Reviewing back translation reports of questionnaires: the EORTC conceptual framework and experience

In the process of translating patient-reported outcomes measures (forward translation(s), reconciliation, back translation(s), review, pilot-testing, review, final translation), there is a general consensus amongst the key players in the field that the back translation review is an important step. Despite this, there has been little guidance published on how to perform it. Areas covered: Having assessed the most recent back translation reports reviewed by the Translation Unit at the European Organisation for Research and Treatment of Cancer (EORTC) in Brussels, we have identified two concepts to help guide the back translation review process: the underlying issue (the problem that the item measures) and the structure (the linguistic and formal construction of the item). This paper presents these concepts and how they are used in the review process. Expert commentary: Despite certain difficulties it might pose, back translation review remains one of the standard steps to assure concept equivalence. This paper aims at starting a much-needed exchange of experience and knowledge among people who perform reviews as part of the process of translating patient-reported outcomes measures.