Translation and Cultural Adaptation of the EQ-5D-Y-5L Into Arabic for Use in Egypt

OBJECTIVES: The EQ-5D-Y-5L was developed by the EuroQol Group in English. The cultural variation between world populations requires instrument translations and adaptations into various languages. This study aims to translate and cross-culturally adapt the EQ-5D-Y-5L into Arabic (Egypt) according to the translation guidelines of the EuroQol’s Version Management Committee (VMC).

METHODS: Two forward translations, then two back translations were undertaken. A consensus version was achieved after each translation process. The cognitive interviews were conducted to evaluate the wording chosen for the Arabic version. The ranking exercise was included in the cognitive interview to confirm that the children correctly understood the hierarchical order of the severity levels in the translated version.

RESULTS: The back translation was found to be comparable to the original version by the VMC. The cognitive interview was conducted on 8 participants, aged 8 to 15 years (the target age range of the instrument). Several issues arose and some changes were suggested. In the fourth dimension ‘HAVING PAIN OR DISCOMFORT’, the Arabic term used for pain was misinterpreted by some children as emotional rather than physical pain, therefore an alternative term was chosen that clearly refers to bodily pain. The initial ranking exercise showed some inconsistencies in identification of the severity levels. After the suggested changes, further cognitive debriefing was performed on 3 other children. The ranking exercise showed no inconsistencies, and all children were able to distinguish between the severity levels in all dimensions. Proofreading was then done and the final approved Arabic version was produced.

CONCLUSIONS: Arabic translation of the EQ-5D-Y-5L by following the EuroQol translation guidelines and cultural adaptation with Egyptian children produced an acceptable Arabic version that can be used in Egypt and possibly other Arabic speaking countries.