The German RECAP questionnaire: linguistic validation and cognitive debriefing in German adults with self-reported atopic eczema and parents of affected children

Abstract

Background Recap of atopic eczema (RECAP) is a patient-reported outcome measure (PROM) assessing eczema control. Long-term control of eczema is one of the four core outcome domains for atopic eczema trials. This instrument has been recently developed in the UK. Objective This study aimed to translate the English RECAP into German and test its content validity in a German population with self-reported atopic eczema. Methods A six-step procedure including two forward and one backward translations, two consensus decisions and an expert review was performed to obtain a German version of RECAP. We conducted semi-standardized cognitive interviews with adults with atopic eczema (n = 7) and parents having children affected by this disease (n = 5). A “think-aloud” method was used and aspects of comprehensibility, comprehensiveness and relevance according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) criteria were examined. Interviews were coded using qualitative content analysis. Results No particular linguistic problems were encountered during forward-backward translation. Minor wording changes were made as required. The title was adjusted to a more familiar German term of the disease (which is ‘Neurodermitis’). The recall period was rephrased from ‘over the last week’ to ‘over the last seven days’ since there was a different cultural understanding of the time frame. Regarding content validity, the items of the German RECAP were considered to be comprehensible, comprehensive and relevant for the participants and parents of affected children. The participants understood the instruction and considered the one-week recall period and the response options as appropriate. Conclusions A German version of RECAP that is linguistically equivalent to the original version is now available but further assessment of its measurement properties is needed.

Systematic Review of the Effect of a One-Day Versus Seven-Day Recall Duration on Patient Reported Outcome Measures (PROMs)

“…In total, 1244 participants were included across the 33 qualitative studies reviewed. Sample sizes of individual studies ranged from 7 [48] to 207 [8] participants (median = 25; mean = 39 (SD = 41). Of the 33 qualitative studies reviewed, five assessed fatigue and sleep-related symptom, three assessed pain-related symptoms, and one assessed physical functioning, eight assessed HRQoL and 17 assessed disease-specific signs and symptoms.…”

“…iii) preference for unambiguous language Some participants indicated a preference to revise the 24-hour recall instruction to "since waking" to disqualify consideration of time while sleeping [64]. Weekly recall instructions were sometimes misinterpreted as the last previous full week (e.g., from Monday to Sunday) [65], or the 5-day working week [66]. Therefore, an explicit seven-day recall instruction was considered preferable to mitigate potential recall period misinterpretations [67].…”

Development of the Japanese Version of the Infertility Stigma Scale: Examination of Its Reliability and Validity

“…As a pilot application and following empirical literature, the scale was administered to eight married women with no children [ 37 , 38 ]. Before the interviews, an interview guide was developed by referring to previous studies [ 32 , 39 , 40 , 41 , 42 , 43 ] ( Table A3 ). The interviews were conducted online to prevent COVID-19 infection.…”

Content validity of the Recap of atopic eczema (RECAP) instrument in Dutch, English and German to measure eczema control in young people with atopic eczema: a cognitive interview study

“…It is currently available in several different languages; however, it has not been validated in every language so far 21 . The German adult and proxy versions of RECAP were obtained by translating the original RECAP using forward and backward translation for linguistic validation, with a subsequent cognitive debriefing to ensure content validity 12 . The same was applied for the Dutch version.…”

“…21 The German adult and proxy versions of RECAP were obtained by translating the original RECAP using forward and backward translation for linguistic validation, with a subsequent cognitive debriefing to ensure content validity. 12 The same was applied for the Dutch version. Due to the fact that in German and Dutch, children and young people are addressed differently from adults, unlike in English, an 'informal' version of RECAP in German and Dutch was created by replacing the formal pronoun with its informal equivalent.…”