Translation of questions: the International Study of Asthma and Allergies in Childhood (ISAAC) experience
Authors: Ellwood, P.1; Williams, H.2; Aït-Khaled, N.3; Björkstén, B.4; Robertson, C.5; ISAAC Phase III Study Group,
Source: The International Journal of Tuberculosis and Lung Disease, Volume 13, Number 9, September 2009 , pp. 1174-1182(9)
Publisher: International Union Against Tuberculosis and Lung Disease
Abstract:
OBJECTIVE: To explore the consequences of translating the International Study of Asthma and Allergies in Childhood (ISAAC) English core questionnaires on asthma, rhinitis and eczema symptoms into other languages.DESIGN: ISAAC Phase III developed 49 language translations for adolescents and 42 for children following standardised guidelines, which included back-translating the questionnaires into English to check their accuracy and meaning. Language deviations were categorised and analysed with regard to influences on the reported symptom prevalence.RESULTS: Category 1 deviations for one or more questions were found in seven translations (14%) for adolescents and in three translations (7%) for children. Data for these questions were excluded from the worldwide analyses. Category 2 deviations were identified in the publications, and Category 3 deviations were ignored.CONCLUSIONS: Translations of questionnaires should follow a consistent protocol in global epidemiological research. Cultural norms need to be considered when evaluating back-translations into English, as disease labels are not available in every language, nor are they understood in the same way. Deviations from literal translations of English should be permitted if the intent of the original meaning is retained. A web-based tool of medical terminology would be useful for international research requiring the use of translations.Keywords: ISAAC; children; translation; epidemiology; asthma; rhinitis; eczema
Document Type: Regular paper
Affiliations: 1: Department of Paediatrics: Child and Youth Health, The University of Auckland, Auckland, New Zealand 2: Centre of Evidence-Based Dermatology, University of Nottingham, Nottingham, United Kingdom 3: International Union Against Tuberculosis and Lung Disease, Paris, France 4: Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden 5: Murdoch Childrens Research Institute, Melbourne, Australia
Publication date: 2009-09-01
- The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website
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- By this author: Ellwood, P. ; Williams, H. ; Aït-Khaled, N. ; Björkstén, B. ; Robertson, C. ; ISAAC Phase III Study Group,

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