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Selfe J1, Callaghan M1, Yusuf M1, Relph N2, Gichuru P2, Dey P2
1Brooks Building, Birley, 53 Bonsall St, Health Profssions, Manchester, United Kingdom, 2Edge Hill University, Department of Applied Health and Social Care, Ormskirk, United Kingdom
Background: As part of a pan-European project investigating the epidemiology of knee problems in the general population, this study reports on the practical use of guidelines developed by Beaton et. al., (2001) for translating and culturally validating self-administered health questionnaires.
Purpose: The sensitivity, specificity and reliability of the Survey instrument for Natural history, Aetiology and Prevalence of Patellofemoral pain Studies (SNAPPS) has been established in the UK (Dey et al. 2016). The questionnaire can identify patellofemoral pain (PFP) in the general population and was created specifically for use in large-scale cohort studies. Prior to use in other countries SNAPPS requires translation.
Methods: Two native target language speakers with fluent English skills independently forward translated SNAPPS (FT1, FT2). Following this, they compared their versions and formed a consensus version (FT3). This was backwards translated into English (BT1, BT2) by two different bilingual target language English speakers. BT1, BT2 were reviewed by an expert committee most of whom were involved in developing SNAPPS to determine the validity of the translated version with regards to the original. Feedback on discrepancies between BT1, BT2 or deviations in meaning from the original was provided to the lead translator via skype. The lead translator then finalised the new target language version of SNAPPS.
Results: To date we have completed Finnish, Dutch and German translations, and work is ongoing in French, Portuguese and Turkish. In an expansion of the current study we are now working with colleagues in Pakistan on an Urdu translation. The accuracy of the BT1, BT2 translations has been very high with only minor discrepancies between translators and minor deviations from the original. Although minor these definitely need reviewing by an expert committee as they could lead to erroneous conclusions. For example one question in the original is phrased 'would you suffer' referring to an activity that people may be avoiding because they know it causes pain. This was often backwards translated into English as 'do you experience' which relates to a response to an activity that has taken place. Although subtle, this difference is significant as the question intends to measure activity avoidance, not activity participation.
Conclusion(s): The whole process takes approximately 12 months to complete, this is a considerable investment in time but it leads to a robust result i.e. a questionnaire that can be used with confidence in new linguistic and cultural environments. The minor yet important differences that emerge emphasise that simple translation is not sufficient. Ideally, one of the translators should be unfamiliar with the topic to ensure that any medical terms are translated into a language end user general population participants will understand.
Implications: The Beaton et. al., (2000) guidelines provide a clear and comprehensive approach to translation and cultural validation of self-administered health questionnaires. Our completed translations are freely accessible at www.snappspfp.com.
Keywords: Patellofemoral Pain, Questionnaire, Translation
Funding acknowledgements: Institutional funding supporting staff time: Manchester Metropolitan and Edge Hill Universities.
Purpose: The sensitivity, specificity and reliability of the Survey instrument for Natural history, Aetiology and Prevalence of Patellofemoral pain Studies (SNAPPS) has been established in the UK (Dey et al. 2016). The questionnaire can identify patellofemoral pain (PFP) in the general population and was created specifically for use in large-scale cohort studies. Prior to use in other countries SNAPPS requires translation.
Methods: Two native target language speakers with fluent English skills independently forward translated SNAPPS (FT1, FT2). Following this, they compared their versions and formed a consensus version (FT3). This was backwards translated into English (BT1, BT2) by two different bilingual target language English speakers. BT1, BT2 were reviewed by an expert committee most of whom were involved in developing SNAPPS to determine the validity of the translated version with regards to the original. Feedback on discrepancies between BT1, BT2 or deviations in meaning from the original was provided to the lead translator via skype. The lead translator then finalised the new target language version of SNAPPS.
Results: To date we have completed Finnish, Dutch and German translations, and work is ongoing in French, Portuguese and Turkish. In an expansion of the current study we are now working with colleagues in Pakistan on an Urdu translation. The accuracy of the BT1, BT2 translations has been very high with only minor discrepancies between translators and minor deviations from the original. Although minor these definitely need reviewing by an expert committee as they could lead to erroneous conclusions. For example one question in the original is phrased 'would you suffer' referring to an activity that people may be avoiding because they know it causes pain. This was often backwards translated into English as 'do you experience' which relates to a response to an activity that has taken place. Although subtle, this difference is significant as the question intends to measure activity avoidance, not activity participation.
Conclusion(s): The whole process takes approximately 12 months to complete, this is a considerable investment in time but it leads to a robust result i.e. a questionnaire that can be used with confidence in new linguistic and cultural environments. The minor yet important differences that emerge emphasise that simple translation is not sufficient. Ideally, one of the translators should be unfamiliar with the topic to ensure that any medical terms are translated into a language end user general population participants will understand.
Implications: The Beaton et. al., (2000) guidelines provide a clear and comprehensive approach to translation and cultural validation of self-administered health questionnaires. Our completed translations are freely accessible at www.snappspfp.com.
Keywords: Patellofemoral Pain, Questionnaire, Translation
Funding acknowledgements: Institutional funding supporting staff time: Manchester Metropolitan and Edge Hill Universities.
Topic: Musculoskeletal; Globalisation: health systems, policies & strategies; Health promotion & wellbeing/healthy ageing
Ethics approval required: No
Institution: Manchester Metropolitan University
Ethics committee: HPSC Ethics committee
Reason not required: Desk based research not involving patients, relatives/carers or students.
All authors, affiliations and abstracts have been published as submitted.
