So You're Not a Doctor: Taking the Plunge into Medical Translation without an MD
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Transcript of So You're Not a Doctor: Taking the Plunge into Medical Translation without an MD
So You’re Not a Doctor:Taking the Plunge into Medial
Translation without an MD
Please take the quiz while you wait.
Quiz review: Question 1
In “Administer 300 IU/kg of body weight,” “IU” means:
A. Iodine UnitB. 5-IodouracilC. International Unit D. Intrauterine
Quiz
Quiz review: Question 2
Which of these does not belong?A. Anjina (TR)B. (RU)C. Angina (EN)D. Angine (FR)
Quiz
Quiz review: Question 3
The largest therapeutic category for drug development is:
A. Central Nervous SystemB. Infections (HIV, Hepatitis, etc.)C. Autoimmune & Inflammatory DiseasesD. Cancer
Quiz
Quiz review: Question 4
Which of the following is an invasive procedure?A. Stress EchocardiographyB. Transesophageal EchocardiogramC. Plain Abdominal X-rayD. Transthoracic Echocardiogram
Quiz
Quiz review: Question 5
Which of the following is not a national regulatory body?
A. FDAB. AFSSAPSC. AQuMedD. Health Canada
Quiz
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1 Introduction & background
Challenges & barriers to entry
Getting it right
A closer look
5 Resources & standards
Presentation overview
1. Introduction & background
Industry overview: Fast facts
1- Introduction & background
2011 pharma sales > $880 bn
25-27% growth in top 17 “pharmerging” countries
It takes the FDA an average of 16 months to approve a new product
Growth industry
Regulatory opportunities
Expanding geographic/linguistic requirements
Average cost to bring to market = $500 mn; Average product life cycle = 10 years
Sustained growth/aggressive vertical
World market trends
1- Introduction & background
Clinical trials around the world
1- Introduction & background
“Pharmerging” markets
1- Introduction & background
Tier 1: China
Tier 2: Brazil, Russia, India
Tier 3: Fast followers
Number 3 market with sales driven by locally manufactured generics & imported products
Consistent double-digit growth with rising middle-class populations, improved infrastructure, and IP rights
Complex, rapidly changing markets contributing $1 – 5 bn (Venezuela, Poland, Argentina, Turkey, Mexico, Vietnam, etc.)
Increases in medical translation volumes
1- Introduction & background
Globalization
Aggressive overseas marketing for sustained
growth
Communications and IT Technology
Increase in text-based information
Development Pipeline
More products in the pipeline to ensure ROI/ “blockbuster” products
What it means to specialize
1- Introduction & background
It’s not enough to know anatomy and biology to be a doctor, so why
would simply being bilingual be enough to be a medical translator
or interpreter?
The perks of specializing
1- Introduction & background
Medical translation prioritizes quality and expertise over deadlines and costs
more profitable market for proficient specialists
… and what will I be translating?
1- Introduction & background
• Case report forms/SOAPs• Clinical and instrumental reports• Clinical development/trial data• Drug monographs• Multilingual consulting• Informed Consent Forms• Linguistic validation• Marketing materials• Medical/scientific journal articles• Packaging and labeling• Pharmacovigilance/safety reporting• PRO and QoL instruments• Regulatory documentation• Sales materials• Software and website localization
Stakeholders & clients
1- Introduction & background
Spectrum of points of entry
1- Introduction & background
Extremely specialized
Minimally specialized
ICFs
Drug monographs
Protocols
PH BrochuresIn-country validation
RA + QC
Medical life cycle opportunities
1- Introduction & background
Regulatory
Clinical stage
R & D
Manufacturing Sales & Marketing
2. Challenges & barriers to entry
Regional divergences
2- Challenges & barriers to entry
• Regional differences in the regulatory/approval process
• Locale-specific terminology• Variations in healthcare systems• Readability index for target population (consent
forms, patient information leaflets, etc.)
Deciphering handwritten notes
2- Challenges & barriers to entry
Extremely common!
A known problem!
2- Challenges & barriers to entry
From an ISMP – FDA – HHS Campaign
… further complicated by translation
2- Challenges & barriers to entry
A practical example
2- Challenges & barriers to entry
Yikes!
Decoding acronyms & symbols
2- Challenges & barriers to entry
Symbols and shorthand are common:
Be vigilant about creating glossaries/references for your future reference
* = birth, † = death= diastolic blood pressure, v = systolic pressure = before, = after
= start of operation, = end of operation= psychologist
( ) = possibly significant= right upper quadrant= plantar response, = extensor response
M = murmur = fluid ounce
# = fracture= pulse rate, = anesthesia
Understanding regulatory requirements
2- Challenges & barriers to entry
• EU Medical Device Directive 93/42/EEC requires companies to adopt a specific multilingual documentation process
• Use of fully prescribed name• Adequate communication of indication• Disclosing risk information
Back-translation is now an essential benchmarking tool and quality strategy
Medical terminology & jargon
2- Challenges & barriers to entry
Transport pt to OT tid via W/C
A. Transport patient to occupational therapy three times a day via wheelchair
B. Transport patient for outpatient treatmentthree times a day per worker’s compensation
C. Transport patient to occupational therapythree times a week via wheelchair
D. Transport patient to outpatient treatmentthree times a week via wheelchair
The learning gap
2- Challenges & barriers to entry
1. Know your limitations2. Learn about the regulatory environment for
your country/language combinations3. Research existing products & companies in
your target language4. Invest in your terminology5. Never make assumptions! Check, then
double check!
3. Getting it right
Defensive translating
3- Getting it right
Part of being a good translator is knowing how to diagnose potential mistakes before you make them
Common misinterpretations
3- Getting it right
Faux amis – False friends
3- Getting it right
Cognates and faux amis can be deadly in a clinical context
Source Faux amis translation Correct translation
(RU) Angina (EN) Tonsillitis
Auricle (FR) Auricle (EN) Atrium
After (DE) After (EN) Anus
Carbunco (ES) Carbuncle (EN) Anthrax
Aspirazione (IT) Aspiration (EN) Suction
Terminology shifts
3- Getting it right
English has a relatively large vocabulary, creating language shifts during translation
Source Translation Comment
Aches and pains Rigidez (ES) 2 words do not exist in Spanish for “aches” and “pains”
Cytomegalovirus (CMV) (--) (EL)
No abbreviation available in Greek, use full term
Magnetic ResonanceImaging (MRI)
Segulómun (MRI) (IS)
Interchangeable use of full Icelandic term and borrowed EN term
Geographic usage
3- Getting it right
Term France Belgium Switzerland Canada
Recommandations 9 2
Lignes directrices 1 2
Guides 1 1
Source: “Répertoire des lignes directrices de pratique médicale et tables rondes consensus francophones, ” http://www.chu-rouen.fr/ssf/recomfr.html, p. 1-6.
Observation: Canada tends to use the
verb recommander, which makes it impossible to use recommandations as the
subject of the verb
Know international standards
3- Getting it right
• ICH Good Clinical Practice GuidelinesHow trials should be conducted, roles and responsibilities of sponsors, investigators, and monitors
• Declaration of HelsinkiEthical principles on human experimentation; cornerstone document for human research ethics
Medical usage & abusage
3- Getting it right
• Default to literal/equivalence translations may be inappropriate and/or deadly
• Medical writing uses a specific style and jargon that can be foreign to linguists
• Interlinguistic shifts in terminology
Translation strategies
3- Getting it right
1. Be methodical: Decode acronymssource expanded source expanded target target acronym
2. Never be satisfied: Research the source term, then find proof in the target language
3. Know your audience: Where does your term fall on the scientific spectrum?
4. A closer look
Back to our example…
4- A closer look
“Physical exam”Sometimes we see “examen objectif” => “objective exam”
is a common false friend
Vital signsLearn these by heart in your language(s) – along with all
shorthand/abbreviations
SystemsLearn the organ systems
and associated systematic examinations
AbbreviationsYou will see these… all the time:
I promise!
Usage
4- A closer look
Are you for or against vaccines?
Vaccin antigrippal, vaccin grippal, vaccin contre la grippe (FR)
Vacuna antigripal, vacuna gripal, vacuna contra la gripe (ES)
Flu vaccine (EN)
Condition Cause of condition
English French
Natural sleep Sleep SommeilCondition in which the patient responds to suggestion
Hypnotism (non-drug-related maneuvers)
Hypnosis HypnoseSynonyms:État hypnotiqueÉtat hypnoïde
Narcoanalysis, Narcosynthesis (Low doses of anesthesia)
Subnarcosis
Hypnosis
SubnarcoseSynonyms:Narcose liminaireHypnose* (not rec.)
Artificial sleep, Loss of consciousnessfrom anesthesia (deep sleep)
Drugs (somniferous drugs, anesthesia)
NarcosisPharmacologicalhypnosisSleep* (not rec.)Hypnosis* (not rec.)
Narcose
Hypnose* (not rec.)
Divergent medical terminology
4- A closer look
Term mapping
4- A closer look
Find your niche!
4- A closer look
5. Resources & standards
Essential print references
5- Resources & standards
Maxwell Quick Medical ReferenceQuick pocket reference: ECGs, lab values, formulas and equations, orders, and admission and progress notes
The Massachusetts General Hospital Handbook of Internal Medicine A loose-leaf reference on common problems in internal medicine, tables, diagrams, and abbreviations
Medical Abbreviations Alphabetic list of abbreviations and acronyms with an index of expanded terms for reverse research
Medical terminology
5- Resources & standards
Lab Tests OnlineClinical lab test resourcewww.labtestsonline.org
MediLexiconMedical abbreviations and dictionary (English with some French, German, and Spanish translations)www.medilexicon.com
Medline Plus DictionaryNational Library of Medicine Dictionarywww.nlm.nih.gov/medlineplus/mplusdictionary.html
Stanford Lay Language DictionaryGlossary of medical terms and corresponding lay terms and definitionswww.humansubjects.stanford.edu/new/docs/glossary_definitions/lay_language.pdf
EMA – QRD
Multilingual QRD templates for product information and packaging
www.ema.europa.eu
Approved terminology
5- Resources & standards
IHTSDO – SNOMED
Comprehensive collection of multilingual clinical healthcare terminology
www.ihtsdo.org/snomed-ct
MedDRA
Clinically validated international medical terminology and AE dictionary
www.meddramsso.com
Registries and term banks
5- Resources & standards
EU Clinical Trials RegisterEU clinical trials registrywww.clinicaltrialsregister.eu
WHO International Clinical Trials Registry Platform (ICTRP)Online, multilingual international clinical trials registrywww.who.it/ictrp/en
US Clinical Trials DatabaseUS registry of clinical trials in a harmonized formatwww.clinicaltrials.gov
Medline Plus DictionaryNational Library of Medicine Dictionarywww.nlm.nih.gov/medlineplus/mplusdictionary.html
RxListOnline drug index, including side effects, interactions, etc.www.rxlist.com
EMAFrequently used non-standard abbreviationswww.emea.europa.eu/htms/human/qrd/docs/listnonstandard.pdf
A reference reference
5- Resources & standards
Tool Box for the Medical Translator by Alain CôtéAn absolute essential for novice or experienced translators with one of the most comprehensive compilations of resources (French –English focus)
www.groupetraduction.ca/documents/ToolBox.pdf
Questions?