OBJECTIVES

: Linguistic validation was carried out on the Crohn’s Disease Questionnaire into 80 languages, performing cognitive debriefing on groups of 5 participants with Crohn’s or Irritable Bowel Disease per language, with a total involvement of 400 participants from the target countries. The aim was to outline the issues encountered and the solutions applied to establish cultural equivalence when localising the various stool sizes and types in the Bristol Stool Scale. The objective is to highlight the importance of providing equivalent information on texture, size and shape of a stool to enable participant understanding and to allow for accurate questionnaire completion.

METHODS

: Participant feedback from the 80 cognitive debriefing review grids was analysed to first ascertain where issues were found and examine any updates made to see where localisations were required in the target language for accurate participant understanding. This will include a particular focus on cross-referencing types 1, 2, 5 and 6 on the stool scale.

RESULTS

: Out of 69 translations of the Bristol Stool Scale, 17 languages required localisations for the above-mentioned stool types. Of these, it was found that 2% of translations for type 1 required localisation. A localised translation was also provided for 13% of type 2 translations, as well as 6% for type 5 and 10% for type 6.

Examples of changes included changing ‘sausage-shaped’ to ‘tamarind-shaped’ in India, changing ‘hard lumps, like nuts’ to ‘fruit core’ in Arabic speaking countries, and ‘fluffy pieces’ to ‘soft’ or ‘cotton-like’ for understanding in several locales.

CONCLUSIONS

: It is important to highlight the need for cognitive debriefing to achieve real-world responses from target language speakers in order to obtain optimum data quality. It is essential that localisation is carried out wherever possible to ensure a cultural equivalent is used.