Cross-cultural adaptation, content, and response process validation of the Malay version of the Ocular Surface Disease Index-6 (Malay OSDI-6).

BACKGROUND: The Ocular Surface Disease Index-6 (OSDI-6) is a shortened version of the widely used OSDI-12 developed to provide a more efficient tool for assessing dry eye symptoms. However, its application in different populations requires appropriate translation and cross-cultural validation to ensure validity and interpretability. METHODS: This study involved the translation and cross-cultural adaptation of the OSDI-6 into Malay (Malay OSDI-6), followed by evaluation of its content validity and response process validity. The translation process was conducted using a standard forward-backward method with expert panel review. Content validity was assessed by eight subject matter experts (SMEs) using the Content Validity Index (CVI), and response process validity was evaluated among 32 public respondents using the Face Validity Index (FVI). Qualitative feedback from both SMEs and respondents was also incorporated to refine the instrument. RESULTS: The Malay OSDI-6 demonstrated excellent content validity, with Item-Level CVI (I-CVI) values ranging from 0.88 to 1.00 and Scale-Level CVI/Average (S-CVI/Ave) of 0.96. Response process validation indicated good clarity and comprehensibility, with most Item-Level FVI (I-FVI) values exceeding 0.90 and Scale-Level FVI/Average (S-FVI/Ave) of approximately 0.90. Minor refinements were made to a few items to enhance linguistic clarity and cultural relevance. CONCLUSION: The Malay version of the OSDI-6 demonstrates strong evidence of content validity and satisfactory response process validity following minor refinements. The instrument is linguistically appropriate, culturally relevant, and suitable for use in the Malay-speaking population.