Validating a new score in different languages requires language-specific validation, not just the translation of an already validated score into another language. Therefore, validation in particular has been a very elaborate statistical process involving more than 2800 questionnaires of different languages. In 2018, development and validation of the EFAS Score was completed in 7 languages (Dutch, English, French, German, Italian, Swedish, Polish). The Finnish and Turkish score versions followed 2020, and the Persian version 2021. Other language versions are under validation (Arabic, Danish, Estonian, Hungarian, Norwegian, Portuguese, Spanish). Non-native European languages such as Persian or Arabic have also been considered for validation to reflect the growing immigration.