To the Editor—We are grateful for Ms. Furtado's letter and welcome the opportunity to reply regarding this important topic. We fully agree with Ms Furtado's point that there is no single right way to approach the need for translations in multiple countries sharing a language. We also agree that creating a global translation is not always ideal and entails a certain amount of compromise; these are points we touched on in the article [1].

The article does not claim to provide a superior methodology in terms of producing the “best wording for each individual country” but explains that some clients specifically request global translations, and in cases where this requirement needs to be met, we have found our methodology to be very effective. The reference to a “superior final translation” was not intended to imply that the results would be superior to that of other translation procedures; the paragraph explains that the process we followed aims to improve the quality of the translation at every stage, thereby resulting in a final translation that is much improved from the initial draft.

Ms. Furtado asserts that the time and cost involved in holding teleconferences would “heavily influence the budget of a project” and suggests instead appointing a lead investigator and discussing their wording suggestions with the other investigators via e-mail. In practice, we have found teleconferences to provide a fast and efficient way of thoroughly discussing linguistic issues; within the space of a single call, all queries can be fully discussed and resolved, allowing simultaneous and equal input from all target countries. Although e-mails can be used effectively to resolve straightforward issues, several rounds of e-mails may be required before a solution is universally agreed upon for more complex items, thereby affecting the timeline of the project. In addition, it may prove more difficult to have a full, in-depth discussion (between several parties) via e-mail. Therefore, a teleconference or other form of live conversation is not only likely to cut time (possibly by several days, depending on how long the exchange of e-mails would take) but also allows for a freer and more thorough exchange of ideas. In addition, we have found that teleconferences add very little to the study budget and can be even more cost-effective for a sponsor than several rounds of e-mail–based reviews.

We would welcome a study comparing the merits of our methodology for producing global translations to those of one involving a lead investigator as suggested by Ms. Furtado. We agree that there is currently no “gold standard” approach; however, our article has presented a real-world application of our recommended methodology, which we found to be highly effective in its goals. It may be that a methodology involving a lead investigator would be equally effective, but it should be recognized that this also has drawbacks, not least the decision in selecting who should be the lead investigator. For example, if a Spanish translation is required for several countries in South America, which country should the lead investigator be chosen from, or is the choice simply arbitrary?

Once again, we thank Ms. Furtado for continuing this interesting debate and look forward to its development in the future.—Rebecca Two, BA, Aneesa Verjee-Lorenz, MSc, and Darren Clayson, MSc, PharmaQuest Ltd., Oxfordshire, UK; Mehul Dalal, PhD, and Kelly Grotzinger, PhD, GlaxoSmithKline, Collegeville, PA, USA; and Zobair M. Younossi, MD, MPH, FACP, FACG, Inova Fairfax Hospital—Center for Liver Diseases, Falls Church, VA, USA.

Source of financial support: None.


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