A Japanese translation, cultural adaptation, and linguistic and content validity confirmation of the Scored Patient-Generated Subjective Global Assessment

Abstract

Purpose The Scored Patient-Generated Subjective Global Assessment (PG-SGA © ) is a globally recognized and used nutritional screening, assessment, monitoring, and triaging tool. The aim of this study was to translate and culturally adapt the original English PG-SGA for the Japanese speaking populations and to assess its linguistic validity (i.e., comprehensibility, difficulty) and content validity, as perceived by Japanese patients and healthcare professionals. Methods In accordance with methodology used in previous Dutch, Thai, German, and Norwegian PG-SGA studies, we followed the ten steps of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Principles of Good Practice for Translation and Cultural Adaptation for Patient-Reported Outcome Measures. The study enrolled 50 patients and 50 healthcare professionals (HCPs) to evaluate the comprehensibility and difficulty of the translated and culturally adapted PG-SGA. The HCPs also evaluated the content validity of the translation. We evaluated each item and quantified scale indices for content validity (item content validity index (I-CVI), scale content validity index (S-CVI)), comprehensibility (item comprehensibility index (I-CI), scale comprehensibility index (S-CI)), and difficulty (item difficulty index (I-DI), scale difficulty index (S-DI)). Results Patients evaluated the comprehensibility and difficulty of the patient component as excellent (S-CI = 0.97, S-DI = 0.96). The professionals rated the Japanese version of both components of the PG-SGA as very relevant (S-CVI = 0.94). The professionals evaluated the comprehensibility of the professional component as being acceptable (S-CI = 0.88) but difficult (S-DI = 0.69), based predominantly on items related to physical examination (I-DI = 0.33-0.67). ConclusionThe PG-SGA was systematically translated and culturally adapted for the Japanese setting according to the ISPOR process. The Japanese version of the PG-SGA was perceived as comprehensive, easy to use, and relevant. Perceived difficulty in professional components, specifically in the context of metabolic demand and physical examination, will require appropriate training for professionals in order to optimize implementation.

Polish translation, cultural adaptation, and validity confirmation of the Scored Patient-Generated Subjective Global Assessment

“…Comprehensibility and di culty of the professional component of the Polish version of the PG-SGA were considered acceptable by HCPs (S-CI = 0.87 and S-DI = 0.80, respectively). These results are in contrast to the results of the Norwegian [24], German [20], Dutch [19], Japanese [22] and Thai [26] studies, in which the professional component of the PG-SGA scored below acceptance in the constructs of di culty, and additionally of comprehensibility in the Norwegian study [24]. On the other hand, in a recently published study on the validation of the Greek version of the PG-SGA [21], comprehensibility and di culty of the professional component were perceived as excellent (≥ 0.90).…”

“…Moreover, HCPs indicated that the patient component of the Polish version of the PGSGA was relevant. Similar results on the patient component were obtained in other studies performed in Denmark [19], Germany [20], Norway [24], Greece [21], Japan [22], the Netherlands [25], Thailand [26] and Italy [27]. In all mentioned studies, content validity, as well as comprehensibility and di culty of the PG-SGA Short Form were perceived as excellent.…”

“…It should be noted that the representation of patients with these two levels of education was the lowest (respectively 6% and 10%) in the entire recruited group, and concluding about the reasons for such a distribution of results is not possible. In the Japanese study, the relationship between educational level and di culty was also analyzed, and in that study no relationship between education level and di culty of the PG-SGA Short Form as perceived by patients was found [22].…”

“…The validity of PG-SGA has also been con rmed in evaluating the nutritional status of nephrology and neurology patients, in elderly and palliative care, amongst others [15][16][17][18]. The PG-SGA has already been culturally adapted and linguistically validated for use in various settings worldwide, including Dutch, Portuguese, German, Thai and more recently Greek and Japanese, as well as Norwegian, Danish and Italian [19][20][21][22][23][24][25][26][27]. The development of these new PG-SGA language versions was based on the Principles of Good Practice for the Translation and Cultural Adaptation Process (ISPOR) [28].…”