Background and aims: The Central Sensitization Inventory (CSI) is a patient-reported screening-tool for evaluating physical and emotional symptoms related to central sensitization. A valid cross-cultural adaption requires those who complete the questionnaire to have an unambiguous understanding of the meaning of test items.
Methods: Following the recommendations of the American Association of Orthopaedic Surgeons Outcomes Committee, the original English CSI was translated into German. An expert committee evaluated language equivalences to the original, produced forward- and the backward-translated versions with input from an original developer of the CSI. Prior to performing a full psychometric evaluation, a three-step pretest interview was conducted with 15 chronic pain patients to identify problematic items.

Results: Most of the test items were translated without difficulty. Additional discussion was required by the expert committee to establish the most equivalent translations and constructs of ‘anxiety attacks’ (A 3), ‘discomfort [in my bladder]’ (A 11) and ‘[my legs feel] uncomfortable’ (A 22). The patient group reported difficulty comprehending the German translation of ‘traumatic experiences in childhood’ (A24) and ‘multiple chemical sensitivities’ (B7), so these items were reworded into a more culturally sensitive translation.

Conclusions: Slight cultural differences in wording and understanding of central sensitization concepts were found between the German translation and the original English version of the CSI. Results of the pretest demonstrated the benefits of involving patients’ perspectives in the translation process.

EXPERT AND PATIENT PERSPECTIVES ON THE CROSS-CULTURAL TRANSLATION AND ADAPTATION OF THE CENTRAL SENSITIZATION INVENTORY INTO GERMAN