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

Abstract

Background The 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. Method The 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. Results In 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. Conclusion The 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.

German Translation and Linguistic Validation of the LIMB‑Q: A Patient-reported Outcome Measure for Lower Extremity Trauma

“…These guidelines have been successfully used in the Danish translation of LIMB-Q and in translations of other PROMs. 4,20,25 The Danish version of the LIMB-Q was successfully translated through a similar rigorous process. 22 The Danish LIMB-Q was validated through a forward translation, backward translation, an expert panel meeting, two rounds of cognitive interviews, and harmonization.…”

“…These guidelines have been successfully used in the Danish translation of LIMB-Q and in translations of other PROMs. 4,20,25…”

“…To date, the LIMB-Q is the only PROM that has been thoroughly developed to address the entire spectrum of care for patients with lower extremity trauma, including those who have undergone amputation or soft tissue reconstruction. 4 The aim of this study was to translate and linguistically validate the LIMB-Q into German, adhering to international standards for PROM translations. Having reliable and valid instrument for assessing the outcomes and experiences of German-speaking patients with traumatic lower limb injuries is vital for enhancing care quality and guiding future treatment strategies.…”

“…1,2 Treatment is dependent on the injury, but it often includes tissue debridement; fracture reduction and fixation; and, in severe injuries, soft tissue reconstruction with a flap or amputation of the limb. 3,4 Given the significant impact of lower extremity traumatic injuries on patients’ lives, it becomes imperative to fully understand and integrate the patient perspective into care. This need is particularly acute in German-speaking regions because there is a growing emphasis on integrating patient-reported outcome measures (PROMs) into their healthcare systems.…”

“…To date, the LIMB-Q is the only PROM that has been thoroughly developed to address the entire spectrum of care for patients with lower extremity trauma, including those who have undergone amputation or soft tissue reconstruction. 4…”