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Translation and cultural adaptation of the SF-6D questionnaire for use in arabic-speaking countries

Article type: Published abstract


Objectives: The use of pharmacoeconomic evaluations, e.g. cost-utility analysis (CUA), in resource allocation is gaining attention in Arabic -speaking countries. The Short Form-6D (SF-6D) is a generic preference-based measure of health-related quality of life (HRQoL) that can be used to generate health-state utilities for use in CUAs. The objective of this study is to translate and culturally-adapt the SF-6D for use in Arabic-speaking countries, with particular focus on Egypt and the United Arab Emirates. Methods: The study followed the International Quality of Life Assessment (IQOLA) methodology. Two forward translations, one consensus and one backward translation were undertaken. The translators (professional linguists and bilingual pharmacoeconomists) reported the difficulties encountered in the translation process. An advisory committee of six researchers and three clinicians who are native Arabic speakers and proficient in English language, assessed the consensus version for accuracy, cultural compatibility and cognitive burden. The difficulties encountered during the process were categorized as grammatical idiomatic, semantic/conceptual, and cultural. The backward translation was completed by a professional medical translator, reviewed and assessed by the committee. Results: Five items raised discussion during the process for grammatical (1 item), semantic (1 item), idiomatic (1 item) and cultural (2 items). For example “emotional problems” had to be culturally adapted and “down-hearted and low” had to be substituted. The committee members approved the forward translation as linguistically and grammatically accurate. Minor changes were made to the forward translation to improve cultural appropriateness. The Backward translation did not reveal major problems and equivalence to the original was confirmed following committee review. Conclusions: The translation and cultural adaptation of the SF-6D into Arabic resulted in a conceptually equivalent and culturally appropriate version. Psychometric validation and a valuation survey will be needed to assess its validity for use in the target populations.

Full citation

Dawoud DM, Soliman AM, Alhyas L, Amin MEK, Hussein M, Mohamed O. Translation and cultural adaptation of the SF-6D questionnaire for use in arabic-speaking countries. Value in Health. 2013;16(7):A606.


Methods Condition Gender Age Country Setting Sample size

Number of items

6 items


Measure does not require training

Required time

Less than 5 min

Access measure

Not available

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Articles last updated: December 2020