Professional translators in clinical cross‑cultural adaptation protocols

Abstract Transnational clinical research is increasingly commonplace, which has led to a growing need for patient-reported outcome instruments (PROIs) that can be used by patients in different countries. The process to cross-culturally adapt these health questionnaires is described in many guidelines, which coincide in that an appropriate translation and cultural transfer are of outmost importance. This article examines the translation methodology used in 100 recent scholarly articles that report on PROI cross-cultural adaptations to explore who is responsible for the initial translation, its subsequent back translation, and the translation review process. It will be argued that the limited involvement of professional translators in these processes signals a mistrust toward these practitioners that stems from assumptions about translation and bilingualism that are not always accurate.