Lessons learned in applying the International Society for Pharmacoeconomics and Outcomes Research methodology to translating Canadian Emergency Department Information System Presenting Complaints List into German

Eur J Emerg Med. 2018 Aug;25(4):295-299. doi: 10.1097/MEJ.0000000000000450.


Objectives: The patient's presenting complaint guides diagnosis and treatment in the emergency department, but there is no classification system available in German. The Canadian Emergency Department Information System (CEDIS) Presenting Complaint List (PCL) is available only in English and French. As translation risks the altering of meaning, the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) has set guidelines to ensure translational accuracy. The aim of this paper is to describe our experiences of using the ISPOR guidelines to translate the CEDIS PCL into German.

Materials and methods: The CEDIS PCL (version 3.0) was forward-translated and back-translated in accordance with the ISPOR guidelines using bilingual clinicians/translators and an occupationally mixed evaluation group that completed a self-developed questionnaire.

Results: The CEDIS PCL was forward-translated (four emergency physicians) and back-translated (three mixed translators). Back-translation uncovered eight PCL items requiring amendment. In total, 156 comments were received from 32 evaluators, six of which resulted in amendments.

Conclusion: The ISPOR guidelines facilitated adaptation of a PCL into German, but the process required time, language skills and clinical knowledge. The current methodology may be applicable to translating the CEDIS PCL into other languages, with the aim of developing a harmonized, multilingual PCL.

MeSH terms

  • Canada
  • Economics, Pharmaceutical*
  • Emergency Service, Hospital / organization & administration*
  • Female
  • Germany
  • Hospital Information Systems*
  • Humans
  • Internationality
  • Male
  • Outcome Assessment, Health Care / methods*
  • Practice Guidelines as Topic / standards*
  • Research Design
  • Societies, Medical
  • Translating*