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Article

Translation and Linguistic Validation of Outcome Instruments for Traumatic Brain Injury Research and Clinical Practice: A Step-by-Step Approach within the Observational CENTER-TBI Study

by
Nicole von Steinbuechel
1,*,
Katrin Rauen
2,3,
Ugne Krenz
1,
Yi-Jhen Wu
1,
Amra Covic
1,
Anne Marie Plass
1,
Katrin Cunitz
1,
Isabelle Mueller
1,
Fabian Bockhop
1,
Suzanne Polinder
4,
Lindsay Wilson
5,
Ewout W. Steyerberg
4,6,
Andrew I. R. Maas
7,
David Menon
8,
Marina Zeldovich
1 and
The Linguistic Validation Group of CENTER-TBI
†
1
Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany
2
Department of Geriatric Psychiatry, Psychiatric Hospital Zurich, University of Zurich, Minervastrasse 145, 8032 Zurich, Switzerland
3
Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Feodor-Lynen-Straße 17, 81377 Munich, Germany
4
Department of Public Health, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands
5
Department of Psychology, University of Stirling, Stirling FK9 4LJ, UK
6
Department of Biomedical Data Sciences, Leiden University Medical Center, 2333 RC Leiden, The Netherlands
7
Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, 2650 Edegem, Belgium
8
Division of Anaesthesia, University of Cambridge, Addenbrooke’s Hospital, Box 157, Cambridge CB2 0QQ, UK
*
Author to whom correspondence should be addressed.
†
The full list of the Linguistic Validation Group is provided in the Appendix A.
J. Clin. Med. 2021, 10(13), 2863; https://doi.org/10.3390/jcm10132863
Submission received: 10 June 2021 / Revised: 22 June 2021 / Accepted: 24 June 2021 / Published: 28 June 2021
(This article belongs to the Special Issue Traumatic Brain Injury: Clinical Characteristics and Outcomes)
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Abstract

Assessing outcomes in multinational studies on traumatic brain injury (TBI) poses major challenges and requires relevant instruments in languages other than English. Of the 19 outcome instruments selected for use in the observational Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study, 17 measures lacked translations in at least one target language. To fill this gap, we aimed to develop well-translated linguistically and psychometrically validated instruments. We performed translations and linguistic validations of patient-reported measures (PROMs), clinician-reported (ClinRO), and performance-based (PerfO) outcome instruments, using forward and backward translations, reconciliations, cognitive debriefings with up to 10 participants, iterative revisions, and international harmonization with input from over 150 international collaborators. In total, 237 translations and 211 linguistic validations were carried out in up to 20 languages. Translations were evaluated at the linguistic and cultural level by coding changes when the original versions are compared with subsequent translation steps, using the output of cognitive debriefings, and using comprehension rates. The average comprehension rate per instrument varied from 88% to 98%, indicating a good quality of the translations. These outcome instruments provide a solid basis for future TBI research and clinical practice and allow the aggregation and analysis of data across different countries and languages.
Keywords: translation; linguistic validation; outcome instruments; traumatic brain injury translation; linguistic validation; outcome instruments; traumatic brain injury

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MDPI and ACS Style

von Steinbuechel, N.; Rauen, K.; Krenz, U.; Wu, Y.-J.; Covic, A.; Plass, A.M.; Cunitz, K.; Mueller, I.; Bockhop, F.; Polinder, S.; et al. Translation and Linguistic Validation of Outcome Instruments for Traumatic Brain Injury Research and Clinical Practice: A Step-by-Step Approach within the Observational CENTER-TBI Study. J. Clin. Med. 2021, 10, 2863. https://doi.org/10.3390/jcm10132863

AMA Style

von Steinbuechel N, Rauen K, Krenz U, Wu Y-J, Covic A, Plass AM, Cunitz K, Mueller I, Bockhop F, Polinder S, et al. Translation and Linguistic Validation of Outcome Instruments for Traumatic Brain Injury Research and Clinical Practice: A Step-by-Step Approach within the Observational CENTER-TBI Study. Journal of Clinical Medicine. 2021; 10(13):2863. https://doi.org/10.3390/jcm10132863

Chicago/Turabian Style

von Steinbuechel, Nicole, Katrin Rauen, Ugne Krenz, Yi-Jhen Wu, Amra Covic, Anne Marie Plass, Katrin Cunitz, Isabelle Mueller, Fabian Bockhop, Suzanne Polinder, and et al. 2021. "Translation and Linguistic Validation of Outcome Instruments for Traumatic Brain Injury Research and Clinical Practice: A Step-by-Step Approach within the Observational CENTER-TBI Study" Journal of Clinical Medicine 10, no. 13: 2863. https://doi.org/10.3390/jcm10132863

APA Style

von Steinbuechel, N., Rauen, K., Krenz, U., Wu, Y.-J., Covic, A., Plass, A. M., Cunitz, K., Mueller, I., Bockhop, F., Polinder, S., Wilson, L., Steyerberg, E. W., Maas, A. I. R., Menon, D., Zeldovich, M., & The Linguistic Validation Group of CENTER-TBI. (2021). Translation and Linguistic Validation of Outcome Instruments for Traumatic Brain Injury Research and Clinical Practice: A Step-by-Step Approach within the Observational CENTER-TBI Study. Journal of Clinical Medicine, 10(13), 2863. https://doi.org/10.3390/jcm10132863

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