Table 3 Recommendations for the production of high-quality adaptations

The dual panel method is recommended for producing high-quality translations. The following recommendations are made:

   Recruit 'translators' who currently live in the target country and whose command of English is good.

The meeting should be held in the country for which the measure is required.

Five to seven people enable fruitful discussion.

It is preferable to exclude professional translators.

   An instrument developer should attend this meeting to explain the intent of the items and their specific meanings in the context of the questionnaire.

   Inform the group of the model underlying the questionnaire, how it was developed, its design and its content and target audience.

   Inform the group of the translation requirements (in particular accessibility and acceptability of wording).

   The group should work as a team with a co-ordinator whose task is to check that none of the parameters are neglected (in particular, structural and metric aspects that could be overlooked).

   Allow adequate time for the meeting to explore all issues fully.

   Once the translated version of the instrument is agreed, have it assessed by a lay panel, again working as a group:

The coordinator involved in the first panel should work with this panel also to ensure that the original meaning of the items and the questionnaire structure are maintained.

The results of this meeting should be used to make final decisions about the wording of the questionnaire.

The whole procedure should be reported in detail, in particular explaining translation choices and changes made following lay panel testing. This not only provides information on the process undertaken but also constitutes a thorough final review.