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David Himmelberger, MS, President and Founder of Health Outcomes Group presenting on Translation and Linguistic Validation of Outcome Measures Collecting data from patients about their health outcomes is challenging, especially when working in a multinational environment. This presentation will focus on the situation when a questionnaire is designed to collect health outcomes as reported by the patient (PROs) in a multinational setting. Most questionnaires are developed in English and then are selected to be used to collect the same data reported by similar patients who speak another language, often in another country. The process for translation and linguistic validation of PRO questionnaires in the context of multinational clinical trials and epidemiology studies will be presented. Most English speakers are monolingual and are unaware of inherent biases and implicit western cultural values that are embedded in a questionnaire that has been created in English. Examples of how the translation and linguistic validation process identifies issues and problems made by English speakers during the creation of a PRO questionnaire will be discussed.