Brazilian Transcultural Adaptation of Informative Statements to Communicate the Findings of Systematic Reviews of Interventions indicated by the GRADE System

Article type
Authors
1Hospital Moinhos De Vento, Porto Alegre, Brazil
2UFCSPA, Porto Alegre, Brazil
3Pfizer Brasil, São Paulo, Brazil
4HAOC, São Paulo, Brazil
5HC USP, São Paulo, Brazil
6Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
7Comissão de Ciência Tecnologia e Assistência Farmacêutica do CNS, Brasília, Brazil
8Hospital Sírio Libanês, São Paulo, Brazil
9Advocacy Baseado em Evidências, Brazil
10Instituto Rene Rachou - FioCruz MG, Belo Horizonte, Brazil
11Ministério da Gestão e da Inovação em Serviços Públicos, Brasilia, Brazil
12Secretaria de Ciência, Tecnologia e Inovação e do Complexo Econômico-Industrial da Saúde – SECTICS/Ministério da Saúde, Brasilia, Brazil
Abstract
Background: Transparent and easy-to-understand communication can enhance scientific communication to inform the results of systematic reviews (SR) to stakeholders. The GRADE group developed an approach to improve the communication of results from SR of interventions in the English language.
Objective: To cross-culturally adapt to Brazil's Portuguese language the approach to communicate the results of SR indicated by the GRADE system.
Methods: The cross-cultural adaptation process of the approach to communicating the results in the Portuguese language spoken in Brazil was performed through 6 steps: 1) translation of the original version by two translators; 2) Synthesis of the translations; 3) Back translation of the consolidated version; 4) evaluation by GRADE experts; 5) pre-test applying the version validated by experts; 6) quantitative and qualitative results evaluation.
Results: All phases were completed. One of the challenges was adjusting the terms related to the classification of low and moderate certainty of evidence: the translation of the term ""may,"" used for low certainty of evidence, was considered by experts as moderate certainty. As a more significant modification, it was understood that using the term ""moderate"" for effect size could confuse, as it is also used to classify certainty of evidence. Therefore, using ""average effect"" was proposed as an alternative to ""moderate effect”. Figure 1 shows the acceptability of the proposed translation by researchers who answered a survey to indicate agreement with statements in Portuguese. Low acceptability (< 50%) was found in some statements of low certainty of evidence combined with large effect, moderate effect, small but important effect, and trivial or null effect.
Conclusion: The main contributions were related to adjustments of English terms that are prone to diverse interpretations but share a similar translation in Portuguese. Through cultural adaptation processes, it is possible to ensure a higher level of understanding and clarity, thereby enhancing the effectiveness of its utilization in the decision-making process by stakeholders.