017.... ⁾	WG/UNICEF Hearing question	(N=472) Children ages 5-15 - Special and Inclusive Education Schools, Fiji	a^* * Questionário aplicado aos: (a) Pais; (b) Professores	78%	41%	88%	97%	--	--	--	--
	WG/UNICEF Hearing question		b^* * Questionário aplicado aos: (a) Pais; (b) Professores	72%	50%	95%	99%	--	--	--	--
Loeb et al.⁽⁷⁸78 Loeb ME, Eide AH, Mont D. Approaching the measurement of disability prevalence: the case of Zambia. Alter. 2008;2(1):32-43. http://dx.doi.org/10.1016/j.alter.2007.06.001. http://dx.doi.org/10.1016/j.alter.2007.0... ⁾	Complete Short Set Module	(N= 5751) All Ages - Rural and Urban Families, Zambia		--	97,7%	--	98,5%	--	--	--	--
Ferrite et al.⁽⁷⁴74 Ferrite S, Mactaggart I, Kuper H, Oye J, Polack S. Prevalence and causes of hearing impairment in Fundong Health District, North-West Cameroon. Trop Med Int Health. 2017;22(4):485-92. http://dx.doi.org/10.1111/tmi.12840. PMid:28102004. http://dx.doi.org/10.1111/tmi.12840... ⁾	Short Set Hearing question	(N= 3567) All Ages – Rural Families, Cameroon		67%	22%	88%	99,6%	16%	65%	99%	97%

[1] Conflict of interests: nothing to declare.

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The use of the Washington Group on Disability Statistics questionnaires to identify hearing disability: a systematic review

ABSTRACT

Purpose

Research strategies

Selection criteria

Data analysis

Results

Conclusion