OBJECTIVES: 1) To assess if a translatability assessment (TA) conducted prior to a psychometric evaluation in PRO instrument development could predict items subsequently eliminated, and 2) to provide evidence to the extent to which a TA adds value to the translation and cultural adaptation of PRO instruments. The Youth Quality-of-Life Instrument–Weight module (YQOL-W) was chosen as a candidate questionnaire for this exercise. METHODS: A team of two linguists, blinded to the results of psychometric analyses and decisions on item reduction, conducted a TA on the 32-item pre-final version of the YQOL-W. Results were categorized into several types of issues. Items for possible deletion were identified and compared to the results of the item-reduction phase, using both qualitative and psychometric methods performed by the developer. RESULTS: During the item-reduction phase, 11 items were dropped; seven for qualitative reasons (items 10, 30, 31, 27-32) and four for weak factor loading (items 14, 16, 18, 19). Out of the 11 items dropped, TA identified nine problematic items (82%) and, among them, advised dropping five items (45.4%), either for redundancy with others (items 14, 19, 29, and 32) or inconsistency of construct with respect to concept (item 27). For item 28, TA recommended changing the original for semantic reasons. For items 10, 30, and 31, TA recommended using alternative wording for translation purposes but did not suggest changing the original. Finally, for items 16 and 18, TA recommended no changes. CONCLUSIONS: Our study showed that a translatability assessment can anticipate results of the item-reduction phase. Although more empirical studies are needed, we have demonstrated that the involvement of linguists in the early development phase could be a plus in detecting irrelevant or inappropriate items, and that a translatability assessment can be a useful step in PRO instrument development.