Translations and Cultural Adaptations of the MATRICS Consensus Cognitive Battery

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Translations and Cultural Adaptations of the
MATRICS Consensus Cognitive Battery

• Keith H. Nuechterlein
• Michael F. Green
• Robert S. Kern

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Neurocognition Committee for MATRICS Consensus
Cognitive Battery

• Keith Nuechterlein (UCLA) - Co-Chair
• Michael Green (UCLA) - Co-Chair
• Deanna Barch (Washington University)
• Jonathan Cohen (Princeton University)
• Susan Essock (Mt. Sinai School of Medicine)
• Wayne Fenton (NIMH)
• Fred Frese (Summit County Recovery Project)
• Jim Gold (Maryland Psychiatric Research Center)
• Terry Goldberg (NIMH)
• Robert Heaton (UCSD)
• Richard Keefe (Duke University)
• Helena Kraemer (Stanford University)
• Daniel Weinberger (NIMH)
• Steve Zalcman (NIMH)

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MATRICS Consensus Cognitive Battery Estimated
administration time 65 min

• Speed of Processing
• Category Fluency
• BACS Symbol Coding
• Trial Making A
• Attention / Vigilance
• Continuous Performance Test
• - Identical Pairs version
• Working Memory
• Letter Number Span
• WMS-III Spatial Span

• Verbal Learning
• Hopkins Verbal Learning Test-R
• Visual Learning
• Brief Visuospatial Memory Test-R
• Reasoning and Problem Solving
• NAB Mazes
• Social Cognition
• MSCEIT Managing Emotions

Nuechterlein et al., Am J Psychiatry, 2008
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MATRICS ASSESSMENT, INC.

• A 501 (c) (3) non-profit company created to
  publish and coordinate distribution of the MCCB
• The principal organizers -- Nuechterlein and
  Green -- receive no financial compensation from
  MATRICS Assessment, Inc.
• The translations of the MCCB to other languages
  have been completed through this nonprofit company

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Translation and Cultural Adaptation of the MCCB

• With the acceptance of the MATRICS Consensus
  Cognitive Battery (MCCB) by the U.S. NIMH and
  FDA, we were immediately asked to adapt the
  battery for international clinical trials of
  cognitive enhancers and to make it available for
  international academic research on cognition in
  schizophrenia
• We educated ourselves about the appropriate steps
  in this process Hambleton, R.K., Merenda,
  P.F., Spielberger, C.D. (eds.), Adapting
  Educational and Psychological Tests for
  Cross-Cultural Assessment. Lawrence Erlbaum,
  2005.

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MATRICS-CT Goals of the Translation Work Stream

• To establish high-priority languages for
  translation of the MATRICS Consensus Cognitive
  Battery (MCCB) to facilitate international
  clinical trials
• To create professionally translated and
  culturally adapted versions of the MCCB in these
  languages that are approved and licensed by test
  developers and intellectual property (IP) owners
• To print and arrange distribution of the
  translated MCCB versions and
• To gather community normative data to aid
  interpretation of these translated MCCB versions.

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MATRICS-CT Consortium-Selected Languages

• Spanish (for Spain, plus dialect version for
  Central and South America)
• Simplified Chinese
• German
• Hindi
• Russian

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Languages Recently Funded by Individual Companies

• Japanese
• Italian
• Hebrew
• Croatian

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Steps in Translation and Cultural Adaptation of
the MATRICS Consensus Cognitive Battery
MAI attorney and seven test IP owners
MAI and IP owners
Professional Translators
Professional Translators
Professional Translators
MAI and Professional Translators
Experts arranged by MAI
8. Review and approval by IP owners
MAI MATRICS Assessment, Inc.
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Challenges and Solutions during Translation and
Adaptation of the MCCB

• Hopkins Verbal Learning Test Revised
• A few literal translations would have resulted in
  words that would very rarely be used within a
  semantic class in another language
• Substituted a word in the same semantic class
  that has similar word frequency as the original
  word within the English language (e.g.,
  English bluebird, Spanish sparrow, German
  thrush, Hindi pigeon)
• Letter-Number Span for Chinese MCCB
• Chinese is character-based and does not involve a
  sequential alphabet, so ordering letters is not
  possible
• After considering alternatives, decided that
  Spatial Span alone can adequately measure working
  memory in Chinese MCCB

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Need for Normative Data
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Normative Data for Translations of the MCCB
Demographic Corrections
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Why Collect Community Normative Data for the
MCCB?

• Improves ability to detect signal in clinical
  trials as it reduces error variance due to bad
  scaling
• Puts all tests on common metric (based on mean
  SD of stratified community sample)
• Enables valid composite scores (e.g., overall
  score)
• Enables valid comparisons between cognitive
  domains (to detect domain-specific effects)
• Provides basis for age, gender, and education
  corrections

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Why Collect Community Normative Data for
Translated Versions of the MCCB?

• Detects and adjusts for differences in difficulty
  level between English and translated tests
• Detects and adjusts for cultural variations in
  meaning of items (e.g., Managing Emotions)
• Puts scores on common metric across languages
  (based on mean SD of stratified community
  samples)
• Enables comparisons across samples using
  different languages (to compare findings and
  combine data across languages)

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MATRICS CT Timeline for Translation of the MCCB
1st Tier Languages Chinese, Hindi, German,
Russian, Spanish (plus dialect)
Oct 09
Jun 09
Jun 07
Feb 08
Jun 10
Jun 08
Obtain Legal Permission, Licensing
Reconciliation, Cultural Adaptation
Lay out, Pre-press, Printing of MCCB Translations
Establish Procedures for MCCB Acad Translations
Collection of Norms in Chinese, Spanish (Spain
Latin America), Russian
Forward / Backward Translations for MATRICS-CT
Languages
Collection of Norms in German and Hindi?
Test Owner Review and Approval
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Distribution of Commercially AvailableMCCB in
1st Tier Languages

• Description of distribution process is available
  through MATRICS Assessment, Inc., website
  (www.matricsinc.org)
• To obtain the translated MCCBs, see Psychological
  Assessment Resources, Inc. (www.parinc.com) or
  Multi-Health Systems (www.mhs.com)

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Translations for Academic Research

• Not externally funded, but permission process is
  available through MATRICS Assessment, Inc.
  (www.matricsinc.org)
• Translations for academic research are completed
  for Norwegian, Japanese, and Italian and have
  been authorized for Polish and Turkish
• Applications are being processed for Brazilian
  Portuguese, Danish, and Dutch
• Inquiries have been received for Korean and French

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Translations for Academic Research

• Steps to convert to commercial-quality clinical
  trials or clinical use version
• Legal agreements with test IP holders
• Translation QA check by a professional
  translation company
• Translation of any components of chapters 5 and 6
  of the MCCB Manual that were omitted
• Page composition
• Initial print run

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Summary

• Versions of the MCCB in Spanish for Spain,
  Spanish for Central and South America, Simplified
  Chinese, German, and Russian are published.
  Hindi will be published in the next month.
• Collection of community normative data is
  underway in China and Spain. Normative studies
  for Russian and Spanish for Latin America will
  start soon. Norms for German and Hindi are
  needed.
• New pathway allows companies to contract with the
  non-profit company directly for additional
  languages. MAI is finding ways to make
  translations faster and more economical, while
  still available to all.

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Summary

• A separate translation permission process is
  available to academic researchers who wish to use
  the MCCB in their own research program.
• Steps to convert an academic translation to a
  commercial clinical trials version are now worked
  out and are underway for Japanese and Italian.