title: A review of guidelines for cross-cultural adaptation of questionnaires could not bring out a consensus.
abstract: OBJECTIVE
  The aim of cross-cultural adaptation (CCA) of a questionnaire is to achieve equivalence between the original and adapted questionnaire. Here, we aimed to review the state of the art in CCA methods.
  
  
  METHODS
  We reviewed cross-disciplinary bibliographic databases for articles on methods and guidelines for CCA of questionnaires. Articles were first selected by their abstract and title, and then, we retrieved full-text English articles. References of selected articles were searched for additional relevant studies.
  
  
  RESULTS
  We identified 31 guidelines and found no consensus in CCA methods. Most methods included use of committees, focus groups, and back translations. Evidence for the best methods is lacking, although clues indicate that back translation may not be mandatory.
  
  
  CONCLUSIONS
  Several methods are available for CCA of questionnaires. According to experts only, most would achieve comparable results, and choosing one is a matter of preference and logistic. More evidence is needed to support recommendations. Adaptation and validation of a questionnaire are two different processes that should be distinguished and undertaken with care.
authors.affiliation: Université de Lorraine, Université Paris Descartes, APEMAC, EA 4360, Faculté de Médecine, 9 avenue de la Forêt de Haye, 54505 Vandoeuvre-lès-Nancy, France.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Epstein
authors.affiliation: Department of Ophthalmology, University of São Paulo, School of Medicine, Av. Dr. Enéas de Carvalho Aguiar 255, São Paulo - SP, 05403-000, Brazil.
authors.forename: Ruth Miyuki
authors.initials: RM
authors.lastname: Santo
authors.affiliation: Université de Lorraine, Université Paris Descartes, APEMAC, EA 4360, Faculté de Médecine, 9 avenue de la Forêt de Haye, 54505 Vandoeuvre-lès-Nancy, France. Electronic address: francis.guillemin@univ-lorraine.fr.
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
mesh_terms: D032921:Consensus; D003431:Cross-Cultural Comparison; D016206:Databases, Bibliographic; D006801:Humans; D007802:Language; D011795:Surveys and Questionnaires; D014177:Translations
keywords: Adaptation; Concept; Culture; Guidelines; Method; Questionnaire