Table 2.

Translatability assessment: summary of overall findings and recommendations

Source (English)	Comments	Suggested final English
Culture issues
Four-item IBS-D Symptom-Event Log with stool descriptors and images of the Astellas Stool Form Scale	Several countries noted that the subject of the questionnaire can be embarrassing, but as this is to be used in a clinical setting, is appropriate.
Irritable Bowel Syndrome – Diarrhea Predominant (IBS-D) Symptom-Event Log	To avoid confusion as to the location of the acronym, a hyphen should be added between “diarrhea” and “predominant” to ensure accurate understanding of the item.	Irritable Bowel Syndrome –Diarrhea-Predominant (IBS-D) Symptom- Event Log
Date (MM/DD/YYYY)	Allow dates to be entered in the standard format of the target country (eg, DD/MM/YYYY or YYYY/MM/DD).
am or pm	Allow for time to be entered as a 24-hour entry if possible, as several cultures do not use “am” or “pm”.
Concept elaboration
How immediate was your need	Suggestion to either change “immediate” to “urgent” or ensure that this is explained in concept elaboration as an appropriate synonym. Also, a question mark should be added for accuracy.	How immediate (or urgent) was your need?
Which best describes what your bowel movement looked like	Add question mark for accuracy	Which best describes what your bowel movement looked like?
Irritable bowel syndrome - diarrhea predominant (IBS-D) daily symptom diary	To avoid confusion as to the location of the acronym, a hyphen should be added between “Diarrhea” and “Predominant” to ensure accurate understanding of the item.	Irritable bowel syndrome - diarrhea- predominant (IBS-D) daily symptom diary
The purpose of this diary is to collect some information about the symptoms of irritable bowel syndrome – diarrhea predominant (IBS-D) that you have experienced.	To avoid confusion as to the location of the acronym, a hyphen should be added between “diarrhea” and “predominant” to ensure accurate understanding of the item.	The purpose of this diary is to collect some information about the symptoms of irritable bowel syndrome – diarrhea-predominant (IBS-D) that you have experienced.
In the past 24 hours, on a scale of 0–10, how would you rate the severity of your stomach pain?	While not specifically noted in each country’s review, the idea of “abdominal pain” and “stomach pain” as separate sensations will need to be further explained during concept elaboration to allow for appropriate differentiation and adaptation into each language.