Translating Quality of Life Questionnaires I

Tatehiko Kishi, Megumi Kobayashi, Raoul Breugelmans

22 September 1999

This presentation focused on the translation and cultural adaptation of health-related quality of life (QOL) questionnaires for use in clinical trials.

R. Breugelmans first presented a short outline of the 5-step process involved in translating such questionnaires into Japanese.

  1. Forward translation
    Two E to J translators produce independent translations of the original questionnaire. These two translations are "reconciled" into a single Japanese version by the coordinator of the project in a meeting with the two translators.
  2. Backward translation
    A J to E translator produces a back translation into English of the Japanese version, without referring to the original English version. The back translation and the original questionnaire are compared by the local project manager during a meeting with the back translator in order to detect possible misunderstandings or misinterpretations, which may result in some changes to the Japanese translation.
  3. Review by clinician
    The Japanese version is reviewed by a clinician, and changes are made accordingly.
  4. Cognitive debriefing
    The Japanese version of the questionnaire is tested on a panel of five patients. Each participant is asked to complete the questionnaire, and is then asked about the understandability and acceptability of each item. Alternative translations may be tested, or the patient may be asked to suggest a different formulation. The translation is revised according to the results of the interviews.
  5. International harmonization
    In order to ensure that all the translated versions measure the same concepts, the different language versions of the questionnaire are compared to one another as well as to the original. The final Japanese version of the questionnaire is established in accordance with the outcome of international harmonization.

T. Kishi and M. Kobayashi discussed some concrete examples of problems they encountered when translating a QOL questionnaire into Japanese.
Some examples of items discussed:

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