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All Graduates

All Graduates is a privately owned translation and interpreting agency specialising in providing services to government, community and corporations in Australia.

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Medical Translation and Back Translation

Translating a sensitive orthopaedic diagnostic questionnaire and a health education questionnaire.

Client: The University of Melbourne, Centre for Rheumatic Diseases.


An example of high quality translations is a series of questionnaires from a leading University of Melbourne medical team, developing critical diagnostic and evaluation tools. The University's Centre for Rheumatic Disease had authored the Multi-attribute Arthritis Prioritisation Tool [MAPT], a psychometrically nuanced questionnaire on degrees and consequences of hip and knee pain that allowed accurate prioritisation of patients for hip and knee replacement operations. The interest in this questionnaire has been international - it will be trialled in Japan and France - as well as being used locally, helping to reduce Victoria's Orthopaedic Waiting List. In the case of the French version, this was being undertaken by us when the University of Melbourne team also received a translation from their colleagues in France itself, adding a further loop in the methodology described below. For local consumption and potentially international use the Tool was translated from English into Arabic, English into Chinese, English into Croatian, English into Greek, English into Italian, English into Macedonian, English into Maltese, English into Polish, English into Russian, English into Spanish, English into Turkish and English into Vietnamese. These latter translations can be seen at

Tasks and challenges

The challenge of this translation was to juggle very precise medical diagnostic categories with a natural language questionnaire that could be understood by averagely educated patients in their language. The methodology included:

  • Commenting on the original text by language consultants to identify translation issues
  • Briefing of forward translators and checkers
  • Forward translation and checking by professionally accredited translators
  • Back translation by professionally accredited translators
  • Comments by the University of Melbourne team on the back-translation
  • Comments in turn by the forward and back translators on the University's comments
  • A teleconference to reconcile differences and approve a final version.


The successful conclusion of the MAPT translations led to on an even more complex translation, the Health Education Impact Questionnaire [heiQ], which was designed for the evaluation of health education and self-management programs for people with chronic illnesses, providing a standard means of evaluating such program. The domains the questionnaire covers are quite diverse and include general demographic information about the subject, motivation to change risk factors, compliance with medical regimens, coping, general 'empowerment' and techniques for self-management. Affect questions intermingle with behavioural and attitudinal items, questions on positive and negative reactions to subject's health status come along with questions about the worth of the program they have undertaken. These translations were completed with the identical methodology to that outlined above for MAPT.

We have described some translations that are among the most challenging that translators can face. There is sometimes of a misconception that the most difficult translations must be those with the most complicated scientific and technical terminology. In fact, this is not always the case: highly specialised terminology - say, chemical formulae, machinery details or electrical schemas - will often have relatively straightforward equivalences in other languages and often have simple or minimal grammatical complexity; indeed, machine translation is sometimes used for such texts. By contrast, texts that contain psychological, personal or behavioural items need very careful and sympathetic translation; they cannot be done by machine translation, as even such basic issues as pain or mood or self-perceptions can vary widely among or within cultures. This is our specialty.


For further information about this project:

Contact: Ismail Akinci, CEO
Phone:1300 854 799
International Phone:+61 (3) 9605 3000


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