Danish translation and linguistic validation of the LIMB-Q, a PROM for traumatic lower limb injuries and amputations

BackgroundThe LIMB-Q is a newly developed patient-reported outcome measure (PROM), applicable for lower extremity trauma patients requiring fracture treatment, soft tissue debridement, reconstruction, and/or amputation. The aim of this study was to translate and linguistically validate the LIMB-Q from English to Danish.MethodThe translation and linguistic validation were performed by combining guidelines from the World Health Organization (WHO) and the International Society for Pharmacoeconomics and Outcomes Research (ISPOR). This approach involved 2 forward translations, a backward translation, an expert panel meeting, and 2 rounds of cognitive patient interviews. The main goal of these steps was to achieve a conceptual translation with simple and clear items. Feedback from the Danish translation was used in combination with psychometric analyses for item reduction of the final international version of LIMB-Q.ResultsIn the forward translation, 6 items were found difficult to translate into Danish. The two translations were harmonized to form the backward translation. From the backward translation, 1 item was identified with a conceptually different meaning and was re-translated. The revised version was presented at the expert panel meeting leading to revision of 10 items. The cognitive patient interviews led to revision of 11 items. The translation process led to a linguistically validated and conceptually equivalent Danish version of the LIMB-Q.ConclusionThe final Danish LIMB-Q version consisting of 16 scales is conceptually equivalent to the original and ready for field-testing in Denmark.Level of evidence: Not gradable.