title: Development, Translation and Validation of Enhanced Asian Rome III Questionnaires for Diagnosis of Functional Bowel Diseases in Major Asian Languages: A Rome Foundation-Asian Neurogastroenterology and Motility Association Working Team Report.
abstract: OBJECTIVE
  The development-processes by regional socio-cultural adaptation of an Enhanced Asian Rome III questionnaire (EAR3Q), a cultural adaptation of the Rome III diagnostic questionnaire (R3DQ), and its translation-validation in Asian languages are presented. As English is not the first language for most Asians, translation-validation of EAR3Q is essential. Hence, we aimed to culturally adapt the R3DQ to develop EAR3Q and linguistically validate it to show that the EAR3Q is able to allocate diagnosis according to Rome III criteria.
  
  
  METHODS
  After EAR3Q was developed by Asian experts by consensus, it was translated into Chinese, Hindi-Telugu, Indonesian, Korean and Thai, following Rome Foundation guidelines; these were then validated on native subjects (healthy [n = 60], and patients with irritable bowel syndrome [n = 59], functional dyspepsia [n = 53] and functional constipation [n = 61]) diagnosed by clinicians using Rome III criteria, negative alarm features and investigations.
  
  
  RESULTS
  Experts noted words for constipation, bloating, fullness and heartburn, posed difficulty. The English back-translated questionnaires demonstrated concordance with the original EAR3Q. Sensitivity and specificity of the questionnaires were high enough to diagnose respective functional gastrointestinal disorders (gold standard: clinical diagnoses) in most except Korean and Indonesian languages. Questionnaires often uncovered overlapping functional gastrointestinal disorders. Test-retest agreement (kappa) values of the translated questionnaires were high (0.700-1.000) except in Korean (0.300-0.500) and Indonesian (0.100-0.400) languages at the initial and 2-week follow-up visit.
  
  
  CONCLUSIONS
  Though Chinese, Hindi and Telugu translations were performed well, Korean and Indonesian versions were not. Questionnaires often uncovered overlapping FGIDs, which were quite common.
authors.affiliation: Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Uday C
authors.initials: UC
authors.lastname: Ghoshal
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Kok-Ann
authors.initials: KA
authors.lastname: Gwee
authors.affiliation: Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
authors.forename: Minhu
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Xiao R
authors.initials: XR
authors.lastname: Gong
authors.affiliation: Asian Institute of Gastroenterology, Hyderabad, India.
authors.forename: Nitesh
authors.initials: N
authors.lastname: Pratap
authors.affiliation: Department of Gastroenterology and Hepatology, Union Hospital of Tongji Medical College, Huazhong University of Science and Techonology, Wuhan, Hubei, China.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Hou
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Cipto Mangunkusumo General Hospital/Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
authors.forename: Ari F
authors.initials: AF
authors.lastname: Syam
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Cipto Mangunkusumo General Hospital/Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
authors.forename: Murdani
authors.initials: M
authors.lastname: Abdullah
authors.affiliation: Department of Gastroenterology, Korea University Guro Hospital, Seoul, South Korea.
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Bak
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
authors.affiliation: GI Motility Research Unit, Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Sutep
authors.initials: S
authors.lastname: Gonlachanvit
authors.affiliation: Gastro Centre Ipoh, Ipoh, Perak, Malaysia.
authors.forename: Andrew S B
authors.initials: AS
authors.lastname: Chua
authors.affiliation: Klinic Chong, Slim River, Perak, Malaysia.
authors.forename: Kuck-Meng
authors.initials: KM
authors.lastname: Chong
authors.affiliation: Division of Gastroenterology & Hepatology, University Medicine Cluster, National University Hospital, Singapore.
authors.forename: Kewin T H
authors.initials: KT
authors.lastname: Siah
authors.affiliation: Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Ching-Liang
authors.initials: CL
authors.lastname: Lu
authors.affiliation: Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
authors.forename: Lishou
authors.initials: L
authors.lastname: Xiong
authors.affiliation: Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
authors.forename: William E
authors.initials: WE
authors.lastname: Whitehead
keywords: Asia; Gastrointestinal diseases; Rome III criteria; Translations; Validation