Translation and Validation of the Multiple Sclerosis Knowledge Assessment Scale for Use in Brazil

Introduction: Multiple sclerosis (MS) is a chronic condition of the central nervous system, significantly impacting the patients’ quality of life. With the recent emergence of various medications for its treatment, the development of patient-reported outcome measures has become increasingly important to ensure adherence.  The Multiple Sclerosis Knowledge Assessment Scale (MSKAS) is a tool validated in 2021 designed to measure patients' knowledge about the disease. Objective: To objective of this work was to translate and validate the original English-language MSKAS into Brazilian Portuguese and validate its cultural and linguistic equivalence for application in Brazil. Methods: The MSKAS consists of 22 true/false statements assessing patients' knowledge of MS pathogenesis, clinical manifestations, and treatment. The questionnaire underwent a rigorous translation and cross-cultural adaptation process following standardized guidelines. This involved initial translation by two independent bilingual translators, followed by back-translation into English by a native English-speaking professional. Subsequently, a specialized committee, comprising professionals from various disciplines, reviewed and refined the translated version to ensure semantic and conceptual equivalence, adapting the content to the cultural context of the target population. Results: The Brazilian Portuguese version of the MSKAS exhibited no significant conceptual discrepancies compared to the original English version. Following review and approval by the multi-professional committee, the final version of the MSKAS in Brazilian Portuguese was deemed to be both linguistically accurate and culturally appropriate for use in Brazil. Conclusions: The translation and validation of the MSKAS for Brazilian Portuguese represent an important tool to assess patients’ understanding of the basic concepts of MS. Analyzing the comprehension of the disease across different regions of the country may aid in the development of educational strategies and enhance patients' active involvement in their treatment.