Measuring disability: a systematic review of the validity and reliability of the Global Activity Limitations Indicator (GALI)
Open Access
- 28 May 2018
- journal article
- review article
- Published by Springer Science and Business Media LLC in Archives of Public Health
- Vol. 76 (1), 1-11
- https://doi.org/10.1186/s13690-018-0270-8
Abstract
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. 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. 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. 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.Keywords
Funding Information
- European Union's Health Programme (664691/BRIDGE Health)
This publication has 40 references indexed in Scilit:
- European innovation partnership on active and healthy ageing: triggers of setting the headline target of 2 additional healthy life years at birth at EU average by 2020Archives of Public Health, 2012
- Socioeconomic status and the trajectory of self-rated healthAge and Ageing, 2011
- Measuring disability and monitoring the UN Convention on the Rights of Persons with Disabilities: the work of the Washington Group on Disability StatisticsBMC Public Health, 2011
- Developing the World Health Organization Disability Assessment Schedule 2.0Bulletin of the World Health Organization, 2010
- Total Survey Error: Past, Present, and FuturePublic Opinion Quarterly, 2010
- The disablement processSocial Science & Medicine, 1994
- Self-rated health: a predictor of mortality among the elderly.American Journal of Public Health, 1982
- The language of disablement: A glossary relating to disease and its consequencesInternational Rehabilitation Medicine, 1980