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Use of differential item functioning analysis to assess the equivalence of translations of a questionnaire

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Abstract

In cross-national comparisons based on questionnaires, accurate translations are necessary to obtain valid results. Differential item functioning (DIF) analysis can be used to test whether translations of items in multi-item scales are equivalent to the original. In data from 10,815 respondents representing 10 European languages we tested for DIF in the nine translations of the EORTC QLQ-C30 emotional function scale when compared to the original English version. We tested for DIF using two different methods in parallel, a contingency table method and logistic regression. The DIF results obtained with the two methods were similar. We found indications of DIF in seven of the nine translations. At least two of the DIF findings seem to reflect linguistic problems in the translation. ‘Imperfect’ translations can affect conclusions drawn from cross-national comparisons. Given that translations can never be identical to the original we discuss how findings of DIF can be interpreted and discuss the difference between linguistic DIF and DIF caused by confounding, cross-cultural differences, or DIF in other items in the scale. We conclude that testing for DIF is a useful way to validate questionnaire translations.

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Authors and Affiliations

  1. Department of Palliative Medicine, Bispebjerg Hospital, Denmark

    Morten Aa. Petersen & Mogens Groenvold

  2. Institute of Public Health, University of Copenhagen, Denmark

    Mogens Groenvold

  3. National Institute of Occupational Health, Copenhagen, Denmark

    Jakob B. Bjorner

  4. Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Neil Aaronson

  5. Department of Medical Oncology, Centre Alexis Vautrin, Vandoeuvre les Nancy, France

    Thierry Conroy

  6. ICRF Psychology Research Group, Western General Hospital, Edinburgh, UK

    Ann Cull

  7. Department of Public Health, Aberdeen University Medical School, Aberdeen, UK

    Peter Fayers

  8. Department of Oncology, Norwegian Radiumhospital, Oslo, Norway

    Marianne Hjermstad

  9. Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    Mirjam Sprangers

  10. Health Care Research Unit, Institute of Internal Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

    Marianne Sullivan

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  1. Morten Aa. Petersen
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  2. Mogens Groenvold
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  3. Jakob B. Bjorner
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  4. Neil Aaronson
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  6. Ann Cull
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  7. Peter Fayers
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  8. Marianne Hjermstad
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  9. Mirjam Sprangers
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  10. Marianne Sullivan
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Petersen, M.A., Groenvold, M., Bjorner, J.B. et al. Use of differential item functioning analysis to assess the equivalence of translations of a questionnaire. Qual Life Res 12, 373–385 (2003). https://doi.org/10.1023/A:1023488915557

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