Establishing a standard for patient-completed instrument adaptations in Eastern Europe: experience with the Nottingham Health Profile in Hungary

The widely used generic patient-completed measures of health status were developed in the USA or the UK. Few Eastern European versions of these measures have been produced and these have used questionable translation methodologies. Clinical trials now commonly include patients from Eastern Europe and require the use of patient-completed instruments. The absence of such instruments led to the development of a Hungarian version of the Nottingham Health Profile (NHP). The adaptation process employed (translation, field-testing and psychometric assessment) also served as a test of whether the standardised rigorous methodology used for adapting the NHP could be applied in Eastern Europe. Few problems were found in producing a conceptually equivalent Hungarian NHP that was acceptable to interviewees. Reliability and internal consistency of the Hungarian NHP were comparable to other language versions. The measure also correlated as expected with perceived physical disability, general health, disease severity and rating of day. This successful adaptation confirms the value of the methodology applied. The Hungarian NHP will be invaluable as an outcome measure in both clinical and health economic trials and (in the absence of a generic quality of life instrument) as a comparator instrument for the validation of future Hungarian adaptations of disease-specific quality of life instruments.