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Translating health status questionnaires and evaluating their quality: the IQOLA Project approach. International Quality of Life Assessment
Quantitative Health Sciences Publications and Presentations
  • Monika Bullinger, Universitatskrankenhaus Eppendorf
  • Jordi Alonso, Institut Municipal d’Investigacio Medica
  • Giovanni Apolone, Istituto di Ricerche Farmacologiche Mario Negri
  • Alain Leplege, INSERM
  • Marianne Sullivan, Goteborg University
  • Sharon Wood-Dauphinee, McGill University
  • Barbara Gandek, New England Medical Center
  • Anita Wagner, New England Medical Center
  • Neil Aaronson, Netherlands Cancer Institute
  • Per Bech, Fredricksborg General Hospital
  • Shunichi Fukuhara, University of Tokyo
  • Stein Kaasa, Norwegian University for Science and Technology
  • John E. Ware, Jr., University of Massachusetts Medical School
UMMS Affiliation
Department of Quantitative Health Sciences
Publication Date
Document Type
Cross-Cultural Comparison; Developed Countries; *Health Status Indicators; Humans; *Quality of Life; Questionnaires; *Translating; Translations

This article describes the methods adopted by the International Quality of Life Assessment (IQOLA) project to translate the SF-36 Health Survey. Translation methods included the production of forward and backward translations, use of difficulty and quality ratings, pilot testing, and cross-cultural comparison of the translation work. Experience to date suggests that the SF-36 can be adapted for use in other countries with relatively minor changes to the content of the form, providing support for the use of these translations in multinational clinical trials and other studies. The most difficult items to translate were physical functioning items, which used examples of activities and distances that are not common outside of the United States; items that used colloquial expressions such as pep or blue; and the social functioning items. Quality ratings were uniformly high across countries. While the IQOLA approach to translation and validation was developed for use with the SF-36, it is applicable to other translation efforts.

DOI of Published Version
J Clin Epidemiol. 1998 Nov;51(11):913-23. Link to article on publisher's site
PubMed ID
Related Resources
Link to Article in PubMed
Citation Information
Monika Bullinger, Jordi Alonso, Giovanni Apolone, Alain Leplege, et al.. "Translating health status questionnaires and evaluating their quality: the IQOLA Project approach. International Quality of Life Assessment" Vol. 51 Iss. 11 (1998) ISSN: 0895-4356 (Linking)
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