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Translation guide

The decision as to whether the MaCriCare survey requires translation is to be made on an individual basis by each National Coordinator (NC). It is important that any translation is properly validated and in this regard it is the NC’s responsibility to coordinate the translation process according to the following guide.

Forward translation
The translation should be undertaken by at least two independent translators. Translators should ideally be translating into their native language. Two separate and independent translations should be produced:

Forward translation #1: performed by a translator who is aware of the concept behind the survey in order to produce a translation that closely resembles the original instrument.

Forward translation #2: performed by a separate naïve translator (someone who is unaware of the survey’s objectives) in the knowledge that it is likely to differ from translation #1

The translators should then discuss and resolve any discrepancies between the two translations to produce a single version.

Reverse translation

The forward translation should then be independently back-translated into the original English to confirm accuracy. Misunderstandings or unclear wordings in the initial translations may accordingly be revealed. The reverse translation should be performed by at least two independent translators, and will preferably be native speakers of English.

Expert committee

An expert committee should thereafter produce a final draft of the translation. Members of the committee should include 1. The NC, who is familiar with the survey design 2. The forward translators 3. The reverse translators. The committee will need to review all versions of the translations and determine whether the translated and original versions achieve semantic, idiomatic, experiential, and conceptual equivalence. Any discrepancies will need to be resolved, and members of the expert committee will need to reach a consensus on all items.

Pilot testing

The final draft of the translated questionnaire will be uploaded to the MaCriCare online tool in order to be pilot tested on a small sample (about 10–30) of the intended respondents. A specific MaCriCare link will be available for this purpose. At the end of the pilot testing, respondents will give their feedback to establish whether any confusion remains with respect to the translated survey. After analysis of the feedback, the final version of the of the translated survey may be accepted.


1. Tsang S, Royse CF, Terkawi AS. Guidelines for developing, translating, and validating a questionnaire in perioperative and pain medicine. Saudi J Anaesth 2017;11, Suppl S1:80-9
2. Michał Seweryn Karbownik , Beata Jankowska-Polańska , Robert Horne, Karol Maksymilian Górski, Edward Kowalczyk, Janusz Szemraj. Adaptation and validation of the Polish version of the Beliefs about Medicines Questionnaire among cardiovascular patients and medical students. PLoS One. 2020 Apr 13;15(4):e0230131.
3. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J Eval Clin Pract. 2011 Apr;17(2):268-74.
4. WHO: Process of translation and adaptation of instruments.