Accepted for/Published in: JMIR Formative Research
Date Submitted: Aug 5, 2025
Date Accepted: Jan 20, 2026
Using artificial intelligence in forward-backward translation of questionnaires for men invited to prostate cancer screening: Methodological study
ABSTRACT
Background:
Translation is important in research to ensure cultural relevance, accuracy, and generalizability, especially in cross-cultural studies. The World Health Organization’s (WHO) forward-backward translation method enhances linguistic and conceptual accuracy but is time-consuming and resource-heavy. With the development of artificial intelligence (AI), translation processes could become more efficient, saving time, and reducing costs. However, AI may struggle with cultural nuances and complex linguistic structures, risking errors.
Objective:
This study aims to explore the use of AI in the forward-backward translation process for questionnaires.
Methods:
The questionnaires was translated from English to Polish using an adapted four-step forward-backward method. First, two AI algorithms (ChatGPT 3.5 and Microsoft BING Co-pilot) were used for translating from English to Polish. Then, two native Polish speakers, focused on content understanding, independently reviewed, and corrected the AI-generated Polish version and agreed on a new version. Thirdly, the AI-generated native-speaker agreed Polish translation underwent back-translation using the same AI algorithms. Any discrepancies were discussed by an expert panel consisting of native speakers of English and Polish. This procedure ensured linguistic accuracy and conceptual similarity. Finally, three individual cognitive interviews were conducted with native speaking polish men to identify whether the questionnaires exactly assess what it is intended to measure and to find any issues that the respondents may meet during the response process.
Results:
Translation and back-translation were used to develop a Polish version of questionnaires for men participating in prostate cancer screening. The original questionnaires and the AI-generated questionnaires had minor differ-ences, but didn't affect the meaning of the questions or what was being asked. After the three cognitive interviews, the questionnaires were adjusted with a few changes to make them easier to understand.
Conclusions:
AI can be an effective tool in the translation process, offering time and resource savings while maintaining accuracy.
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