Skip to main content

Advertisement

SpringerLink
Log in

A Japanese translation, cultural adaptation, and linguistic and content validity confirmation of the Scored Patient-Generated Subjective Global Assessment

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

The Scored Patient-Generated Subjective Global Assessment (PG-SGA©) is a globally recognized and used nutritional screening, assessment, monitoring, and triaging tool. The aim of this study was to translate and culturally adapt the original English PG-SGA for the Japanese speaking populations and to assess its linguistic validity (i.e., comprehensibility, difficulty) and content validity, as perceived by Japanese patients and healthcare professionals.

Methods

In accordance with methodology used in previous Dutch, Thai, German, and Norwegian PG-SGA studies, we followed the ten steps of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Principles of Good Practice for Translation and Cultural Adaptation for Patient-Reported Outcome Measures. The study enrolled 50 patients and 50 healthcare professionals (HCPs) to evaluate the comprehensibility and difficulty of the translated and culturally adapted PG-SGA. The HCPs also evaluated the content validity of the translation. We evaluated each item and quantified scale indices for content validity (item content validity index (I-CVI), scale content validity index (S-CVI)), comprehensibility (item comprehensibility index (I-CI), scale comprehensibility index (S-CI)), and difficulty (item difficulty index (I-DI), scale difficulty index (S-DI)).

Results

Patients evaluated the comprehensibility and difficulty of the patient component as excellent (S-CI = 0.97, S-DI = 0.96). The professionals rated the Japanese version of both components of the PG-SGA as very relevant (S-CVI = 0.94). The professionals evaluated the comprehensibility of the professional component as being acceptable (S-CI = 0.88) but difficult (S-DI = 0.69), based predominantly on items related to physical examination (I-DI = 0.33–0.67).

Conclusion

The PG-SGA was systematically translated and culturally adapted for the Japanese setting according to the ISPOR process. The Japanese version of the PG-SGA was perceived as comprehensive, easy to use, and relevant. Perceived difficulty in professional components, specifically in the context of metabolic demand and physical examination, will require appropriate training for professionals in order to optimize implementation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data availability

Data is not available because of ethical issues.

Code availability

Excel 2016.

References

  1. Arends J, Bachmann P, Baracos V, Barthelemy N, Bertz H, Bozzetti F et al (2017) ESPEN guidelines on nutrition in cancer patients. Clin Nutr 36:11–48

    Article  Google Scholar 

  2. Sachlova M, Majek O, Tucek S (2014) Prognostic value of scores based on malnutrition or systemic inflammatory response in patients with metastatic or recurrent gastric cancer. Nutr Cancer 66:1362–1370

    Article  CAS  Google Scholar 

  3. Laky B, Janda M, Cleghorn G, Obermair A (2008) Comparison of different nutritional assessments and body-composition measurements in detecting malnutrition among gynecologic cancer patients. Am J Clin Nutr 87:1678–1685

    Article  CAS  Google Scholar 

  4. Aaldriks AA, van der Geest LG, Giltay EJ, le Cessie S, Portielje JE, Tanis BC et al (2013) Frailty and malnutrition predictive of mortality risk in older patients with advanced colorectal cancer receiving chemotherapy. J Geriatr Oncol 4:218–226

    Article  Google Scholar 

  5. Capuano G, Gentile PC, Bianciardi F, Tosti M, Palladino A, Di Palma M (2010) Prevalence and influence of malnutrition on quality of life and performance status in patients with locally advanced head and neck cancer before treatment. Support Care Cancer 18:433–437

    Article  Google Scholar 

  6. Diabetics AoNa (n.d) NUTRITION CARE PROCESS (https://www.andeal.org/ncp). Accessed at 04/Feb/2021

  7. Baldwin C, Spiro A, Ahern R, Emery PW (2012) Oral nutritional interventions in malnourished patients with cancer: a systematic review and meta-analysis. J Natl Cancer Inst 104:371–385

    Article  Google Scholar 

  8. Nitichai N, Angkatavanich J, Somlaw N, Voravud N, Lertbutsayanukul C (2019) Validation of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) in Thai Setting and Association with Nutritional Parameters in Cancer Patients. Asian Pac J Cancer Prev 20:1249–1255

    Article  Google Scholar 

  9. Rodrigues CS, Lacerda MS, Chaves GV (2015) Patient Generated Subjective Global Assessment as a prognosis tool in women with gynecologic cancer. Nutrition 31:1372–1378

    Article  Google Scholar 

  10. Mendes NP, de Barros TA, de Oliveira Barbosa Rosa C, Sdo Carmo Castro Franceschini (2019) Nutritional screening tools used and validated for cancer patients: a systematic review. Nutrition and cancer 71:898–907

    Article  Google Scholar 

  11. Jager-Wittenaar H, Ottery FD (2017) Assessing nutritional status in cancer: role of the Patient-Generated Subjective Global Assessment. Curr Opin Clin Nutr Metab Care 20:322–329. https://doi.org/10.1097/mco.0000000000000389

    Article  PubMed  Google Scholar 

  12. Food AD (2009) Guidance for industry: patient-reported outcome measures: use in medical product development to support labeling claims. Fed Regist 74:65132–65133

    Google Scholar 

  13. Wild D, Eremenco S, Mear I, Martin M, Houchin C, Gawlicki M et al (2009) Multinational trials—recommendations on the translations required, approaches to using the same language in different countries, and the approaches to support pooling the data: the ISPOR patient-reported outcomes translation and linguistic validation good research practices task force report. Value in Health 12:430–440

    Article  Google Scholar 

  14. Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A et al (2005) Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value in health 8:94–104

    Article  Google Scholar 

  15. Sealy MJ, Haß U, Ottery FD, van der Schans CP, Roodenburg JL, Jager-Wittenaar H (2018) Translation and cultural adaptation of the Scored Patient-Generated Subjective Global Assessment: an interdisciplinary nutritional instrument appropriate for Dutch cancer patients. Cancer Nurs 41:450–462

    Article  Google Scholar 

  16. Erickson N, Storck LJ, Kolm A, Norman K, Fey T, Schiffler V et al (2019) Tri-country translation, cultural adaptation, and validity confirmation of the Scored Patient-Generated Subjective Global Assessment. Support Care Cancer 27:3499–3507

    Article  Google Scholar 

  17. Henriksen C, Thoresen L, Fjøseide B, Lorentzen SS, Balstad TR, Ottery FD et al (2020) Linguistic and content validation of the translated and culturally adapted PG-SGA, as perceived by Norwegian cancer patients and healthcare professionals. Clinical Nutrition ESPEN 38:178–184

    Article  Google Scholar 

  18. Nitichai N, Angkatavanich J, Somlaw N, Sirichindakul B, Chittawatanarat K, Voravud N et al (2005) Translation and cross-cultural adaptation of the Scored Patient-Generated Subjective Global Assessment (PG-SGA) to the Thai setting. Value Health 8:94–104

    Article  Google Scholar 

  19. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL et al (2012) COSMIN checklist manual. University Medical Center, Amsterdam

    Google Scholar 

  20. Polit DF, Beck CT, Owen SV (2007) Is the CVI an acceptable indicator of content validity? Appraisal and recommendations Res Nurs Health 30:459–467. https://doi.org/10.1002/nur.20199

    Article  PubMed  Google Scholar 

  21. Jager-Wittenaar H, de Bats HF, Welink-Lamberts BJ, Gort-van Dijk D, van der Laan BF, Ottery FD et al (2020) Self-completion of the patient-generated subjective global assessment short form is feasible and is associated with increased awareness on malnutrition risk in patients with head and neck cancer. Nutr Clin Pract 35:353–362

    Article  Google Scholar 

Download references

Acknowledgements

We thank Ms. Masako Ikeda and Ms. Sachiko Nagatsuma of the National Cancer Center Hospital East for their secretarial support.

Author information

Authors and Affiliations

  1. Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan

    Tomofumi Miura, Ayumi Okizaki & Yoshihisa Matsumoto

  2. Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, Netherlands

    Rikako Elgersma & Harriët Jager-Wittenaar

  3. Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan

    Ayumi Okizaki

  4. Division of Nutrition, National Cancer Center Hospital East, Kashiwa, Japan

    Mihoko Kazawa Inoue & Haruka Chitose

  5. Department of Palliative Medicine, Osaka City General Hospital, Osaka, Japan

    Koji Amano

  6. Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan

    Masanori Mori

  7. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands

    Harriët Jager-Wittenaar

  8. Ottery & Associates, LLC, Vernon Hills, IL, USA

    Faith D. Ottery

Authors
  1. Tomofumi Miura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rikako Elgersma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ayumi Okizaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mihoko Kazawa Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Koji Amano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Masanori Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Haruka Chitose
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yoshihisa Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Harriët Jager-Wittenaar
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Faith D. Ottery
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Tomofumi Miura: study design; protocol writing; patient enrollment; analysis; and manuscript development.

Rikako Elgersma: patient enrollment; analysis; review, input, and approval of manuscript.

Ayumi Okizaki: patient enrollment; analysis review, input, and approval of manuscript.

Mihoko Kazawa Inoue: patient enrollment; review, input, and approval of manuscript.

Koji Amano: patient enrollment; review, input, and approval of manuscript.

Masanori Mori: patient enrollment; review, input, and approval of manuscript.

Haruka Chitose: patient enrollment [review, input, and approval of manuscript].

Yoshihisa Matsumoto: patient enrollment; review, input, and approval of manuscript.

Harriët Jager-Wittenaar: study design; analysis; review, input, and approval of manuscript.

Faith D. Ottery: permission and collaboration; back translation review; review, input, and approval of manuscript.

Corresponding author

Correspondence to Tomofumi Miura.

Ethics declarations

Ethics approval

The study was approved by the medical ethics committee of the National Cancer Center Hospital East (IRB-approval No. 2017–106).

Consent to participate

Participants were enrolled after giving signed informed consent.

Consent for publication

Participants were informed about publication of aggregate results.

Conflict of interest

Faith D. Ottery is the creator of the PG-SGA©, co-creator of the Scored PG-SGA, the copyright holder of the PG-SGA and its derivatives, as well as co-developer of a PG-SGA-based Pt-Global app/web tool. Harriët Jager-Wittenaar was a co-developer of the PG-SGA-based Pt-Global app/web tool.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Miura, T., Elgersma, R., Okizaki, A. et al. A Japanese translation, cultural adaptation, and linguistic and content validity confirmation of the Scored Patient-Generated Subjective Global Assessment. Support Care Cancer 29, 7329–7338 (2021). https://doi.org/10.1007/s00520-021-06310-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-021-06310-w

Keywords

Search

Navigation