Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Archives of Public Health
Published in: Archives of Public Health 1/2018

Open Access 01-12-2018 | Systematic review

Measuring disability: a systematic review of the validity and reliability of the Global Activity Limitations Indicator (GALI)

Authors: Herman Van Oyen, Petronille Bogaert, Renata T. C. Yokota, Nicolas Berger

Published in: Archives of Public Health | Issue 1/2018

Login to get access

Abstract

Background

GALI or Global Activity Limitation Indicator is a global survey instrument measuring participation restriction. GALI is the measure underlying the European indicator Healthy Life Years (HLY). Gali has a substantial policy use within the EU and its Member States. The objective of current paper is to bring together what is known from published manuscripts on the validity and the reliability of GALI.

Methods

Following the PRISMA guidelines, two search strategies (PUBMED, Google Scholar) were combined to identify manuscripts published in English with publication date 2000 or beyond. Articles were classified as reliability studies, concurrent or predictive validity studies, in national or international populations.

Results

Four cross-sectional studies (of which 2 international) studied how GALI relates to other health measures (concurrent validity). A dose-response effect by GALI severity level on the association with the other health status measures was observed in the national studies. The 2 international studies (SHARE, EHIS) concluded that the odds of reporting participation restriction was higher in subjects with self-reported or observed functional limitations. In SHARE, the size of the Odds Ratio’s (ORs) in the different countries was homogeneous, while in EHIS the size of the ORs varied more strongly. For the predictive validity, subjects were followed over time (4 studies of which one international). GALI proved, both in national and international data, to be a consistent predictor of future health outcomes both in terms of mortality and health care expenditure. As predictors of mortality, the two distinct health concepts, self-rated health and GALI, acted independently and complementary of each other. The one reliability study identified reported a sufficient reliability of GALI.

Conclusion

GALI as inclusive one question instrument fits all conceptual characteristics specified for a global measure on participation restriction. In none of the studies, included in the review, there was evidence of a failing validity. The review shows that GALI has a good and sufficient concurrent and predictive validity, and reliability.
Literature
1.
Chatterji S, Byles J, Cutler D, Seeman T, Verdes E. Health, functioning, and disability in older adults--present status and future implications. Lancet. 2015;385:563–75.CrossRefPubMed
2.
Nagi SZ. The concept and measurement of disability. In: Berkowitz ED, editor. Disability policies and government programs. New York: Praeger; 1979. p. 1–15.
3.
4.
Wood PHN. The language of disablement: a glossary relating to disease and its consequences. Int Rehab Med. 1980;2:86–92.
5.
6.
7.
Dijkers MP. Issues in the conceptualization and measurement of participation: an overview. Arch Phys Med Rehabil. 2010;91:S5–16.CrossRefPubMed
8.
Badley EM. Enhancing the conceptual clarity of the activity and participation components of the international classification of functioning, disability, and health. Soc Sci Med. 2008;66:2335–45.CrossRefPubMed
9.
Berger N, Robine JM, Ojima T, Madans J, Van Oyen H. Harmonising summary measures of population health using global survey instruments. J Epidemiol Community Health. 2016;70:1039–44.CrossRefPubMedPubMedCentral
10.
Ustun TB, Chatterji S, Kostanjsek N, Rehm J, Kennedy C, Epping-Jordan J, et al. Developing the World Health Organization disability assessment schedule 2.0. Bull World Health Organ. 2010;88:815–23.CrossRefPubMedPubMedCentral
11.
Madans JH, Loeb ME, Altman BM. Measuring disability and monitoring the UN convention on the rights of persons with disabilities: the work of the Washington group on disability statistics. BMC Public Health. 2011;11(Suppl 4):S4.CrossRefPubMedPubMedCentral
12.
13.
14.
Verbrugge LM, Merrill SS, Liu X. Measuring disability with parsimony. Disabil Rehabil. 1999;21:295–306.CrossRefPubMed
15.
Robine JM, Jagger C, Egidi V, Gispert M, Nusselder W, Perenboom R, et al. Creating a coherent set of indicators to monitor health across Europe: the Euro-REVES 2 project. Eur J Publ Health. 2003;13:6–14.CrossRef
16.
17.
Eurostat. Minimum European Health Module. In: Glossary:Minimum European Health Module (MEHM) - Statistics Explained; 2017.
18.
19.
World Health Organization. International Classification of Functioning, Disability and Health: ICF. Geneva: World Health Organization; 2001. WHO | International Classification of Functioning, Disability and Health (ICF)
20.
21.
Lagiewka K. European innovation partnership on active and healthy ageing: what have been the policy drivers and determinants to set a headline target of 2 additional healthy life years at birth at EU average by 2020? Arch Public Health. 2012;70:23.CrossRefPubMedPubMedCentral
22.
23.
Gouvernement Français. Esperance de vie en bonne santé. 2016. 17–2-2017. Espérance de vie | Gouvernement.fr.
24.
Leonardi M. Measuring health and disability: supporting policy development. The European MHADIE project. Disabil Rehabil. 2010;32:1–8.CrossRef
25.
United Nations. Convention on the Rights of Persons with Disabilities : resolution adopted by the General Assembly. New York: UN General Assembly; 2007. Convention on the Rights of Persons with Disabilities [A/RES/61/106] | United Nations Enable
26.
European Commission. European Pillar of Social Rights. 2017. European Pillar of Social Rights | European Commission.
27.
Romaniuk P, Brukalo K. Designing solutions for the retirement system - in search of balance between economy and health. Front Public Health. 2016;4:184.CrossRefPubMedPubMedCentral
28.
Drost EA, editor. Validity and reliability in social science research. Educ Res Perspect. 2011;38:105–23.
29.
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6:e1000097.CrossRefPubMedPubMedCentral
30.
Groves R, Lyberg L, editors. Total survey error. Past, present and future. Public Opin Q. 2010;74:849–79.
31.
Cabrero-Garcia J, Julia-Sanchis R. The global activity limitation index mainly measured functional disability, whereas self-rated health measured physical morbidity. J Clin Epidemiol. 2014;67:468–76.CrossRefPubMed
32.
Van Oyen H, Van der Heyden J, Perenboom R, Jagger C. Monitoring population disability: evaluation of a new global activity limitation Indicator (GALI). Soz Praventiv Med. 2006;51:153–61.CrossRef
33.
Berger N, Van Oyen H, Cambois E, Fouweather T, Jagger C, Nusselder W, et al. Assessing the validity of the global activity limitation Indicator in fourteen European countries. BMC Med Res Methodol. 2015;15:1.CrossRefPubMedPubMedCentral
34.
Jagger C, Gillies C, Cambois E, Van Oyen H, Nusselder W, Robine JM. The global activity limitation index measured function and disability similarly across European countries. J Clin Epidemiol. 2010;63:892–9.CrossRefPubMed
35.
Van der Heyden J, Van Oyen H, Berger N, De Bacquer D, Van Herck K. Activity limitations predict health care expenditures in the general population in Belgium. BMC Public Health. 2015;15:267.CrossRefPubMedPubMedCentral
36.
Berger N, Van der Heyden J, Van Oyen H. The global activity limitation indicator and self-rated health: two complementary predictors of mortality. Arch Public Health. 2015;73:25.CrossRefPubMedPubMedCentral
37.
Van der Heyden J, Berger N, Van Oyen H. Comparison of self-rated health and activity limitation as predictors of short term mortality in the older population. Public Health. 2015;129:283–5.CrossRefPubMed
38.
Verropoulou G. Specific versus general self-reported health indicators predicting mortality among older adults in Europe: disparities by gender employing SHARE longitudinal data. Int J Public Health. 2014;59:665–78.CrossRefPubMed
39.
Cox B, Van Oyen H, Cambois E, Jagger C, Le Roy S, Robine JM, et al. The reliability of the minimum European health module. Int J Public Health. 2009;54:55–60.CrossRefPubMed
40.
Leonardi M, Bickenbach J, Ustun TB, Kostanjsek N, Chatterji S. The definition of disability: what is in a name? Lancet. 2006;368:1219–21.CrossRefPubMed
41.
42.
Freedman VA, Kasper JD, Spillman BC, Agree EM, Mor V, Wallace RB, et al. Behavioral adaptation and late-life disability: a new spectrum for assessing public health impacts. Am J Public Health. 2014;104:e88–94.CrossRefPubMedPubMedCentral
43.
Leveille SG, Fried LP, McMullen W, Guralnik JM. Advancing the taxonomy of disability in older adults. J Gerontol A Biol Sci Med Sci. 2004;59:86–93.CrossRefPubMed
44.
Chan A, Saito Y, Robine JM. International perspectives on summary measures of population health in an aging world. J Aging Health. 2016;28:1119–23.CrossRefPubMed
45.
Cambois E, Grobon S, Van Oyen H, Robine JM. Impact of question wording on the measurement of activity limitation: evidence from a randomized test in France. J Aging Health. 2016;28:1315–38.CrossRefPubMed
46.
Foraker RE, Rose KM, Chang PP, McNeill AM, Suchindran CM, Selvin E, et al. Socioeconomic status and the trajectory of self-rated health. Age Ageing. 2011;40:706–11.CrossRefPubMedPubMedCentral
47.
Idler EL, Benyamini Y. Self-rated health and mortality: a review of twenty-seven community studies. J Health Soc Behav. 1997;38:21–37.CrossRefPubMed
48.
49.
Van der Heyden J, De Backer D, Tafforeau J, Van Herck K. Reliability and validity of a global question on self-reported chronic morbidity. J Public Health (Springer). 2014;22:371–80.CrossRef
50.
Cambois E, Jagger C, Nusselder W, Van Oyen H, Robine JM. International comparisons of disability prevalence estimates: impact of accounting or not accounting for the institutionalized population. In: Altman BM, editor. International measurement of disability: purpose, method and application, the work of the Washington group, vol. 350. Hyattsville: National Center for Health Statistics; 2016. p. 207–29.
51.
Johnsen NF, Davidsen M, Michelsen SI, Juel K. Health profile for Danish adults with activity limitation: a cross-sectional study. BMC Public Health. 2017;18:46.CrossRefPubMedPubMedCentral
Metadata
Title
Measuring disability: a systematic review of the validity and reliability of the Global Activity Limitations Indicator (GALI)
Authors
Herman Van Oyen
Petronille Bogaert
Renata T. C. Yokota
Nicolas Berger
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Archives of Public Health / Issue 1/2018
Electronic ISSN: 2049-3258
DOI
https://doi.org/10.1186/s13690-018-0270-8

Other articles of this Issue 1/2018

Archives of Public Health 1/2018 Go to the issue

Study protocol

Longitudinal pharmacoepidemiological and health services research for substance users in treatment: protocol of the Belgian TDI-IMA linkage

Research

A data infrastructure for the assessment of health care performance: lessons from the BRIDGE-health project

Editorial

Small steps towards an EU health information system

Research

Determinants of health- related quality of life (HRQoL) among deaf and hard of hearing adults in Greece: a cross-sectional study

Research

Comparing performance of mothers using simplified mid-upper arm circumference (MUAC) classification devices with an improved MUAC insertion tape in Isiolo County, Kenya

Research

Developing a workplace lactation promotion model in Indonesia using Delphi technique