When it comes to the translation and linguistic validation of clinical outcome assessments (COAs), translatability assessment is a useful, insightful, and efficient pre-translation step, which can prevent many potential downstream problems.
What is translatability assessment?
Translatability assessment has been defined as “the evaluation of the extent to which a measure can be meaningfully translated into another language”1. A “meaningful translation” in this context means that the translated text is “conceptually equivalent to the source text and culturally and linguistically appropriate in the target country, to facilitate the pooling and comparison of data”2.
Translatability assessment helps to ensure that a translated COA is well understood, so that study participants can fully comprehend the instructions, questions, and response options, and therefore provide accurate responses. If a question is not applicable to a participant due to geography or culture, or part of the text is not understood, they may select an answer at random, or one that they mistakenly believe to be true for them, and unknowingly skew the results. Translatability assessment can mitigate misunderstandings and mistranslations and help enable conceptual equivalence across all language versions of your COA.
Issues detected through translatability assessment
- The English idiom ‘feeling blue’, is not directly translatable in most other languages; in fact, in some languages the phrase does exist, but has a completely different meaning, such as feeling drunk.
- A COA may ask about ‘pain’ in one area of the body, and in separate questions also ask about ‘aches’ and ‘soreness’ in that same body part. Some languages only have one word to describe any kind of pain, thus making it challenging to differentiate between the three questions.
- Sometimes COAs ask about the ability to take part in activities that are not relevant to the target population. For example, when asking about mobility, COAs have been known to ask about ‘golf’ and ‘bowling’, which are not common sports in some parts of the world. Additionally, in many places where they are played, women are less likely than men to participate.
How does the process work in practice?
Translatability assessment should be carried out as part of the COA development process, before psychometric validation, so that any suggested changes can be implemented before publication.
At Vitaccess, a Localization Project Manager will send the source text to multiple linguists from a selection of appropriate countries, for them to identify any words, phrases, questions, or response options that may be culturally sensitive, untranslatable, ambiguous, or irrelevant in their native language.
Once a COA has been reviewed, any translatability issues and suggestions are discussed with the author, who has the final say on any changes, and a revised version can then be produced, which should be more easily translatable in an equivalent way across different cultures, languages, and countries.
Why should you take the time to incorporate this step?
Preparation is key. Ultimately, doing this work upfront can save time in the future, dealing with the queries, frustrations, and confusion that can come from an unclear or untranslatable source text.
If you are interested in hearing more about how a translatability assessment could benefit your COA development process, please get in touch with us at info@vitaccess.com.
By Fiona Miller
References
1. Conway K and Patrick D. Translatability assessment. In C. Acquadro, K. Conway, C. Giroudet, & I. Mear (Eds.), Linguistic validation manual for health outcome assessments. 2012;127-132.
2. Acquadro C, Patrick DL, Eremenco S et al. Emerging good practices for translatability assessment (TA) of patient-reported outcome (PRO) measures. J Patient Rep Outcomes.2018;2(1):8.
