Assessing dentists' knowledge about oral cancer: Translation and linguistic validation of a standardized questionnaire from American English into German

Oral cancer represents a considerable health problem with more than 10,000 new cases each year in Germany. Nevertheless, little information is available on the knowledge of dentists and the public on oral cancer. This project aims at investigating the knowledge and opinions of dentists via a questionnaire. The present article describes the translation process of an internationally accepted instrument into German. The translation was carried out by the Mapi Research Institute, Lyon, France. The translation procedure followed an established linguistic validation process, consisting of the conceptual analysis of the source instrument, a forward and backward translation, the clinicians' review, proofreading, and the finalization. The institute identified nine cultural adaptations. After forward and backward translations, the clinical reviewers suggested 16 stylistic changes, four alternative wordings, two more cultural adaptations, and five changes of nomenclature. After debriefing, the translated questionnaire involved nine stylistic changes, four alternative wordings, and 11 changes for cultural adaptation. The described translation and validation procedure guarantees a high-quality standard instrument for the evaluation of dentists' knowledge and opinions on oral cancer in Germany and prevents misinterpretations due to cultural differences, which allows an international comparison of the data. (C) 2009 Elsevier Ltd. All rights reserved.