J Korean Med Sci.  2024 Dec;39(49):e336. 10.3346/jkms.2024.39.e336.

Translation and Cross-Cultural Adaptation: A Critical Step in Multi-National Survey Studies

• Benlidayi IC
• Gupta L

• KMID: 2563297
• DOI: http://doi.org/10.3346/jkms.2024.39.e336

Abstract

Survey studies are valuable tools that can quickly and cost-effectively collect data from diverse populations across different cultures and locations. When conducted across multiple countries, careful translation and cross-cultural adaptation are necessary to maintain the validity and reliability of the findings. This point is particularly important for patient-facing questionnaires, especially in fields like psychology and sexual medicine. Translation to other languages also helps the researchers reach a more diverse and broader sample, which enables the generalizability of the findings/conclusions. An accurate translation would ensure higher response rates. Careful and rigorous selection of translators, following a translation guideline, ensuring sufficient time for the translation process, using a checklist, and quality assessment following translation can increase the accuracy of the translation. At each step, the specific field of the questionnaire should be taken in consideration. The objective of this article is to underscore the necessity of translation and cross-cultural adaptation in survey studies, as well as to discuss the methods to combat against challenges experienced in the translation process.

Keyword

Translating; Translations; Surveys and Questionnaires; Cultural Competency; Patient Health Questionnaire

Reference

1. Zimba O, Gasparyan AY. Designing, conducting, and reporting survey studies: a primer for researchers. J Korean Med Sci. 2023; 38(48):e403. PMID: 38084027.

2. Arshabayeva GA, Qumar AB, Yessirkepov M, Zimba O, Kocyigit BF. Advancing research, writing, and publishing in nursing: addressing challenges and improving standards. J Korean Med Sci. 2024; 39(38):e297. PMID: 39376192.

3. Gupta L, Gasparyan AY, Zimba O, Misra DP. Scholarly publishing and journal targeting in the time of the Coronavirus Disease 2019 (COVID-19) pandemic: a cross-sectional survey of rheumatologists and other specialists. Rheumatol Int. 2020; 40(12):2023–2030. PMID: 33048199.

4. Gaur PS, Zimba O, Agarwal V, Gupta L. Reporting survey based studies - a primer for authors. J Korean Med Sci. 2020; 35(45):e398. PMID: 33230988.

5. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000; 25(24):3186–3191. PMID: 11124735.

6. Cruchinho P, López-Franco MD, Capelas ML, Almeida S, Bennett PM, Miranda da Silva M, et al. Translation, cross-cultural adaptation, and validation of measurement instruments: a practical guideline for novice researchers. J Multidiscip Healthc. 2024; 17:2701–2728. PMID: 38840704.

7. Hinkle JL. The importance of cross-cultural adaptation of health measures. J Nurs Meas. 2023; 31(4):479. PMID: 37871961.

8. Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, et al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health. 2005; 8(2):94–104. PMID: 15804318.

9. Maneesriwongul W, Dixon JK. Instrument translation process: a methods review. J Adv Nurs. 2004; 48(2):175–186. PMID: 15369498.

10. Seninde DR, Chambers Iv E. Comparing four question formats in five languages for on-line consumer surveys. Methods Protoc. 2020; 3(3):49. PMID: 32674527.

11. Booker QS, Austin JD, Balasubramanian BA. Survey strategies to increase participant response rates in primary care research studies. Fam Pract. 2021; 38(5):699–702. PMID: 34213547.

12. Pasick RJ, Sabogal F, Bird JA, D’onofrio CN, Jenkins CN, Lee M, et al. Problems and progress in translation of health survey questions: the pathways experience. Health Educ Q. 1996; 23(1):suppl. 28–40.

13. Ozolins U, Hale S, Cheng X, Hyatt A, Schofield P. Translation and back-translation methodology in health research - a critique. Expert Rev Pharmacoecon Outcomes Res. 2020; 20(1):69–77. PMID: 32089017.

14. Dorer B. Advance Translation in the 5th Round of the European Social Survey (ESS). FORS Working Paper Series, Paper 2011-4. Lausanne, Switzerland: FORS;2011.

15. Gogtay NJ, Thatte UM, Dasgupta B, Deshpande S. Use of the WOMAC questionnaire in Mumbai and the challenges of translation and cross cultural adaptation. Indian J Med Ethics. 2013; 10(1):33–35. PMID: 23439195.

16. Gomes JL, Águeda AF, Heaney A, Duarte C, Lopes C, Costa T, et al. Translation, cross-cultural adaptation and validation of the Osteoarthritis Quality of Life (OAQoL) questionnaire for use in Portugal. Rheumatol Int. 2019; 39(4):715–722. PMID: 30415453.

17. Pencheva DT, Coffey A, McKenna SP, Monov SV. Adaptation and validation of the Bulgarian version of the systemic Lupus Erythematosus Quality of Life Questionnaire (L-QoL). Clin Rheumatol. 2023; 42(7):1811–1817. PMID: 36913029.

18. Qiu G. Towards the effects of translators’ emotional intelligence and anxiety on their translation quality. Heliyon (Lond). 2023; 9(9):e19276.

19. Khan G, Mirza N, Waheed W. Developing guidelines for the translation and cultural adaptation of the Montreal Cognitive Assessment: scoping review and qualitative synthesis. BJPsych Open. 2022; 8(1):e21. PMID: 34991771.

20. The Survey Research Center, Institute for Social Research, University of Michigan. Guidelines for best practice in cross-cultural surveys. Updated 2011. Accessed October 10, 2024. https://ccsg.isr.umich.edu/wp-content/uploads/2020/02/CCSG_Guidelines_Archive_2010_Version.pdf. .

21. Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol. 1993; 46(12):1417–1432. PMID: 8263569.

22. Eremenco SL, Cella D, Arnold BJ. A comprehensive method for the translation and cross-cultural validation of health status questionnaires. Eval Health Prof. 2005; 28(2):212–232. PMID: 15851774.

23. Sarac DC, Bayraktar D, Tore NG, Kurut Aysin I, Otman E, Inanc I, et al. Systemic Sclerosis Quality of Life Questionnaire (SScQoL): translation into Turkish and assessing its psychometric properties. Clin Rheumatol. 2023; 42(8):2135–2143. PMID: 37178266.

24. European Social Survey (ESS). Methodology-Translation. Accessed September 28, 2024. https://www.europeansocialsurvey.org/methodology/ess-methodology/translation .

25. Harkness J. Guidelines for Best Practice in Cross-Cultural Surveys. Full Guidelines. 3rd ed. Ann Arbor, MI, USA: Survey Research Center, Institute for Social Research, University of Michigan;2011. p. 290–351.

26. Kim S, Bae WK, Kim JY, Jang M, Kim JH, Noh HH. Validation of the Korean version of schedule of fatigue and anergia: general physician questionnaire. J Korean Med Sci. 2016; 31(2):159–163. PMID: 26839466.

27. Walde P, Völlm BA. The TRAPD approach as a method for questionnaire translation. Front Psychiatry. 2023; 14:1199989. PMID: 37398605.

28. Algarni AD, Alrabai HM, Al-Ahaideb A, Kachanathu SJ, AlShammari SA. Arabic translation, cultural adaptation, and validation study of Knee Outcome Survey: Activities of Daily Living Scale (KOS-ADLS). Rheumatol Int. 2017; 37(9):1585–1589. PMID: 28726019.

29. Vujcich D, Roberts M, Gu Z, Kao SC, Lobo R, Mao L, et al. Translating best practice into real practice: Methods, results and lessons from a project to translate an English sexual health survey into four Asian languages. PLoS One. 2021; 16(12):e0261074. PMID: 34919577.

30. Elsevier. Checklist for reviewers/authors of studies on the translation and cross-cultural adaptation of questionnaires/assessment instruments. Accessed October 10, 2024. https://static.elsevier.es/miscelanea/checklistEN.PDF .

31. Tyupa S. A theoretical framework for back-translation as a quality assessment tool. New Voices Transl Stud. 2011; 7(1):35–46.

32. Colina S, Marrone N, Ingram M, Sánchez D. Translation quality assessment in health research: a functionalist alternative to back-translation. Eval Health Prof. 2017; 40(3):267–293. PMID: 27207929.

33. Son J. Back translation as a documentation tool. Transpl Int. 2018; 10(2):89–100.

34. Mirza N, Waheed MW, Waheed W. A new tool for assessing the cultural adaptation of cognitive tests: demonstrating the utility of the Manchester Translation Evaluation Checklist (MTEC) through the Mini-Mental State Examination Urdu. BJPsych Open. 2022; 9(1):e5. PMID: 36533559.

35. Popel M, Tomkova M, Tomek J, Kaiser Ł, Uszkoreit J, Bojar O, et al. Transforming machine translation: a deep learning system reaches news translation quality comparable to human professionals. Nat Commun. 2020; 11(1):4381. PMID: 32873773.

36. Lin SC, Li M, Lin J. Aggretriever: a simple approach to aggregate textual representations for robust dense passage retrieval. Trans Assoc Comput Linguist. 2023; 11:436–452.

37. Munkova D, Munk M, Benko Ľ, Hajek P. The role of automated evaluation techniques in online professional translator training. Peer J Comput Sci. 2021; 7:e706.

38. Lion KC, Lin YH, Kim T. Artificial intelligence for language translation: the equity is in the details. JAMA. 2024; 332(17):1427–1428. PMID: 39264601.

39. Gong M. The neural network algorithm-based quality assessment method for university English translation. Network. 2024; 1–13.

40. Barrington NM, Gupta N, Musmar B, Doyle D, Panico N, Godbole N, et al. A bibliometric analysis of the rise of ChatGPT in medical research. Med Sci (Basel). 2023; 11(3):61. PMID: 37755165.

41. Wilhelm TI, Roos J, Kaczmarczyk R. Large language models for therapy recommendations across 3 clinical specialties: comparative study. J Med Internet Res. 2023; 25:e49324. PMID: 37902826.

42. Wang Y. Artificial intelligence technologies in college English translation teaching. J Psycholinguist Res. 2023; 52(5):1525–1544. PMID: 37100967.

43. Steigerwald E, Ramírez-Castañeda V, Brandt DY, Báldi A, Shapiro JT, Bowker L, et al. Overcoming language barriers in academia: machine translation yools and a vision for a multilingual future. Bioscience. 2022; 72(10):988–998. PMID: 36196221.

44. Coskun Benlidayi I. Artificial intelligence and critical thinking. Cent Asian J Med Hypotheses Ethics. 2024; 5(2):127–129.

45. Yessirkepov M, Zimba O, Gasparyan AY. Emerging online tools and platforms for scholarly activities in medicine. Cent Asian J Med Hypotheses Ethics. 2020; 1(2):112–117.

46. Oliver N, Barber X, Roomp K, Roomp K. Assessing the impact of the COVID-19 pandemic in Spain: large-scale, online, self-reported population survey. J Med Internet Res. 2020; 22(9):e21319. PMID: 32870159.

47. Ali SH, Foreman J, Capasso A, Jones AM, Tozan Y, DiClemente RJ. Social media as a recruitment platform for a nationwide online survey of COVID-19 knowledge, beliefs, and practices in the United States: methodology and feasibility analysis. BMC Med Res Methodol. 2020; 20(1):116. PMID: 32404050.