Abstract
BackgroundMost health-related quality of life (HRQoL) instruments have been created in English, which can influence their reliability and validity in non-English speaking populations. This study assessed the translation methodology of HRQoL instruments that have been used and translated into South African languages and which could be applied in cost-utility analyses (CUAs).MethodsA 2019 systematic review was updated with searches conducted in Medline, the Web of ScienceTM (WoSTM) Core Collection and the South African SciELO collection via the WoSTM Platform. Additional searches in Sabinet’s African Journals database and on instrument developers’ webpages were performed. Only HRQoL instruments suitable for CUAs were included. Articles reporting at least one element of the translation methods were included. Established good practice principles were used to evaluate the translation methodology.ResultsWithin the 39 publications identified, a dozen translated instruments have been used in South Africa. All instruments used were translated from English and none had originally been created in South Africa. Instrument developers’ translations were used more than study investigators’ translations. Almost all instrument developer versions met the full translation criteria. No investigator translated instrument met the full translation criteria primarily because recommendations on forward and back translations were not followed. However, this analysis was hampered by a lack of methodological reporting details. The most used instruments, which also had the most translated versions available, were the EQ-5D-3L, SF-36 version 2 and EORTC QLQ-C30.ConclusionInstrument developers’ translations more often met recommended translation methodology compared with investigators’ versions. The EQ-5D-3L may be best suited for South African economic evaluations and for use in clinical practice, but further work may be needed.
Highlights
Patient reported outcomes measures (PROMs) can be applied in diverse settings to guide the choice of healthcare interventions
On this point the 2019 NHI Bill stated that: The Ministerial Advisory Committee on Health Technology Assessment for National Health Insurance, which must be established to advise the Minister on Health Technology Assessment ... must regularly review the range of health interventions and technology by using the best available evidence on costeffectiveness, allocative, productive and technical efficiency and Health Technology Assessment.[1] (p. 29). Such cost-effective evaluations frequently use health-related quality of life (HRQoL) data in costutility analyses (CUAs) because it allows for comparisons across health situations and programmes
The study forms part of a broader project that aimed to identify evidence and research gaps in HRQoL data in South Africa against the background of national health technology assessment (HTA) and CUA; and for which a systematic review was conducted in January 2019
Summary
Patient reported outcomes measures (PROMs) can be applied in diverse settings to guide the choice of healthcare interventions. Measuring provider performance and quality of services using PROMs, the use of health technology assessment (HTA) and economic evaluations will play an increasingly important role in South African private healthcare provision and national public health policy decisions.[1,2,3,4] under National Health Insurance (NHI), economic evaluations as part of a more formal HTA programme could be used to determine the cost-effectiveness of treatments provided as part of the NHI fund On this point the 2019 NHI Bill stated that: The Ministerial Advisory Committee on Health Technology Assessment for National Health Insurance, which must be established to advise the Minister on Health Technology Assessment ... This study assessed the translation methodology of HRQoL instruments that have been used and translated into South African languages and which could be applied in cost-utility analyses (CUAs)
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