Please take the quiz               while you wait.So You’re Not a Doctor: Taking the Plunge into Medial    Translation wit...
Quiz review: Question 1   In “Administer 300 IU/kg of body weight,”   “IU” means:        A.   Iodine Unit        B.   5-Io...
Quiz review: Question 2   Which of these does not belong?        A. Anjina (TR)        B.          (RU)        C. Angina (...
Quiz review: Question 3   The largest therapeutic category for drug   development is:        A.   Central Nervous System  ...
Quiz review: Question 4   Which of the following is an invasive procedure?        A.   Stress Echocardiography        B.  ...
Quiz review: Question 5   Which of the following is not a national   regulatory body?        A.   FDA        B.   AFSSAPS ...
Presentation overview  1   Introduction & background  2   Challenges & barriers to entry  3   Getting it right  4   A clos...
1. Introduction & background
Industry overview: Fast facts                                                  Growth industry  2011 pharma sales > $880 b...
World market trends1- Introduction & background
Clinical trials around the world1- Introduction & background
“Pharmerging” markets                                         Tier 1: China  Number 3 market with sales  driven by locally...
Increases in medical                  translation volumes       Globalization           Communications and       Developme...
What it means to specialize               It’s not enough to know anatomy              and biology to be a doctor, so why ...
The perks of specializing     Medical translation prioritizes quality    and expertise over deadlines and costs           ...
… and what will I be translating?                •    Case report forms/SOAPs                •    Clinical and instrumenta...
Stakeholders & clients1- Introduction & background
Spectrum of points of entry                          PH Brochures      RA + QC   Drug monographs    In-country     validat...
Medical life cycle opportunities                               Clinical stage                                             ...
2. Challenges & barriers to entry
Regional divergences       • Regional differences in the regulatory/         approval process       • Locale-specific term...
Deciphering handwritten notes                                Extremely common!2- Challenges & barriers to entry
A known problem!    From an ISMP – FDA – HHS Campaign2- Challenges & barriers to entry
… further complicated by                   translation2- Challenges & barriers to entry
A practical example                                    Yikes!2- Challenges & barriers to entry
Decoding acronyms & symbols      Symbols and shorthand are common:                 Be vigilant about creating glossaries/ ...
Understanding regulatory                   requirements       • EU Medical Device Directive 93/42/EEC requires         com...
Medical terminology & jargon                          Transport pt to OT tid via W/C     A. Transport patient to occupatio...
The learning gap       1. Know your limitations       2. Learn about the regulatory environment for          your country/...
3. Getting it right
Defensive translating            Part of being a good translator is           knowing how to diagnose potential           ...
Common misinterpretations3- Getting it right
Faux amis – False friends     Cognates and faux amis can be deadly in a     clinical context                      Source  ...
Terminology shifts         English has a relatively large vocabulary, creating         language shifts during translation ...
Geographic usage                                                             Observation:                                 ...
Know international standards     • ICH Good Clinical Practice Guidelines         How trials should be conducted, roles and...
Medical usage & abusage   • Default to literal/equivalence translations may be     inappropriate and/or deadly   • Medical...
Translation strategies        1. Be methodical: Decode acronyms                source    expanded source   expanded target...
4. A closer look
Back to our example…                                                      “Physical exam”                                 ...
Usage                    Are you for or against vaccines?   Vaccin antigrippal, vaccin grippal, vaccin contre la grippe (F...
Divergent medical terminology     Condition          Cause of               English               French                  ...
Term mapping4- A closer look
Find your niche!4- A closer look
5. Resources & standards
Essential print references                               Maxwell Quick Medical Reference                               Qui...
Medical terminology                           Lab Tests Online                           Clinical lab test resource       ...
Approved terminologyEMA – QRD                        IHTSDO – SNOMED               MedDRAMultilingual QRD templates for   ...
Registries and term banks       EU Clinical Trials Register                   Medline Plus Dictionary       EU clinical tr...
A reference reference        Tool Box for the Medical Translator        by Alain Côté        An absolute essential for nov...
Questions?
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So You're Not a Doctor: Taking the Plunge into Medical Translation without an MD

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Medical and life sciences translation is an intimidating specialization for linguists lacking a scientific or technical background. The technical terminology, handwritten doctor notes, acronyms, complex medical phraseology, and regulatory requirements can leave novices treading in troubled waters. In this presentation, we will tackle the primary barriers to entry, explore linguistic and medical resources to build a better understanding of medical terminology and concepts, and examine the structure and scope of commonly translated documents (reports, journal articles, regulatory submissions, trial protocols, etc.). We will also discuss appropriate points of entry, industry standards, and language- and locale-specific challenges.

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So You're Not a Doctor: Taking the Plunge into Medical Translation without an MD

  1. 1. Please take the quiz while you wait.So You’re Not a Doctor: Taking the Plunge into Medial Translation without an MD
  2. 2. Quiz review: Question 1 In “Administer 300 IU/kg of body weight,” “IU” means: A. Iodine Unit B. 5-Iodouracil C. International Unit D. IntrauterineQuiz
  3. 3. Quiz review: Question 2 Which of these does not belong? A. Anjina (TR) B. (RU) C. Angina (EN) D. Angine (FR)Quiz
  4. 4. Quiz review: Question 3 The largest therapeutic category for drug development is: A. Central Nervous System B. Infections (HIV, Hepatitis, etc.) C. Autoimmune & Inflammatory Diseases D. CancerQuiz
  5. 5. Quiz review: Question 4 Which of the following is an invasive procedure? A. Stress Echocardiography B. Transesophageal Echocardiogram C. Plain Abdominal X-ray D. Transthoracic EchocardiogramQuiz
  6. 6. Quiz review: Question 5 Which of the following is not a national regulatory body? A. FDA B. AFSSAPS C. AQuMed D. Health CanadaQuiz
  7. 7. Presentation overview 1 Introduction & background 2 Challenges & barriers to entry 3 Getting it right 4 A closer look 5 Resources & standards
  8. 8. 1. Introduction & background
  9. 9. Industry overview: Fast facts Growth industry 2011 pharma sales > $880 bn Regulatory opportunities It takes the FDA an average of 16 months to approve a new product Expanding geographic/linguistic requirements 25-27% growth in top 17 “pharmerging” countries Sustained growth/aggressive vertical Average cost to bring to market = $500 mn; Average product life cycle = 10 years1- Introduction & background
  10. 10. World market trends1- Introduction & background
  11. 11. Clinical trials around the world1- Introduction & background
  12. 12. “Pharmerging” markets Tier 1: China Number 3 market with sales driven by locally manufactured generics & imported products Consistent double-digit growth Tier 2: Brazil, Russia, India with rising middle-class populations, improved infrastructure, and IP rights Complex, rapidly changing Tier 3: Fast followers markets contributing $1 – 5 bn (Venezuela, Poland, Argentina, Turkey, Mexico, Vietnam, etc.)1- Introduction & background
  13. 13. Increases in medical translation volumes Globalization Communications and Development Pipeline IT Technology Aggressive overseas More products in the marketing for sustained Increase in text-based pipeline to ensure ROI/ growth information “blockbuster” products1- Introduction & background
  14. 14. What it means to specialize 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?1- Introduction & background
  15. 15. The perks of specializing Medical translation prioritizes quality and expertise over deadlines and costs more profitable market for proficient specialists1- Introduction & background
  16. 16. … and what will I be translating? • 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 localization1- Introduction & background
  17. 17. Stakeholders & clients1- Introduction & background
  18. 18. Spectrum of points of entry PH Brochures RA + QC Drug monographs In-country validation Minimally Extremely specialized specialized ICFs Protocols1- Introduction & background
  19. 19. Medical life cycle opportunities Clinical stage R&D Regulatory Manufacturing Sales & Marketing1- Introduction & background
  20. 20. 2. Challenges & barriers to entry
  21. 21. Regional divergences • 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.)2- Challenges & barriers to entry
  22. 22. Deciphering handwritten notes Extremely common!2- Challenges & barriers to entry
  23. 23. A known problem! From an ISMP – FDA – HHS Campaign2- Challenges & barriers to entry
  24. 24. … further complicated by translation2- Challenges & barriers to entry
  25. 25. A practical example Yikes!2- Challenges & barriers to entry
  26. 26. Decoding acronyms & symbols 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, = anesthesia2- Challenges & barriers to entry
  27. 27. Understanding regulatory requirements • 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 strategy2- Challenges & barriers to entry
  28. 28. Medical terminology & jargon 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 treatment three times a day per worker’s compensation C. Transport patient to occupational therapy three times a week via wheelchair D. Transport patient to outpatient treatment three times a week via wheelchair2- Challenges & barriers to entry
  29. 29. The learning gap 1. Know your limitations 2. Learn about the regulatory environment for your country/language combinations 3. Research existing products & companies in your target language 4. Invest in your terminology 5. Never make assumptions! Check, then double check!2- Challenges & barriers to entry
  30. 30. 3. Getting it right
  31. 31. Defensive translating Part of being a good translator is knowing how to diagnose potential mistakes before you make them3- Getting it right
  32. 32. Common misinterpretations3- Getting it right
  33. 33. Faux amis – False friends 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) Suction3- Getting it right
  34. 34. Terminology shifts 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 No abbreviation available in (CMV) (--) (EL) Greek, use full term Magnetic Resonance Segulómun (MRI) Interchangeable use of full Imaging (MRI) (IS) Icelandic term and borrowed EN term3- Getting it right
  35. 35. Geographic usage Observation: Canada tends to use the verb recommander, which makes it impossible to use recommandations as the subject of the verb 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. 1-6.3- Getting it right
  36. 36. Know international standards • ICH Good Clinical Practice Guidelines How trials should be conducted, roles and responsibilities of sponsors, investigators, and monitors • Declaration of Helsinki Ethical principles on human experimentation; cornerstone document for human research ethics3- Getting it right
  37. 37. Medical usage & abusage • 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 terminology3- Getting it right
  38. 38. Translation strategies 1. Be methodical: Decode acronyms source 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?3- Getting it right
  39. 39. 4. A closer look
  40. 40. Back to our example… “Physical exam” Sometimes we see “examen objectif” => “objective exam” is a common false friend Vital signs Learn these by heart in your language(s) – along with all shorthand/abbreviations Systems Learn the organ systems and associated systematic examinations Abbreviations You will see these… all the time:4- A closer look I promise!
  41. 41. Usage 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)4- A closer look
  42. 42. Divergent medical terminology Condition Cause of English French conditionNatural sleep Sleep SommeilCondition in Hypnotism (non- Hypnosis Hypnosewhich the drug-related Synonyms:patient responds maneuvers) État hypnotiqueto suggestion État hypnoïde Narcoanalysis, Subnarcosis Subnarcose Narcosynthesis Synonyms: (Low doses of Hypnosis Narcose liminaire anesthesia) Hypnose* (not rec.)Artificial sleep, Drugs Narcosis NarcoseLoss of (somniferous Pharmacologicalconsciousness drugs, hypnosisfrom anesthesia anesthesia) Sleep* (not rec.)(deep sleep) Hypnosis* (not rec.) Hypnose* (not rec.)4- A closer look
  43. 43. Term mapping4- A closer look
  44. 44. Find your niche!4- A closer look
  45. 45. 5. Resources & standards
  46. 46. Essential print references Maxwell Quick Medical Reference Quick 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 research5- Resources & standards
  47. 47. Medical terminology Lab Tests Online Clinical lab test resource www.labtestsonline.org MediLexicon Medical abbreviations and dictionary (English with some French, German, and Spanish translations) www.medilexicon.com Medline Plus Dictionary National Library of Medicine Dictionary www.nlm.nih.gov/medlineplus/mplusdictionary.html Stanford Lay Language Dictionary Glossary of medical terms and corresponding lay terms and definitions www.humansubjects.stanford.edu/new/docs/glossary_definit ions/lay_language.pdf5- Resources & standards
  48. 48. Approved terminologyEMA – QRD IHTSDO – SNOMED MedDRAMultilingual QRD templates for Comprehensive collection of Clinically validated internationalproduct information multilingual clinical medical terminology andand packaging healthcare terminology AE dictionarywww.ema.europa.eu www.ihtsdo.org/snomed-ct www.meddramsso.com5- Resources & standards
  49. 49. Registries and term banks EU Clinical Trials Register Medline Plus Dictionary EU clinical trials registry National Library of Medicine Dictionary www.clinicaltrialsregister.eu www.nlm.nih.gov/medlineplus/mplusdiction ary.html WHO International Clinical Trials Registry Platform (ICTRP) RxList Online, multilingual international clinical Online drug index, including side effects, trials registry interactions, etc. www.who.it/ictrp/en www.rxlist.com US Clinical Trials Database EMA US registry of clinical trials in a Frequently used non-standard harmonized format abbreviations www.clinicaltrials.gov www.emea.europa.eu/htms/human/qrd/doc s/listnonstandard.pdf5- Resources & standards
  50. 50. A reference reference Tool Box for the Medical Translator by Alain Côté An absolute essential for novice or experienced translators with one of the most comprehensive compilations of resources (French – English focus) www.groupetraduction.ca/do cuments/ToolBox.pdf5- Resources & standards
  51. 51. Questions?

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