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Cross-cultural adaptation and its impact on research in emergency care
  1. Tom Roberts1,2,
  2. Edward Carlton2,3,
  3. Matthew Booker4,
  4. Sarah Voss2,
  5. Samuel Vaillancourt5,6,
  6. Anisa Jabeen Nasir Jafar7,
  7. Jonathan Benger2,8
  1. 1 Doctoral Fellow, The Royal College of Emergency Medicine, London, UK
  2. 2 Faculty of Health and Life Sciences, University of the West of England, Bristol, UK
  3. 3 Emergency Department, North Bristol NHS Trust, Westbury on Trym, UK
  4. 4 School of Social and Community Medicine, University of Bristol, Bristol, UK
  5. 5 St Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
  6. 6 Emergency Department, St Michael's Hospital, Toronto, Ontario, Canada
  7. 7 Humanitarian and Conflict Response Institute, The University of Manchester, Manchester, UK
  8. 8 University of the West of England, Bristol, UK
  1. Correspondence to Dr Tom Roberts, The Royal College of Emergency Medicine, London SE1 1EU, UK; tomkieranroberts{at}


The perspective of patients is increasingly recognised as important to care improvement and innovation. Patient questionnaires such as patient-reported outcome measures may often require cross-cultural adaptation (CCA) to gather their intended information most effectively when used in cultures and languages different to those in which they were developed. The use of CCA could be seen as a practical step in addressing the known problems of inclusion, diversity and access in medical research.

An example of the recent adaptation of a patient-reported outcome measure for use with ED patients is used to explore some key features of CCA, introduce the importance of CCA to emergency care practitioners and highlight the limitations of CCA.

  • methods
  • emergency department
  • research design

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  • Handling editor Richard Body

  • Twitter @DrTomRoberts, @eddcarlton

  • Contributors TR and EC conceived the idea for this article. The manuscript was drafted by TR with revision of subsequent drafts by EC, JB, SVo, MB and SVa. All authors approved the final submitted version. Following initial review a further author (AJNJ) was invited to provide specific expertise in positionality and reflexivity.

  • Funding TR is funded by Royal College of Emergency Medicine. EC, MB and JB receive funding from the National institute for Health Research.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.