Translation, cultural adaptation and validation of the WHO fracture risk assessment tool (FRAX®) into Bengali

Aim
To develop a translated and culturally adapted Bengali version of the WHO Fracture Risk Assessment Tool (FRAX®) and to test its feasibility, content validity and reliability.

Method
The English FRAX was translated and culturally adapted for use in Bangladeshi populations following established forward–backward translation methods and being extensively field-tested. The final version was interviewer-administered to 130 consecutive osteoporotic patients between 40 and 90 years of age. For test–retest reliability, the questionnaire was re-administered after 14 days in 60 odd serial-numbered patients.

Results
To better match with the Bengali culture, several adaptations were made to the FRAX items, including replacements and additions for tobacco, prednisolone and alcohol use. The response rate of the pre-final Bengali version of FRAX was 100% and all patients could understand the questions. Test–retest reliability (Pearson's r) in osteoporotic patients was > 0.93 for all items.

Conclusion
The culturally adapted Bengali version of the FRAX appears to be an acceptable and reliable instrument. Further studies are needed to confirm the ability of the tool to accurately predict the 10-year probability of hip and major osteoporotic fractures in the Bengali population.