Background Cross cultural influences affect health practices. It is not adequate to simply translate a tool word for word into another language. LESS-CHRON criteria (List of Evidence-baSed depreScribing criteria for CHRONic patients) is a new Spanish tool to guide deprescribing in patients with chronic pathologies.
Purpose To design and develop a cross cultural process of adaptation of the LESS-CHRON criteria and its manual, translating the Spanish (S) language to English (E).
Material and methods According to the literature, three steps were defined:
Translation of the original version (version S0) into the target language (E1).
Back translation of the preliminary initial translated version (E1) to the original language (S1).
Comparison between versions S0 and S1, detection of discrepancies in E1 and resolution of them to obtain the final version (E2) in consensus with an investigator involved in the creation of the tool.
Translators must be bilingual, must know the cultures of the original and target languages and must have worked in the health system to know both jargon and medical expressions. Steps 1 and 2 were done by email in March 2015. The last step (June 2015) was face to face. After completing this process, the translators were asked about the difficulties they found.
Results Profiles of the people selected for developing each step of the cross cultural processes were:
An English physician who was working in a Spanish hospital.
A Spanish pharmacist who was working in the UK.
A bilingual bi-cultural professional translator and an investigator of the team.
The face to face meeting was the key point because the translator and investigator came to an agreement on the conflicted points: titles of the tool divisions and descriptions of the scales used. They also came to the conclusion that it was necessary to make a subdivision in the tool to classify drugs as a function of their pharmacological activity (ATC classification). This proposal was also added to the original version.
Translators found it much more difficult to translate the manual than the tool.
Conclusion LESS-CHRON criteria have been translated into English following a validated method: the cross cultural adaptation. It is necessary to design a clinical validation of the English version of the tool.
References and/or Acknowledgements To the translators: Jessie, Esperanza and John. Also to the CRONOS-SEFH group and PPyEA-SEMI group.
Conflict of interest.
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