Quality of life in adult GH deficiency: why translating the questionnaire matters
A question about fatigue or social participation may sound easy to translate.
A question about fatigue or social participation may sound easy to translate. Yet a subtle change in wording can alter who answers “yes,” especially across languages and cultures. A quality-of-life instrument developed for adult growth hormone deficiency illustrates why Bali clinicians and readers should preserve the language and version of a score.
How the instrument was developed
The developers of QoL-AGHDA produced and evaluated a disease-specific instrument in several languages, examining properties such as reliability, internal consistency and construct validity. Participants' experiences informed the content. Those steps matter because a list of questions can sound sensible without producing a comparable or reproducible score in the intended population. A validated instrument also has instructions that define how it should be completed and interpreted.
What happens when wording changes?
Consider a hypothetical question about having enough energy for a usual activity. Replacing “usual” with “strenuous” changes the standard the respondent must meet. Translating a frequency question as a severity question changes it again. A bilingual health professional can clarify communication during clinical care. That does not make an improvised translation a validated research version. The source, version and language should remain in the record alongside the score.
| A validated questionnaire has a setting | What to look for |
|---|---|
| Instrument | QoL-AGHDA for adults with growth hormone deficiency |
| Validation | Reliability and construct validity in the tested language versions |
| Scoring | Use the authorized questionnaire and instructions |
What a quality-of-life score cannot establish
A result documents a patient-reported outcome on a specified instrument. It is not on its own a diagnosis of growth hormone deficiency, a measure of the amount in a patient's bloodstream or a guarantee of benefit from somatropin. Symptoms and scores can change with other medical or personal circumstances. The clinical team can examine these alongside endocrine testing, medical history and any treatment follow-up.
Using a score across two countries
If a Bali clinician reviews an overseas questionnaire, keep the original wording, scoring sheet, date and language, and note any help the patient needed. Ask whether the same validated version can be used for follow-up or whether the scores must be interpreted separately. A clear narrative about daily activities remains useful even when two questionnaire scores cannot be compared directly. The patient's experience deserves both accurate translation and an appropriately limited interpretation.
