OBJECTIVES: The UCSD SOBQ, a 24-item instrument developed in US English, assesses self-reported shortness of breath while performing a variety of daily living activities. The objective of this report is to underline the importance of collaboration with the developers to clarify concepts and ensure their correct interpretation while translating the original version into other languages. METHODS: Interactive discussion with the developers of the SOBQ was undertaken to formalize a concept list that would: 1) Explain and clarify the conceptual notions underlying each item in simple language so they would be accurately reflected in each language version produced, and 2) Provide acceptable approved translation alternatives. RESULTS: The concept list was revised five times and widely expanded with definitions and alternate translations validated by the developers. Through questions raised during the linguistic validation process, collaboration with the developers highlighted items initially considered as unambiguous but which required additional information to be faithfully rendered in all languages. Among the 24 items of the SOBQ, four items proved to be unclear (e.g., “dressing” was clarified as “putting on and taking off clothes” and “picking up and straightening” as “picking things up and tidying them up”). Three other items appeared as culturally inappropriate and, therefore, needed to be adapted to be suitable to the countries for which these activities were not relevant (e.g., “washing car or any other vehicle” was one of the accepted alternatives for “washing car” and “watering flowers” for “watering the lawn”).  CONCLUSIONS: It is essential to involve the developers in the clarification of the concepts underlying each item in a questionnaire to allow their correct interpretation in other languages and cultures. This step is crucial to ensure comparable content validity between different language versions. This example with the SOBQ shows that the involvement of developers is a dynamic and necessary process.