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Abstract
Clinicians and researchers without a suitable health-related quality of life (HRQOL)
measure in their own language have two choices: (1) to develop a new measure, or (2)
to modify a measure previously validated in another language, known as a cross-cultural
adaptation process. We propose a set of standardized guidelines for this process based
on previous research in psychology and sociology and on published methodological frameworks.
These guidelines include recommendations for obtaining semantic, idiomatic, experiential
and conceptual equivalence in translation by using back-translation techniques and
committee review, pre-testing techniques and re-examining the weight of scores. We
applied these guidelines to 17 cross-cultural adaptation of HRQOL measures identified
through a comprehensive literature review. The reporting standards varied across studies
but agreement between raters in their ratings of the studies was substantial to almost
perfect (weighted kappa = 0.66-0.93) suggesting that the guidelines are easy to apply.
Further research is necessary in order to delineate essential versus optional steps
in the adaptation process.