LETTERS TO THE EDITOR:

Bridging Cultures:

Challenges and Opportunities when Translating and Adapting Instruments for Dental Studies

Uniendo culturas:

desafíos y oportunidades al traducir y adaptar instrumentos en estudios odontológicos

Jesus Giancarlo Pares-Ballasco¹ https://orcid.org/0000-0001-9589-8033

Gabriela Araceli Campos-Hermoza¹ https://orcid.org/0009-0003-7460-9652

Teresa Evaristo-Chiyong DDS, MSc, PhD² https://orcid.org/0000-0001-7129-5617

1. Universidad Nacional Mayor de San Marcos, Faculty of Dentistry, Sociedad Científica de Odontología, Lima, Peru.

2. Universidad Nacional Mayor de San Marcos, Faculty of Dentistry, SAETA Research Group, Lima, Peru.

Correspondence to: Teresa Evaristo-Chiyong - tevaristoc@unmsm.edu.pe

Received: 1-III-2024 Accepted: 4-IV-2024

Dear Editor,

What should we do when we encounter a measurement instrument that is correctly validated and useful in Dentistry, but was developed in a country with a culture and language different from Peru? This situation poses a significant challenge for researchers, since translation and cultural adaptation can be complex and require careful consideration" researchers, as translation and cultural adaptation can be complex and require careful consideration (1). In some cases, the apparent solution of creating a new instrument can result in an indiscriminate development of instruments, which negatively affects the efficiency and optimization of resources, as well as the comparability of results, maintenance of metric characteristics and the synthesis of evidence (1-4). This problem raises fundamental questions that require discussion within the dental community. Therefore, the purpose of this letter to the editor is to identify the challenges and benefits associated with conducting studies on translation and cultural adaptation of measurement instruments in this field.

The translation and cultural adaptation of an instrument involve various stages, which include searching for equivalence of concepts and items, having the instrument translated by at least two individuals, synthesizing the translated versions, having the instrument back-translated by two other individuals, synthesizing the back translations, expert committee advising, conducting a pilot study, reviewing observations, investigating operational equivalence, conducting the main study, and performing exploratory and confirmatory analyses (2, 5). This entire process culminates in the creation of the final instrument for use in dental research.

In this regard, based on our experience in research as well as in teaching in research-related subjects and as a thesis advisor (Evaristo-Chiyong) at a dental school in Peru, we have observed a shortage of studies addressing the translation and adaptation of measurement instruments in undergraduate or graduate thesis. This scarcity could be due to the lack of awareness of such research by students and professionals, as well as the challenging perception they may have when starting this line of research.

To identify translation and cultural adaptation studies of measurement instruments related to the field of dentistry, both in Peru and worldwide, we used the following search equation in Scopus: (TITLE-ABS-KEY (“translation" OR "translating" OR "translated”) AND TITLE-ABS-KEY (“cultural adaptation" OR "cross-cultural adaptation”) AND KEY (“Dentistry" OR "Oral health" OR "Dental research”)). AND PUBYEAR > 2003 AND PUBYEAR < 2024 AND (LIMIT-TO (DOCTYPE, "ar”)). A total of 86 articles were identified, with 27 originating from Brazil (Figure 1). Additionally, there was an observed increase in the publication trend from 2004 to 2023, particularly notable in the last decade (Figure 2).

All this poses a series of challenges and benefits that allow for improving the quality of research in dentistry (Table 1), ensuring the validity and reliability of the measurement instruments employed, thereby strengthening the scientific basis of clinical practice and contributing to the advancement of the dental field.

References

1. Tsai T.I., Luck L., Jefferies D., Wilkes L. Challenges in adapting a survey: ensuring cross-cultural equivalence. Nurse Res [Internet]. 2018 [citado el 12 de febrero de 2024]; 26 (1): 21-5. Disponible en: https://pubmed.ncbi.nlm.nih.gov/29856168/

2. Gjersing L., Caplehorn J.R., Clausen T. Cross-cultural adaptation of research instruments: Language, setting, time and statistical considerations. BMC Med Res Methodol [Internet]. el 10 de febrero de 2010 [citado el 29 de enero de 2024]; 10 (1): 1-10. Disponible en: https://link.springer.com/articles/10.1186/1471-2288-10-13

3. Ortiz-Gutiérrez S., Cruz-Avelar A. Proceso de traducción y adaptación cultural de instrumentos de medición en salud. Actas Dermosifiliogr [Internet]. el 1 de abril de 2018 [citado el 12 de febrero de 2024]; 109 (3): 202-6. Disponible en: http://www.actasdermo.org/es-proceso-traduccion-adaptacion-culturalinstrumentos-articulo-S0001731017305616

4. Reyes-Rojas M. Los retos de la traducción y adaptación cultural de instrumentos. Duazary. 2023; 20 (3): 161-2.

5. Sousa V.D., Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: a clear and user-friendly guideline. J Eval Clin Pract 17 Abril 2011, 17 (2): 268-74.