The Chinese translation and cross-cultural adaptation of PRISMA-7 questionnaire: an observational study to establish the accuracy, reliability and validity

Background

Frailty is a health condition linked to adverse health outcomes and lower life quality. The PRISMA-7, a 7-item questionnaire from the Program on Research for Integrating Services for the Maintenance of Autonomy (PRISMA), is a validated case-finding tool for frailty with good sensitivity and specificity. This study aimed to translate, culturally adapt, and validate the PRISMA-7 questionnaire for Chinese use.

Methods

A prospective observational study with convenience sampling recruited bilingual adults aged 65 and over living in the community. The Functional Autonomy Measurement System (SMAF) was the gold standard benchmark. The English PRISMA-7 questionnaire was culturally adapted to Chinese using forward and backward translation. Intra- and inter-rater reliability were determined using the intraclass correlation coefficient (ICC). Face, content and criterion validity were determined. The Receiver Operator characteristic (ROC) curve determined the optimal cut-off score.

Results

One-hundred-twenty participants (55 females and 65 males) were recruited. The Chinese PRISMA-7 questionnaire had excellent intra-rater and inter-rater reliability (ICC = 1.000). The rigorous forward and backward translation established the face and content validity. The moderately high correlations between the English PRISMA-7 with SMAF (r = − 0.655, p < 0.001) and Chinese PRISMA-7 with SMAF (r = − 0.653, p < 0.001) pairs established the criterion validity. An optimal cut-off score of three “Yes” responses was reported with 100% sensitivity and 85.3% specificity.

Conclusion

This translation, cross-cultural adaptation, and validation study established the Chinese PRISMA-7 questionnaire. The preliminary results suggest adequate diagnostic test accuracy for frailty screening among the Chinese literate community.