Gut Feelings Questionnaire in 8 languages: procedure and results

Here you find the gut feelings questionnaire, appropriate for use in real practice or in an experimental case vignette situation, both in American-English and British-English language.The construct and linguistic validation procedures are described in a publication in BMC-Family Practice (see Publications ) and also below.

There are also a French, German, Polish, Catalan and Spanish linguistic validated translation available.(see

In 2017, we conducted a think-aloud study to explore whether the way experienced GPs, GP-trainees and medical students in the Netherlands understood the GFQ items was in line with what we aimed for when composing the questionnaire. The next step was a feasibility study in daily practice with the GFQ. As these two phases led to some adaptations, the modified questionnaire was retested during a second feasibility study. After some minor changes we determined the final version of the GFQ. A report of these studies is in process. The validated part of the adapted questionnaire concerns the items 1-7 and 11 in all versions. We added three exploring questions, the items 8, 9 and 10.

Cut-off values are available.

British-English language:

GFQ BE realpractice 2017


Explanation of the GFQ

American-English language:

GFQ AE realpractice definitive

Questionnaire case vignette definitive AE

Dutch language:

GFQ Dutch real practice 2017

GFQ Dutch case vignette design 2017

Toelichting bij de PNP vragenlijst

French language (real practice version):

french questionnaire gut feeling.

German language:

GFQ German real practice 2017


Polish language:

GFQ-Polish-real-practice 2017

Spanish language:


Catalan language:


Turkish language:

Gut Feelings Questionnaires Turkish


For a scheme of the linguistic validation procedure, made by Marie Barais, Johannes Hauswaldt, Daniel Hausmann, Slawomir Czachowski and Agnieszka Sowinska see Procedural_scheme_linguistic_validation_20160523.


The linguistic validation procedure as performed by the Maastricht-Antwerp research group (2010-11)

The entire procedure that we followed in translating the Dutch Gut Feelings Questionnaire into English met the standardization criteria found in the international literature, 1-8 and on some websites (see below).


  • Two native-speaker (UK-English) translators with medical knowledge separately translated the questionnaire after receiving information about the goal of the questionnaire and the way it will be used in research. They were invited to add comments if needed.
  • Two native-speaker Dutch language translators with medical knowledge were asked to provide separate backward translations. They were also invited to add comments if needed.


  • Two members of the Maastricht research group prepared a first draft for a consensus translation, putting all the differences and questions in an extended table. The four translators were separately asked to read this first consensus carefully, including all the comments in the table, and to add their opinions to this table. Afterwards, the same two members of the research group adjusted the consensus and collected all the remaining questions and translation problems in a new table. They then held a telephone meeting with all four translators, in which all problems were discussed. One of the Maastricht research group acted as a chair, while the other focused on all linguistic items, and a secretary made a report of the discussion. At the end of the meeting, almost a complete consensus was reached. Only the wording of item 10 of the questionnaire had to be reviewed before a decision could be made.

Cultural check

  • The second draft of the translation was sent to all translators. After adjusting minor points, we sent this text to ten UK GPs (native speakers) and ten USA GPs (native speakers) asking them to check for grammatical errors and cultural misunderstandings. Their comments were collected in a third table. The four translators studied the comments and gave their final judgment.


  • After considering the translators’ recommendations, the two members of the Maastricht research group finally determined the definitive text (BE version and AE version) of the questionnaire. During the whole procedure, the Maastricht research group was informed about all steps they took, and the group agreed with the final results.

Reference List

(1)   Acquadro C, Conway K, Hareendran A, Aaronson N. Literature review of methods to translate health-related quality of life questionnaires for use in multinational clinical trials. Value Health 2008; 11(3):509-521.

(2)   Koller M, Aaronson NK, Blazeby J, Bottomley A, Dewolf L, Fayers P et al. Translation procedures for standardised quality of life questionnaires: The European Organisation for Research and Treatment of Cancer (EORTC) approach. Eur J Cancer 2007; 43(12):1810-1820.

(3)   Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976 ) 2000; 25(24):3186-3191.

(4)   Streiner DL, Norman GR. Health Measurement Scales. A practical guide to their development and use. 3 ed. Oxford: Oxford University Press; 2006.

(5)   Herdman M, Fox-Rushby J, Badia X. A model of equivalence in the cultural adaptation of HRQoL instruments: the universalist approach. Qual Life Res 1998; 7(4):323-335.

(6)   Herdman M, Fox-Rushby J, Badia X. ‘Equivalence’ and the translation and adaptation of health-related quality of life questionnaires. Qual Life Res 1997; 6(3):237-247.

(7)   Acquadro C, Conway K, Giroudet C, Mear I. Linguistic validation manual for patient-reported outcomes (PRO) instruments. Lyon: MAPI Research Institute; 2004.

(8)   MAPI Institute. . 1-9-2011.

See the World Health Organisation:

And an article in The International Journal for Translation and Interpreting Research: