CROSS-CULTURAL COMPARISONS OF THE CONTENT OF SF-36 TRANSLATIONS ACROSS 10 COUNTRIES - RESULTS FROM THE IQOLA PROJECT

Increasingly, translated and culturally adapted health-related quality of life measures are being used in cross-cultural research. To assess comparability of results, researchers need to know the comparability of the content of the questionnaires used in different countries. Base d on an item-by-item discussion among International Quality of Life As sessment (IQOLA) investigators of the content of the translated versio ns of the SF-36 in 10 countries, We discuss the difficulties that aros e in translating the SF-36. We also review the solutions identified by IQOLA investigators to translate items and response choices so that t hey are appropriate within each country as well as comparable across c ountries. We relate problems and solutions to ratings of difficulty an d conceptual equivalence for each item. The most. difficult items to t ranslate were physical functioning items that refer to activities not common outside the United States and items that use colloquial express ions in the source version. Identifying the origin of the source items , their meaning to American English-speaking respondents and American English synonyms, in response to country-specific translation issues, greatly helped the translation process. This comparison of the content of translated SF-36 items suggests that the translations are cultural ly appropriate and comparable in their content. (C) 1998 Elsevier Scie nce Inc.