Conducting multinational, cross-cultural research in the functional gastrointestinal disorders: issues and recommendations. A Rome Foundation working team report

Abstract

SUMMARY BackgroundCross-cultural, multinational research can advance the field of functional gastrointestinal disorders (FGIDs). Cross-cultural comparative research can make a significant contribution in areas such as epidemiology, genetics, psychosocial modulators, symptom reporting and interpretation, extra-intestinal co-morbidity, diagnosis and treatment, determinants of disease severity, health care utilisation, and health-related quality of life, all issues that can be affected by geographical region, culture, ethnicity and race.

Development, Translation and Validation of Enhanced Asian Rome III Questionnaires for Diagnosis of Functional Bowel Diseases in Major Asian Languages: A Rome Foundation-Asian Neurogastroenterology and Motility Association Working Team Report

“…Translation-validation was conducted according to the Rome Foundation guidelines for new language translations. 21 The process of translation of the Enhanced Asian Rome III questionnaire EAR3Q was translated into each language by 2 independent translators separately (Asian versions 1a and 1b, Figure). Subsequently, the 2 versions were reconciled by another expert wellconversant in the respective language to create a final translated questionnaire (Asian version 2), which was back translated into English by another qualified expert well-conversant in both languages.…”

Translation and Validation of Enhanced Asian Rome III Questionnaires in Bengali Language for Diagnosis of Functional Gastrointestinal Disorders

“…[9][10][11] We believe that the culturally adapted, translated, and validated Bengali questionnaire has wide applicability. For example, this questionnaire may be useful for cross-cultural, multi-national epidemiologic, therapeutic and pathophysiological studies.…”

“…The importance of multi-national crosscultural research has been increasingly recognized in the recent years. [9][10][11] Moreover, physicians can use this questionnaire in clinical practice. This will help them to recognize overlap conditions that may have important implications in treatment and prognosis.…”

“…7 Socio-cultural factors influence the illness beliefs, perception, and expression of gastrointestinal (GI) symptoms. [8][9][10][11] Therefore, for symptom-based diagnosis, linguistic translation of a questionnaire alone is quite inadequate unless cultural adaptation of the terminology is undertaken to imply the underlying intentions. Since FGIDs are diagnosed by symptoms-based criteria, 1,12 and symptoms are influenced by psychosocial and socio-cultural factors, [8][9][10][11] there has been concern whether the Rome III questionnaire in its original form would be similarly applicable for uniform diagnosis, sub-typing, and treatment allocation for FGIDs throughout the world.…”

“…[8][9][10][11] Therefore, for symptom-based diagnosis, linguistic translation of a questionnaire alone is quite inadequate unless cultural adaptation of the terminology is undertaken to imply the underlying intentions. Since FGIDs are diagnosed by symptoms-based criteria, 1,12 and symptoms are influenced by psychosocial and socio-cultural factors, [8][9][10][11] there has been concern whether the Rome III questionnaire in its original form would be similarly applicable for uniform diagnosis, sub-typing, and treatment allocation for FGIDs throughout the world. 11,13 To overcome some of the above-mentioned limitations, the Enhanced Asian Rome III questionnaire (EAR3Q) 14 has been developed by the Asian experts by consensus, which is a culturally adapted version of the Rome III diagnostic questionnaire (R3DQ).…”