LUTS patient reported outcomes tool: Linguistic validation in 10 European languages


  • Christopher Chapple led the peer-review process as the Associate Editor responsible for the paper.

  • Conflict of interest: Barbara A Brandt and Colpan Angün are employees of Corporate Translations who were paid consultants to Pfizer in connection with the development of this manuscript. Editorial assistance was provided by Nancy Sheridan and Colin Mitchell of Complete Healthcare Communications, Inc., and was funded by Pfizer Inc.



To linguistically validate the translation of the Lower Urinary Tract Symptoms (LUTS) Tool from

English to 10 European languages and assess whether the translations adequately reflected the concepts in the original version and if urological terms and the individual items were readily understood.


Residents of the target countries who spoke the native language and had LUTS were asked to evaluate a harmonized translation of the LUTS Tool, which was developed in 10 languages: Danish (Denmark), Dutch (Belgium, Netherlands), Finnish (Finland), French (Belgium, France, Luxembourg, and Switzerland), German (Germany, Switzerland), Greek (Greece), Icelandic (Iceland), Italian (Italy), Norwegian (Norway), and Spanish (Spain). After reviewing the language-appropriate version, participants were asked to explain why any words were difficult to understand and to paraphrase each sentence during a standardized cognitive debriefing interview. Linguistic validation teams (original translators, back translator, project manager, interviewer, and survey research expert) conducted a qualitative analysis of the cognitive debriefing findings.


The terminology and concepts in the English-language version of the LUTS Tool were adequately captured in all language translations. The overall item comprehension rate, across languages, was 98.5%. Terms related to storage, voiding, and post-micturition LUTS were comprehensible. Minor difficulties with comprehension were identified in 9 of 10 translations, and those changes were made to improve clarity.


Individuals with LUTS from 10 countries understood the individual items captured in translated versions of the LUTS Tool. The overall comprehension rate was high. Most changes were made to improve conceptual clarity based on country-specific linguistic and cultural nuances. Neurourol. Urodynam. 32: 75–81, 2013. © 2012 Wiley Periodicals, Inc.