Translation and validation of the American Urological Association symptom index into Spanish

The US population is multiethnic in composition: many languages thrive, and Spanish is the second most frequently spoken language. The Hispanic population is one of the fastest growing ethnic groups in the United States. The majority of Hispanics speak Spanish at home (63%), and a significant proportion speak little or no English (25%). The purpose of this study was to translate the American Urological Association (AUA) symptom index into Spanish and to validate the final translation. To translate the AUA symptom index, a combination of four methods was used: forward- and back-translation, evaluation of the translated version by a committee, testing of the translated index with healthy bilingual subjects, and correlation of the scores of bilingual patients with benign prostatic hyperplasia (BPH) who were administered both the AUA symptom index and the Maine Medical Assessment Program (MMAP) symptom index. One-way analysis of variance was used to compare the scores of healthy bilinguals, and no significant differences were found between the English and Spanish versions. Multivariate analysis of variance revealed that none of the seven questions showed statistical differences between the Spanish and English versions. This provided further evidence that the questions were translated properly into Spanish and that they can be used to measure the same concepts as the English questions. After both indexes (AUA and MMAP) were administered to bilingual patients with BPH, the study found that the correlation between the Spanish version of the AUA symptom index and the MMAP was 0.85. This is further evidence that the Spanish version of the AUA symptom index is accurate and can be used to measure the symptoms of BPH as well as the English counterpart.