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

Abstract

Purpose The Scored Patient-Generated Subjective Global Assessment (PG-SGA) is the only malnutrition (risk) assessment tool that combines patient-generated measures with professional-generated (medical) factors. We aimed to apply international standards to produce a high quality, validated, translation and cultural adaptation of the original PG-SGA for the Austrian, German, and Swiss setting. Methods Analogue to methodology used for the Dutch, Portuguese, and Thai versions of PG-SGA, the ten steps of the International Society for Pharmacoeconomics and Outcomes Research's principles of good practice for translation and cultural adaptation were followed. Comprehensibility and difficulty of the translation were assessed in 103 patients and 104 healthcare professionals recruited from all three German-speaking countries. Content validity of the translation was assessed among healthcare professionals (HCP). Item and scale indices were calculated for content validity (I-CVI; S-CVI), comprehensibility (I-CI; S-CI), and difficulty (I-DI; S-DI). Results Patients' perceived comprehensibility and difficulty of the PG-SGA fell within the range considered to be excellent (S-CI = 0.90, S-DI = 0.90), HCP-perceived content validity (S-CVI = 0.90) was also excellent, while HCP-perceived comprehensibility fell within the high range of acceptable (S-CI = 0.87). The professional component of the PG-SGA was perceived as below acceptable (S-DI = 0.72) with the physical exam being rated the most difficult (I-DI=0.29-0.75). Conclusions The systematic approach resulted in a high-quality validation of the German language version of the PG-SGA, that is internationally comparable, comprehensible, easy to complete, and considered relevant for use in Austria, Germany and Switzerland.

Linguistic and content validation of the translated and culturally adapted PG-SGA, as perceived by Norwegian cancer patients and healthcare professionals

“…The high scores on comprehensibility and difficulty indices of the patient component of the PG-SGA was in line with results from two previous studies [16,17]. While the Scale CI was 0.98 in the present study, it was 0.99 and 0.96 in the Dutch and German study respectively [16,17].…”

“…This indicates that the patient component is feasible to complete by patients from different countries and cultures. The fact that HCPs considered the patient component as highly relevant, is also in line with studies from the other countries [16,17].…”

“…The scale CI was 0.78, and even lower than the Dutch and German study (0.81 and 0.87 respectively) [13,14]. In the current study, the scale DI was 0.66, which is just in between the Dutch and German results (i.e., 0.55 and 0.72) [16,17].…”

“…While the Scale CI was 0.98 in the present study, it was 0.99 and 0.96 in the Dutch and German study respectively [16,17]. Likewise, the scale DI was 0.99 in the present study, compared to 0.96 and 0.91 in the other studies [16,17]. This indicates that the patient component is feasible to complete by patients from different countries and cultures.…”

Self‐Completion of the Patient‐Generated Subjective Global Assessment Short Form Is Feasible and Is Associated With Increased Awareness on Malnutrition Risk in Patients With Head and Neck Cancer

“…Boxes 1-4 of the PG-SGA SF were all perceived as easy to complete by the patients, even though about two-thirds of the study population had a lower level of education (ie, primary or secondary education). The excellent results on perceived difficulty are in line with those found in the pilot testing of the Dutch (S-DI = 0.96), 21 Portuguese (S-DI = 0.94), 27 Thai (S-DI = 0.95), 28 and German language versions (S-DI = 0.91) 29 of the PG-SGA, demonstrating broad applicability and reproducibility across language versions. Our results on difficulty with completing the PG-SGA SF also appear to be in line with those reported on the self-completion of the MUST.…”