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adapt the English version of the ASAS-HI into Spanish-language spoken in Colombia and to re-assess reliability and construct validity for patients with SpA after translation.
METHODS
Translation and cultural adaptation
Translation and cross-cultural adaptation of the English version of ASAS-HI was performed according to the published recommendations using a standardized operating procedure (forward- backward procedure) 8. This method consists of the following 5 steps: translation, synthesis of translation, back translation, expert committee review and pre-testing in a field test with cognitive debriefing. First, three persons (all bilingual) with different profiles or background (including non- medical), independently performed a forward translation of the instrument from the original language (English) to the Spanish-language according to the characteristics of our patients. Back translation was then conducted by two independent bilingual native English speakers blinded to the English version. The expert committee agreed upon the final wording of the Spanish version, who examined semantic, idiomatic, experiential and conceptual issues. All the versions of the questionnaire were consolidated to develop a pre-final version for the field test. The final version (Appendix 1) was tested with 10 native patients with axSpA (60% AS and 40% nr-axSpA). The patients completed the questionnaire in a face to face interview with a physician. Each question was discussed with the patient in order to check whether all items had been fully understood and whether the patient had problems with wording, relevance, acceptability, incomplete concept coverage and comprehensiveness of the translation. Notes were taken about the time to complete the questionnaire and whether the patients made comments about specific items when completing the questionnaires.
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