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Evaluating Translations of Health Status Questionnaires: Methods From the IQOLA Project

  • John E. Ware (a1), Susan D. Keller (a1), Barbara Gandek (a1), John E. Brazier (a2) and Marianne Sullivan (a3)...

There is growing demand for translations of health status questionnaires for use in multinational drug therapy studies and for population comparisons of health statistics. The International Quality of Life Assessment (IQOLA) Project is conducting a three-stage research program to determine the feasibility of translating the SF-36 Health Survey, widely used in English-speaking countries, into other languages. In stage 1, the conceptual equivalence and acceptability of translated questionnaires are evaluated and improved using qualitative and quantitative methods. In stage 2, assumptions underlying the construction and scoring of questionnaire scales are tested empirically. In stage 3, the equivalence of the interpretation of questionnaire scores across countries is tested using methods that closely approximate their intended use, and empirical results are compared. Data analyses from Sweden and the United Kingdom, as well as other research cited, support the feasibility of cross-cultural health measurement using the SF-36.

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1.N. K. Aaronson , C. Acquadro , J. Alonso , International quality of life assessment (IQOLA) project. Quality of Life Research, 1992, 1, 349–51.

2.N. K. Aaronson , M. Bullinger , & S. Ahmedzai A modular approach to quality-of-life assessment in cancer clinical trials. Recent Results in Cancer Research, 1988, 111, 231–49.

3.M. Almagor , & Y. S. Ben-Porath The two-factor model of self-reported mood: A cross-cultural replication. Journal of Personality Assessment, 1989, 53, 1021.

4.G. F. Anderson , J. Alonso , L. T. Kohn , & C. Black Analyzing health outcomes through international comparisons. Medical Care, 1994, 32, 526634.

5.R. T. Anderson , N. K. Aaronson , & D. Wilkin Critical review of the international assessments of health-related quality of life. Quality of Life Research, 1993, 2, 369–95.

6.D. Andrich Rasch models for measurement. Newbury Park, CA: Sage, 1988.

8.R. Angel , & P. Thoits The impact of culture on the cognitive structure of illness. Culture, Medicine and Psychiatry, 1987, 11, 465–94.

9.D. M. Berwick , J. M. Murphy P. A. Goldman , Performance of a five-item mental health screening test. Medical Care, 1991, 29, 169–76.

10.R. Berzon , R. D. Hays , & S. A. Shumaker International use, application and performance of health-related quality of life instruments. Quality of Life Research, 1993, 2, 367–68.

11.T. W. Bice , & E. Kalimo Comparisons of health-related attitudes: A cross-national, factor analytic study. Social Science and Medicine, 1971, 5, 283318.

12.T. W. Bice , & K. L. White Cross-national comparative research on the utilization of medical services. Medical Care, 1971, 9, 253–71.

13.H. Blanc Multilingual interviewing in Israel. American Journal of Sociology, 1956, 62, 205–09.

14.J. Bousquet , J. Knani , H. Dhivert , Quality-of-life in asthma, I: Internal consistency and validity of the SF-36 questionnaire. American Journal of Respiratory and Critical Care Medicine, 1994, 149, 371–75.

15.B. A. Bracken , & A. Barona State of the art procedures for translating, validating and using psychoeducational tests in cross-cultural assessment. School Psychology International, 1991, 12, 119–32.

16.J. E. Brazier , R. Harper , N. M. B. Jones , Validating the SF-36 health survey questionnaire: New outcome measure for primary care. British Medical Journal, 1992, 305, 160–64.

20.M. Bullinger , R. Anderson , D. Cella , & N. Aaronson Developing and evaluating cross-cultural instruments from minimum requirements to optimal models. Quality of Life Research, 1993, 2, 451–59.

21.A. R. Buss , & J. R. Royce Detecting cross-cultural commonalities and differences: Intergroup factor analysis. Psychological Bulletin, 1975, 82, 128–36.

22.G. L. Candell , & C. L. Hulin Cross-language and cross-cultural comparisons in scale translations: Independent sources of information about item nonequivalence. Journal of Cross-Culture Psychology, 1986, 17, 417–40.

23.R. B. Cattell Comparing factor trait and state scores across ages and cultures. Journal of Gerontology, 1989, 24, 348–60.

24.D. W. Chapman , & J. F. Carter Translation procedures for the cross cultural use of measurement instruments. Educational Evaluation and Policy Analysis, 1978, 1, 7176.

25.P. D. Cleary , S. Greenfield , & B. J. McNeil Assessing quality of life after surgery. Controlled Clinical Trials, 1991, 12, 189S–203S.

27.L. J. Cronbach Coefficient alpha and the internal structure of tests. Psychometrika, 1951, 16, 297334.

28.A. R. Davidson , J. J. Jaccard , H. C. Triandis , Cross-cultural model testing: Toward a solution of the emic-etic dilemma. International Journal of Psychology, 1976, 11, 113.

30.J. M. de Figueiredo , & P. V. Lemkau Psychiatric interviewing across cultures: Some problems and prospects. Social Psychiatry, 1980, 15, 117-21.

32.B. B. Ellis , & H. D. Kimmel Identification of unique cultural response patterns by means of item response theory. Journal of Applied Psychology, 1992, 77, 177–84.

33.EuroQOL Group.EuroQOL: Anew facility for the measurement of health-related quality of life. Health Policy, 1990, 16, 199208.

34.P. L. Gardner Scales and statistics. Review of Educational Research, 1975, 45, 4357.

35.A. M. Garatt , D. A. Ruta , M. I. Abdalla , The SF-36 Health survey questionnaire: An outcome measure suitable for routine use within the NHS? British Medical Journal, 1993, 306, 1440–44.

39.F. Guillemin , C. Bombardier , & D. Beaton Cross-cultural adaption of health-related quality of life measures: Literature review and proposed guidelines. Journal of Clinical Epidemiology, 1993, 46, 1417–32.

40.G. H. Guyatt The philosophy of health-related quality of life translation. Quality of Life Research, 1993, 2, 461–65.

41.S. M. Haley , C. A. McHorney , & J. W. Ware Evaluation of the MOS SF-36 Physical Functioning scale (PF-10), I: Unidimensionality and reproducibility of the Rasch item scale. Journal of Clinical Epidemiology, 1994, 47, 671–84.

44.R. D. Hays , C. D. Sherbourne , & R. M. Mazel The RAND 36-Item Health Survey 1.0. Health Economics, 1993, 2, 217–27.

46.D. K. Heyman , & F. C. Jeffers Effect of time lapse on consistency of self-health and medical evaluations of elderly persons. Journal of Gerontology, 1963, 18, 160–64.

47.K. I. Howard , & G. G. Forehand A method for correcting item-total correlations for the effect of relevant item inclusion. Educational and Psychological Measurement, 1962, 22, 731–35.

48.C. H. Hui , & H. C. Triandis Measurement in cross-cultural psychology: A review and comparison of strategies. Journal of Cross-Cultural Psychology, 1985, 16, 131–52.

49.C. L. Hulin A psychometric theory of evaluations of item and scale translations: Fidelity across languages. Journal of Cross-Cultural Psychology, 1987, 18, 115–42.

50.C. L. Hulin , F. Drasgow , & J. Komocar Applications of item responses theory to analysis of attitude scale translations. Journal of Applied Psychology, 1982, 67, 818–25.

52.S. M. Hunt Cross-cultural issues in the use of socio-medical indicators. Health Policy, 1986, 6, 149–58.

53.S. M. Hunt , J. Alonzo , D. Bucquet , Cross-cultural adaptation of health measures. Heath Policy, 1991, 19, 3344.

56.W. L. Hunt , W. W. Crane , & J. C. Wahlke Interviewing political elites in cross-cultural comparative research. American Journal of Sociology, 1964, 70, 5968.

57.E. L. Idler , & R. Angel Self-rated health and mortality in the NHANES-I epidemiologic follow-up study. American Journal of Public Health, 1990, 80, 446–52.

60.C. Jenkinson , A. Coulter , & L. Wright Short form 36 (SF-36) Health Survey Questionnaire: Normative data for adults of working age. British Medical Journal, 1993, 306, 1437–40.

61.C. Jenkinson , L. Wright , & A. Coulter Criterion validity and reliability of the SF-36 in a population sample. Quality of Life Research, 1994, 3, 712.

64.J. Kim , & C. W. Mueller Factor analysis: Statistical methods and practical issues. Beverly Hills, CA: Sage Publications, 1978.

65.A. Kleinman , L. Eisenberg , & B. Good Culture, illness, and care: Clinical lessons from anthropologic and cross-cultural research. Annals of Internal Medicine, 1978, 88, 251–58.

66.W. Kuyken , J. Orley , P. Hudelson , & N. Sartorius Quality of life assessment across cultures. International Journal of Mental Health, 1994, 23, 527.

67.T. R. Lancaster , D. E. Singer , M.A. Sheehan , The impact of long-term warfarin therapy on quality of life: Evidence from a randomized trial. Archives of Internal Medicine, 1991, 151, 1944–49.

68.J. Liang , S. C. Wu , N. M. Krause , The structure of the mental health inventory among Chinese in Taiwan. Medical Care, 1992, 30, 659–76.

70.P. A. Marshall Cultural influences on perceived quality of life. Seminars in Oncology Nursing, 1990, 6, 278–84.

71.C. A. McHorney , M. Kosinski , & J. E. Ware Comparisons of the costs and quality of norms for the SF-36 Health Survey collected by mail versus telephone interview: Results from a national survey, Medical Care, 1994, 32, 551–67.

72.C. A. McHoney , J. E. Ware , J. F. R. Lu , & C. D. Sherbourne The MOS 36-item short-form health survey (SF-36), III. Tests of data quality, scaling assumptions and reliability across diverse patient groups, Medical Care, 1994, 32, 4066.

73.C. A. McHorney , J. E. Ware , & A. E. Raczek The MOS 36-item short-form health survey (SF-36), II: Psychometric and clinical tests of validity in measuring physical and mental health constructs. Medical Care, 1993, 31, 247–63.

79.J. T. Osterhaus , R. J. Townsend , B. Gandek , & J. E. Ware Measuring the functional status and well-being of patients with migraine headaches. Headache, 1994, 34, 337–43.

83.B. G. Rasch An item analysis which takes individual differences into account. British Journal of Mathematical and Statistical Psychology, 1966; 19, 4957.

85.L. Sechrest , T. L. Fay , & S. M. H. Zaidi Problems of translation in cross-cultural research. Journal of Cross-Cultural Psychology, 1972, 3, 4156.

88.E. P. Stoller Self-assessments of health by the elderly: The impact of informal assistance. Journal of Health and Social Behavior, 1984, 25, 260–70.

89.M. A. Straus Phenomenal identity and conceptual equivalence of measurement in cross national comparative research. Journal of Marriage and the Family, 1969, 31, 233.

94.H. C. Triandis , & R. W. Brislin Cross-cultural psychology. American Psychologist, 1984, 39, 1006–16.

99.J. E. Ware , B. Gandek , & the IQOLA Project Group. The SF-36 Health Survey: Development and use in mental health research and the IQOLA Project. International Journal of Mental Health, 1994, 23, 4973.

103.J. E. Ware , & C. D. Sherbourne The MOS 36-item short-form health survey (SF-36), I: Conceptual framework and item selection. Medical Care, 1992, 30, 473–83.

105.M. Weinberger , G. P. Samsa , J. T. Hanlon , An evaluation of a brief health status measure in elderly veterans. Journal of the American Geriatrics Society, 1991, 39, 691–94.

106.WHOQOL Group, Division of Mental Health, World Health Organization. Study protocol for the World Health Organization Project to develop a quality of life assessment instrument (WHOQOL). Quality of Life Research, 1993, 2, 153–59.

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International Journal of Technology Assessment in Health Care
  • ISSN: 0266-4623
  • EISSN: 1471-6348
  • URL: /core/journals/international-journal-of-technology-assessment-in-health-care
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