“Improving access to vestibular schwannoma quality of life research through multilanguage translations of the Mayo Clinic Vestibular Schwannoma Quality of Life Index” (*Carlson et al., J Neurosurg. 2025;142(Suppl):S2. doi:10.3171/2024.11.JNS242317*)
This article reports on the translation of the Mayo Clinic Vestibular Schwannoma Quality of Life Index into six widely spoken languages: Simplified Chinese, Spanish, Japanese, Arabic, French, and Norwegian. It is presented as a digital supplement to the *Journal of Neurosurgery* and is positioned as a response to a key limitation in vestibular schwannoma research: the lack of validated, multilingual tools to assess the quality of life (QOL) in a culturally diverse patient population.
The VSQOL Index, developed originally in English, is a domain-specific tool covering eight core categories that reflect the multidimensional burden of VS, ranging from hearing loss to psychosocial and cognitive impacts. The article emphasizes accessibility, global equity in research, and the potential for cross-cultural validation.
2. Strengths
– Timely and Inclusive Effort: In a field increasingly aware of the importance of patient-reported outcomes (PROs), the expansion of the VSQOL Index to multiple languages addresses a real and urgent need. The effort reflects a commitment to diversity, equity, and inclusion (DEI) in neurosurgical research.
– Breadth of Domains: The eight domains covered are comprehensive and clinically relevant, reflecting an understanding of VS as a condition that affects patients beyond physical symptoms.
– Noncommercial Open Access: Making the tool freely available for noncommercial use significantly boosts its adoption potential in both research and clinical settings.
– Forward-Looking Implementation Strategy: By inviting further translations and offering a methodology for doing so, the authors promote scalability and community collaboration.
3. Limitations and Areas for Improvement
– Lack of Validation Data for Translations: A critical omission is the absence of psychometric validation data for the translated versions. Translation alone does not ensure cultural equivalence or measurement validity. Were back-translations performed? Were cognitive interviews or pilot tests conducted in native-speaking populations?
– No Discussion on Linguistic/Cultural Adaptation Challenges: Certain concepts (e.g., “regret” or “impact on employment”) may not translate directly or may have different cultural connotations, particularly in non-Western contexts. This nuance is missing.
– Digital Supplement Format: The article feels more like a resource announcement than a full scientific paper. There’s no detailed methodology on how the translations were produced, reviewed, or tested. A table comparing the original and translated items or discussing challenges in specific languages would have enriched the value.
– Unclear How This Affects Clinical Decision-Making: Although QOL is important, the article could have outlined practical examples of how this tool has been or could be used to guide treatment planning, shared decision-making, or monitoring outcomes in real-world clinics.
4. Future Directions
– Cross-Cultural Validation Studies: Essential next steps include conducting validation study in diverse populations to confirm that the VSQOL Index is both reliable and sensitive across languages and cultures.
– Integration into Registries and Trials: The authors could propose integrating the VSQOL Index into prospective multicenter studies or national registries, which would increase the visibility and utility of the tool.
– Digital Implementation: The use of a mobile app or integration with electronic health records (EHRs) for real-time patient input could enhance its impact and usability in clinical workflows.
Conclusion
Carlson et al. make a significant and commendable contribution to the field of vestibular schwannoma research by expanding the reach of a multidimensional QOL assessment tool through multilingual translation. However, to truly fulfill its potential, the translated versions must undergo rigorous psychometric validation, and future work should aim to embed the Index in clinical and research settings more explicitly. As it stands, this is a valuable first step—but just the beginning—in making QOL data accessible and actionable in a globalized neurosurgical landscape.