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Table 1 Nine-step procedure for translation and cross-cultural adaptation of the Agitated Behavior Scale

From: German version, inter- and intrarater reliability and internal consistency of the “Agitated Behavior Scale” (ABS-G) in patients with moderate to severe traumatic brain injury

Step Aim Required personnel
1 To obtain permission to use instrument and to invite instrument developer to be involved. First author
2 To receive three independent forward translations and make necessary cross-cultural adaptations of the item content, scoring system and scoring instructions into the target language. The two informeda translators and the naiveb translator were native speakers of the target language
3 To synthesize the forward translation into a single forward translation and to resolve any discrepancies with translators’ reports.
To review layout, grammar and typography.
The synthesis was done by the first author
4 To back translate the reconciled translation into the source language by two English native speaker. The two back translators, one informedaand one naiveb, were bilingual and unaware of the original ABS
5 To synthesize the backward translation into a single backward translation and to detect conceptual errors, inconsistencies, unclear wording, equivalence (semantic and idiomatic) of the translation.
To review layout, grammar and typography.
The first author did the synthesis and review.
To review the back translation by the original author. Original author
6 Expert committee review: To review all reports in a committee and to reach consensus on discrepancies.
To achieve semantic and idiomatic equivalence of the forward translation.
To produce pre-final version: to review layout, grammar and typography (adapt and re-check).
Expert committee: Four of five translators were present at the meeting as well as the first author and the two pre-testing professionals
7 To pre-test the translated version with two patients including the comprehension of item content, scoring system and scoring instructions and to detect difficulties or discrepancies within the translated version.
To finalize the translation and to proof the finalized translation
Two professionals have tested the pre-test version with patients and have written a short report. The first author has integrated their feedback in the finalized version. Proof-reading was done by a professional translator
8 To report the process of translation. First author
9 To evaluate the inter-, intrarater reliability and internal consistency. Patients, therapists, first author
  1. a an informed translator has expertise of the underlying concepts being tested by the assessment and has a medical or clinical background
  2. b a naive translator has no inside in the underlying concept and has no clinical background. Favourably, the naive translator has expertise in translation