Cross-cultural adaptation of the locally recurrent rectal cancer – Quality of life questionnaire

Abstract

Aim: The Locally Recurrent Rectal Cancer - Quality of Life (LRRC-QoL) questionnaire was developed as a disease specific measure of health-related quality of life (HrQoL) in locally recurrent rectal cancer (LRRC), it has previously been validated for use in the UK and Australia. The aim of this study was to translate and cross-culturally adapt the LRRC-QoL to enable its use on an international platform. Materials and methods: Cross-cultural adaptation of the LRRC-QoL was undertaken through a process of 1) Translatability Assessment (TA), 2) forward-backward translation, and 3) pre-testing interviews to establish content validity and conceptual equivalence across all versions. The QQ-10 measure was used to assess face validity and acceptability. The LRRC-QoL was translated into 13 languages: Danish, Dutch, French, Hindi, Italian, Mandarin, Marathi, Portuguese, Russian, Spanish, Swedish, Telugu, and Urdu. Results: In total, 67 patients and 6 clinicians were recruited to pre-testing interviews across 12 countries: Brazil, Canada, Denmark, France, India, Italy, the Netherlands, New Zealand, Pakistan, Singapore, Spain, and Sweden. TA was also undertaken in the USA and Ireland, and translations were prepared in Russian, Marathi, and Telugu. The LRRC-QoL was found to demonstrate conceptual equivalence and content validity across all versions. Mean QQ-10 Value score 76.80 (SD 13.88) and mean Burden score 20.22 (SD 23.03), confirming face validity and acceptability in this international cohort. Conclusion: The LRRC-QoL has now undergone cross-cultural adaptation to enable its use in 10 languages and 16 countries. Its psychometric properties will be further examined through external validation in an international cohort.