Table 2.

Comments from patients, the translation coordinator, and EORTC on pilot testing

Item No	Item content	Comments from patients	Changes proposed by the translation coordinator	EORTC comments	Final results
35	Have you been short of breath when you climbed stairs?	One postoperative patient said that healthy people may also feel short of breath when climbing stairs, so the question should be whether the patient feels more shortness of breath compared to the time before treatment or before the illness Two postoperative patients said they had not climbed stairs in the last week, so they could not answer this question	No changes were required because only one postoperative patient mentioned this issue and two patients did not answer this question	Agreed, no change necessary	No change
39	Have you had hair loss?	One postoperative patient mentioned that healthy people also lose a small amount of hair every day, so the question should be whether the patient is losing more hair than usual due to treatment	We selected another translation from the existing translation column to make it more specific	The translation you selected is for the colorectal patients and the source is slightly different: Have you lost hair as a result of your treatment? Seeing as 'as a result of your treatment' is not in the source of this questionnaire, I suggest we keep the translation as it is. It should be clear from the context what it is asking, and the comment only comes from one patient	No change
49	Have you been afraid of tumour progression?	One patient undergoing radiotherapy said she did not know her disease was a tumour, so she was a bit confused when she read this question	No changes were required because most patients are aware of their cancer diagnosis nowadays	Agreed, no change necessary	No change
50	Have you had thin or lifeless hair as a result of your disease or treatment?	Three patients undergoing chemotherapy were confused by the chosen Chinese word for “lifeless” ("无生气"); because this word also contains a meaning of “angry” in Chinese	Use another Chinese word (“无生机”) to represent “lifeless” to avoid the ambiguity. Fifty percent of the patients thought the reworded version was better, and the other 50% considered both words were acceptable	For the sake of clarity, you mention that 50% of patients agreed with the change. Did the other 50% disagree and prefer the previous version? Your opinion on whether the change is better would be useful	Replace “无生气" with "无生机"
53	Have you experienced a decrease in your physical capabilities?	One patient undergoing chemotherapy said he did not know how to answer this question because he has not undertaken any physical activity recently	No changes were required because only one patient mentioned this issue	Agreed, no change necessary	No change
54	Has weight loss been a problem for you?	One patient undergoing chemotherapy said he had no weight loss and did not know how to answer this question	Almost all questions in the EORTC QLQ-LC29 are about what symptoms or problems patients have rather than how patients feel about symptoms that they may not have at all. Therefore, we recommend asking patients directly if they have any symptoms or problems, which is consistent with the format of the previous questions	Thank you for your input. I am afraid that we cannot change the wording of the original questionnaire, and the translation must match the source. If patients have not had weight loss, they can select 'not at all'. No change to the translation	No change
56	Has the area of your wound been oversensitive?	One postoperative patient mentioned that the word "oversensitive" was a little difficult to understand	No changes were required because only one postoperative patient mentioned this issue	OK, no change	No change
57	Have you been restricted in your performance due to the extent of surgery?	One postoperative patient mentioned that the meaning of the word “performance” was vague. Does it refer to living ability or daily activities?	“Daily activities” would be more specific than “performance”	If the majority of patients understood, is a change necessary? “Performance” relates to abilities/strength and how well particular tasks can be performed. This is a bit different to 'daily activities'. Seeing as only one patient mentioned this, I suggest no change	No change