Translation and cultural adaptation of the CLEFT-Q into Arabic, Dutch, Hindi, Swedish, and Turkish

Elena Tsangaris, Karen W.Y. Wong Riff, Marieke Dreise, Mia Stiernman, Manraj Nirmal Kaur, Bhoomika Piplani, Asim Aydin, Ghassan Naser Moh’d Kharashgah, Mitchell A. Stotland, Lehana Thabane, Achilleas Thoma, Anne F. Klassen

Research output: Contribution to journalArticlepeer-review


Background: Treatment for cleft lip and/or palate (CL/P) involves a multidisciplinary team of experts who aim to improve ones’ appearance, health-related quality of life, and speech function. To appropriately measure outcomes in CL/P from the patient perspective, a CL/P-specific patient-reported outcome (PRO) instrument is needed. The CLEFT-Q is a self-report PRO instrument developed to evaluate treatment outcomes in patients with CL/P. The aim of this study was to translate and culturally adapt the CLEFT-Q. Methods: The CLEFT-Q was translated and culturally adapted from English into Arabic, Dutch, Hindi, Swedish, and Turkish using guidelines set forth by the International Society for Pharmacoeconomics and Outcomes Research. For each language, two forward translations, one back translation, and cognitive debriefing interviews with patients were conducted. Results: The field test version of the CLEFT-Q consisted of 154 items across 13 scales. Forward translations for each language revealed few items that were difficult to translate into the various languages. Comparison of each back translation to the English version identified that a change in the meaning of an item was more common in the Turkish (n = 40, 26%) and Arabic (n = 17, 11%) translations, and required re-translation. Cognitive debriefing interviews involved 41 participants from plastic surgery centers in India, Qatar, Sweden, the Netherlands, and Turkey. Participants reported few difficulties in understanding the items, instructions, and response options in each CLEFT-Q translation. Conclusions: Semantic, idiomatic, experiential, and conceptual equivalence of the CLEFT-Q was achieved for all language versions, thus providing evidence of the CLEFT-Q’s transferability to other languages and cultures. Level of Evidence: Not ratable

Original languageEnglish
Pages (from-to)643-652
JournalEuropean Journal of Plastic Surgery
Issue number6
Early online date2018 Aug 15
Publication statusPublished - 2018 Dec

Subject classification (UKÄ)

  • Surgery

Free keywords

  • PRO
  • Translation and cultural adaptation


Dive into the research topics of 'Translation and cultural adaptation of the CLEFT-Q into Arabic, Dutch, Hindi, Swedish, and Turkish'. Together they form a unique fingerprint.

Cite this