Atkinson Mark J, Lohs Jan, Kuhagen Ilka, Kaufman Julie, Bhaidani Shamsu
Worldwide Health Outcomes Research, La Jolla Laboratories, Pfizer Inc,, San Diego, CA 92121, USA.
Health Qual Life Outcomes. 2006 Sep 22;4:64. doi: 10.1186/1477-7525-4-64.
This proof of concept (POC) study was designed to evaluate the use of an Internet-based bulletin board technology to aid parallel cross-cultural development of thematic content for a new set of patient-reported outcome measures (PROs).
The POC study, conducted in Germany and the United States, utilized Internet Focus Groups (IFGs) to assure the validity of new PRO items across the two cultures--all items were designed to assess the impact of excess facial oil on individuals' lives. The on-line IFG activities were modeled after traditional face-to-face focus groups and organized by a common 'Topic' Guide designed with input from thought leaders in dermatology and health outcomes research. The two sets of IFGs were professionally moderated in the native language of each country. IFG moderators coded the thematic content of transcripts, and a frequency analysis of code endorsement was used to identify areas of content similarity and difference between the two countries. Based on this information, draft PRO items were designed and a majority (80%) of the original participants returned to rate the relative importance of the newly designed questions.
The use of parallel cross-cultural content analysis of IFG transcripts permitted identification of the major content themes in each country as well as exploration of the possible reasons for any observed differences between the countries. Results from coded frequency counts and transcript reviews informed the design and wording of the test questions for the future PRO instrument(s). Subsequent ratings of item importance also deepened our understanding of potential areas of cross-cultural difference, differences that would be explored over the course of future validation studies involving these PROs.
The use of IFGs for cross-cultural content development received positive reviews from participants and was found to be both cost and time effective. The novel thematic coding methodology provided an empirical platform on which to develop culturally sensitive questionnaire content using the natural language of participants. Overall, the IFG responses and thematic analyses provided a thorough evaluation of similarities and differences in cross-cultural themes, which in turn acted as a sound base for the development of new PRO questionnaires.
本概念验证（POC）研究旨在评估基于互联网的公告板技术在辅助为一组新的患者报告结局指标（PROs）进行主题内容的平行跨文化开发中的应用。
在德国和美国进行的POC研究利用互联网焦点小组（IFGs）来确保新的PRO项目在两种文化中的有效性——所有项目均旨在评估面部油脂过多对个人生活的影响。在线IFG活动以传统的面对面焦点小组为模型，并由一份共同的“主题”指南组织，该指南在皮肤科和健康结局研究领域的思想领袖的参与下设计而成。两组IFG均以每个国家的母语进行专业主持。IFG主持人对转录本的主题内容进行编码，并使用代码认可的频率分析来识别两国之间内容相似和不同的领域。基于此信息，设计了PRO项目草案，并且大部分（80%）的原始参与者回来对新设计问题的相对重要性进行评分。
对IFG转录本进行平行跨文化内容分析，能够识别每个国家的主要内容主题，并探究各国之间任何观察到的差异的可能原因。编码频率计数和转录本审查的结果为未来PRO工具测试问题的设计和措辞提供了依据。随后对项目重要性的评分也加深了我们对潜在跨文化差异领域的理解，这些差异将在未来涉及这些PROs的验证研究过程中进行探究。
使用IFGs进行跨文化内容开发得到了参与者的积极评价，并且被发现具有成本效益和时间效益。新颖的主题编码方法提供了一个实证平台，可在此平台上使用参与者的自然语言来开发具有文化敏感性的问卷内容。总体而言，IFG的回答和主题分析对跨文化主题的异同进行了全面评估，这反过来又为开发新的PRO问卷奠定了坚实基础。
