Use of AI within COA linguistic validation and eCOA migration processes: analysis and good practice recommendations

Abstract: While there has been much discussion around the use of Artificial Intelligence (AI) for multilingual translations in other areas, recommendations pertaining specifically to the use of AI in the context of Clinical Outcome Assessment (COA) translation, linguistic validation, and electronic migration within clinical trials are lacking. Without published recommendations or guidelines, stakeholders involved in the COA translation process may be hesitant to explore or include AI. To address this gap, the AI Working Group of the ISOQOL TCA-SIG conducted a study to assess the landscape of AI in this specific context aimed at proposing recommendations for potential implementation of AI in COA translation, linguistic validation and electronic migration processes. The study consisted of three parts: (1) a literature review targeting studies using AI in COA translation; (2) a survey among relevant stakeholders assessing perceptions of AI use in COA translation; and (3) interviews with AI subject matter experts (SMEs). Survey responses were received from a total of 50 individuals from a wide variety of stakeholder groups, including COA copyright holders, representatives from pharmaceutical company COA/HEOR teams, respondents holding roles associated with the COA translation, eCOA, and AI industries, and authors of the 2005 ISPOR task force article on linguistic validation methodology. Survey data provided detailed feedback regarding the appropriateness of using AI during all reviewed process steps. Results of the literature review and AI expert interviews provided additional depth and nuance, allowing for the generation of detailed recommendations covering the use of AI within linguistic validation and eCOA migration processes. When assessing the potential use of AI tools within the linguistic validation process, it is important to consider not only the capabilities of the technology, but also the degree to which use of AI may or may not align with the spirit and intent of existing linguistic validation guidelines. The recommendations included in this manuscript are designed to balance considerations of technological capability and improved efficiency with concerns related to intellectual property protection, data privacy/security, and the goal of keeping patients at the center of outcomes research.

Shawn McKown, Benjamin Arnold, Frederique Boucher, Helena Correia, Sonya Eremenco, Tomislav Geršić, Melinda Johnson, Andriana Koumbarou, Igor Matias, Emily Parks-Vernizzi, Tim Poepsel, Jiyoung Son, Erin Strouse, C. B. Terwee & Mark Wade

In ,Journal of Patient-Reported Outcomes, 6 February 2026.

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