A novel method for the translation and crosscultural adaptation of health-related quality of life patient-reported outcome measurements

Authors

  • Catherine JP Teig Surgical Division, Akershus University Hospital, Lørenskog, Norway
  • Malcolm J Bond School of Medicine, Flinders University, Adelaide, Australia
  • Margreth Grotle Faculty of Health Science, OsloMet – Oslo Metropolitan University, Oslo, Norway
  • Møyfrid Kjøllesdal Drammens Gynekologen, Drammen, Norway
  • Susan Saga Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
  • Milada S Cvancarova Department of Biostatistics, University of Oslo, Oslo, Norway
  • Marie A Ellström Engh Obstetrics and Gynaecology, Akershus University Hospital, Lørenskog, Norway
  • Angelita Martini Centre for Health Services Research, School of Population Health, University of Western Australia, Perth, Australia

Abstract

Objectives: This paper presents a novel methodology for translation and cross-cultural adaptation of
health-related quality-of-life patient-reported outcome measures, incorporating the Delphi method.
Specifically, we describe the process of translating the Pelvic Floor Distress Inventory-20 and Pelvic
Floor Impact Questionnaire-7 from English to Norwegian using this method.

Methods: The multistep translation method combined the European Organization for Research and
Treatment of Cancer Quality of Life guidelines, an Expert Panel review, and the Delphi method. It
comprised two independent forward and back translations with the addition of the Delphi method
(comprising three attributes: anonymity, controlled feedback, and statistical group response) to establish
consensus on translated items using a bilingual pelvic floor Expert Panel. The Expert Panel was added
to ensure rigorous cross-checking and effective cross-cultural adaptation.

Outcomes: Application of the Delphi method in the Expert Panel phaseproved adequate in producing
comprehensible intermediate Norwegian versions ready for pilot testing. The Expert Panel reviewed
participant comments and offered advice to allow final translated versions to be produced and tested
for measurement properties. This iterative approach, internal logic and anonymity between rounds
improved the evaluations that the panel members provided, which in turn enhanced the final translated
PROMs.

Conclusions: To our knowledge, this work represents the first demonstration applying this specific set
of procedures: an Expert Panel review incorporating a Delphi method to cross-culturally validate and
translate health-related quality-of-life instruments. The controlled feedback approach, iterative nature,
internal logic and anonymity of the Delphi consensus method appeared to ensure a good cross-cultural
adaptation of these PROMs.

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Published

2022-06-03

Issue

In Press

Section

Articles