# Translation and cultural adaptation of the EQ-5D-Y-5L into Modern Standard Arabic for use in Egypt

## TL;DR

This paper translates and adapts the EQ-5D-Y-5L health questionnaire into Modern Standard Arabic for use in Egypt, ensuring cultural relevance and accuracy.

## Contribution

The study provides the first culturally adapted Arabic version of the EQ-5D-Y-5L for children and adolescents.

## Key findings

- A culturally adapted Arabic version of the EQ-5D-Y-5L was developed following EuroQol guidelines.
- Cognitive interviews with children led to minor modifications in the Pain/Discomfort dimension and VAS instructions.
- The final Arabic version is suitable for use in Egypt and other Arabic-speaking countries.

## Abstract

The use of the EQ-5D-Y-5L to evaluate children and adolescents’ health-related quality of life (HRQOL) is an essential contribution to economic evaluation methods. Accurate translation and cultural adaptation of questionnaires are crucial for their effective use, enabling comparison of data across different languages. Therefore, this study aimed to translate and culturally adapt the EQ-5D-Y-5L into Standard Arabic for use in Egypt.

The translation process was done according to the methodology and translation guidelines approved by the EuroQol Group Version Management Committee. Two forward translations into Arabic, then two back translations to English were performed, independently. The third step was conducting cognitive interviews with the children, which included a card-ranking exercise, self-completion of the translated Arabic questionnaire, and detailed discussion with the children about the questionnaire sentences. The last step was proofreading of the final Arabic version of the questionnaire.

The first Arabic versions of the paper and digital questionnaires were created after the forward translation. Following the back translation, only one modification was made in the digital source of the Arabic version. Cognitive interviews were conducted with 11 children with a mean age of 10.6 years. Some changes were suggested based on the initial 8 interviews in the Pain or Discomfort dimension and in the visual analogue scale (VAS) instructions. Three additional interviews were carried out to discuss these changes, and all were accepted. The final Arabic version was then developed after proofreading.

The Standard Arabic version of the EQ-5D-Y-5L produced in this study is an acceptable version that can be used in Egypt and other Arabic-speaking countries.

The online version contains supplementary material available at 10.1186/s41687-025-00985-z.