Self-report outcome measures for low back pain: searching for international cross-cultural adaptations

Systematic review.

To describe the available cross-cultural adaptations of low back pain (LBP) self-report outcome measures and the psychometric testing that has occurred for each adaptation.

Self-report measures are commonly used in clinical practice and in research studies. Most existing questionnaires were developed in English, and it is not clear how many have been adapted to other languages.

Two different searches on MEDLINE, EMBASE, CINAHL, and LILACS were performed. The first search identified questionnaires specifically designed for patients with LBP. The second search combined the name of the questionnaire with 35 different languages in order to locate cross-cultural adaptations of the questionnaire. Data on the psychometric testing of the translated questionnaires were extracted.

Forty questionnaires were identified, only 15 of which had been adapted to a new language. Only 19 of the 35 different languages we searched for were represented in the search results. From 1400 possible adaptations, only 61 have been completed. Psychometric testing of the adapted questionnaires was quite variable and in general suboptimal with testing usually restricted to an assessment of reliability and construct validity.

There is a clear need for further cross-cultural adaptation of LBP self-report measures and for greater attention to the quality of psychometric evaluation of adapted questionnaires. Without appropriately adapted measures, the clinical management of LBP patients who do not speak English is potentially compromised.