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The WHO disability grading has been in use for many years. Its main use has been as an indicator for early case detection/reporting. More recently, the WHO grading has also been used as a change indicator of impairments for patients while on treatment. In such instances, the individual scores for eyes hand, and feet are added to obtain the so-called EHF sum score. A major drawback in the use of the grading system has been the lack of operational definitions of the descriptions for the grades. This may result in data and results of comparisons of data across programs and countries being flawed. The paper discusses the WHO grading in the light of its dual use: as an indicator for early case detection and as an indicator for change in impairments. The paper presents operational definitions for the grading options.
Brandsma et al. (Mon,) studied this question.