Medical and Pharmaceutical Translation

Need – Challenges and Risks in Medical Translation

The need for medical translation is felt in an array of situations. Pharma companies and CROs have a worldwide outreach for their medicines and must make all literature about the production and use available to people in different languages. Manufacturers of medical equipment have a competitive advantage when their literature is translated in different languages. Doctors and medical professionals need to treat and interact with patients of different cultures and linguistic backgrounds.

Health Perspective of Medical Document Translation

Patients may have allergies which must be correctly understood by the doctors, without ambiguity. Medical reports and medical histories require accuracy because the diagnosis and treatment can make a difference between life and death. Manufacturing and assembly manuals can go awry if not translated correctly or if misinterpreted by the translator.

Just as a good diagnosis is essential in administering the right treatment for a disease, so also, an accurate rendition of the same is equally crucial in a multilingual situation. Translation of prescriptions, medical and consent forms require a great deal of care and attention. Allergies to particular substances or drugs must be correctly understood, interpreted and reported.

Any error can lead to the wrong choice of treatment or course of medication, which may not have otherwise been the intention of the doctor, patient or health-care professional. 

Legal and Financial Implications of Medical Translation

Errors in translation have clinical consequences including health or life hazard. They can lead to serious financial claims and lawsuits. Stakes are so high in medical translation, that it is worth investing a higher price to ensure that a translation is 100% accurate.

Types of Medical Documents for Translation

There is a broad range of documents when we speak of medical translations. The following is an exhaustive list of documents that we include within its scope.
● application dossiers
● registrations for new medicines and devices
● instructions manuals for medical equipment
● health surveys
● consent forms, posters, leaflets, brochures
● clinical trials
● clinical protocols
● manufacturing process descriptions
● production manuals
● pharmacological studies
● articles in scientific journals
● regulatory documents
● patents for drugs and vaccines

Examples of Errors in Medical Translation

Below are some examples of translations that can go seriously wrong.

While translating from Portuguese to English, «déficit cognitivo ligeiro» has many times been incorrectly translated as «light dementia» while the right term should be: «mild dementia». This happens because «ligeiro» gets literally translated to «light».

Another example is from Hungarian. The term ‘drug’ translated as «drog» or «kábítószer» which refer to illicit drugs like LSD, heroin, cocaine, etc. The correct translation is «gyógyszer» which means medicine, used for healing people.

In translating from French to English, for instance, an « otorhinolaryngologue » must be translated as «ENT (ear nose throat) physician». The word is Latin based in French use, but not always in English (depending on the target audience).

A common error in English to Korean is for the term «chronic renal failure». It should be translated as «만성 신부전», but is sometimes translated as «만성 신기능 상실». This happens due to the meaning of the Korean word «부전» which means imperfection, and is quite similar in meaning to «기능 상실», which actually means loss of function.

In Japanese, «高糖» is an incorrect choice for «diabetes». The appropriate word for diabetes is «糖尿病».

Fig.1: Common Errors in Medical Translation

While translating from English to Turkish for example, measurement units like “mL” need to be converted to “ml”. We also change the place of “%” like “%4” for “4%”. These are important when one is working on license files as everything is based largely on numbers.

Qualifications for Medical Translation

Considering the complexity and highly technical nature of medical translation, it requires a corresponding level of specialization. The two focal components are qualification and specialisation in medical translation. Education in the area of medicine is undoubtedly an added advantage. 

The translator should be a qualified professional linguist. Next, they should specialise in medical translation. Often, medical practitioners with linguistic qualifications also assume the role of medical translators. They can also play the role of consultants, lexicographers (for glossary generation) or reviewers within the process of translation.

For medical interpreters, knowledge of medical mediation is essential.

Ongoing Training for Medical Translation

In reality, the number of qualified and specialised medical translators is far less than the need. Medical translations will perforce be done by non-medicos. From within the industry, there is a need to train and develop the skills required for this wing of translation. Ongoing education and research on the part of agencies and translators has grown. This needs to be regulated and monitored.

Quality Control in Medical Translation – Method over Person

Quality control is an aspect of vital significance in medical translation. Detection of errors is critical. It is necessary to make medical translation more process driven and less dependent on the individual translator. Translation companies need to stress not only on training and qualification, but also verification and review.

Quality Management – Practices, Methods and Procedures in Medical Translation

Methods, processes and procedures are crucial, both in science and translation. Especially in medical translation. The field of medicine itself is vast. It is not always possible to have translators with the right combination of qualifications and specialisation. What then are the ways to ensure accuracy and quality in medical translation? A multi-pronged approach may be necessary. The various aspects and practices are discussed here.

Selection of Medical Translators

This is by far the most fundamental quality control measure. Identifying and selecting the right fit for the requirement obviates effort in review,  Verification and correction. Translators should be qualified linguists and specialise in medical and pharmaceuticals. [Also read an article about who makes a good translator, here.]

Pre-Translation Preparation and Post- Translation Verification

Medical translation must have multiple levels of control and error detection. A typical translation process will follow the following stages:   

1. Preparation (Pre-Translation)
1. preparation of glossary
2. consultation, reference and research
3. conceptual debrief
2. Translation
3. Verification (Post-Translation)
1. review and reconciliation
2. proofreading
3. review for legal compliance with local laws

Engaging Medical Professionals in the Process

A physician or medical professional must form part of the process in at least one phase of the process. Below is a schematic representation of the various possibilities of where and how a medico contributes to the quality check. They can either be the consultant for glossary development or participate in a debrief at the pre-translation stage. They could be the translators themselves, or review, vet and validate a translation.

Figure 2: Medical Translation Process Options

Lexicographical Consultation, Reference and Research

Medicine being a vast area of knowledge, translator must continue to research glossaries, dictionaries and other reference material. The process of translation especially in the medical field is one of ongoing education. Translators require access to ready references to concepts and terms. One such online medical dictionary available easily is the Harvard Medical School’s medical dictionary. [See here.]

Translation Style, Conventions and Guidelines

There is no room for ambiguity in medical translation. Translators should in the first instance self-assess their capability to participate in such translation activity. One should avoid idiomatic use of language as much as possible. Medical translation is a highly technical and scientific subject, and figurative use of language can be completely avoided. Word-for-word translation is to be avoided and sense-for- sense translation is to be adopted. 

Client debriefs are of great consequence. Clients can have their own guidelines, conventions and preferences, which need to be shared with the translation team. When no documented guidelines are available, an agency MUST develop a glossary and a list of queries, and run it by the client. A structured list of queries and terms validated by the client goes a long way in avoiding rework. 

It is important to develop a glossary overtime. Conventions should be agreed upon for acronyms and highly technical words, for which equivalents are not available in the target language. Translators’ associations could consider transliteration or borrowing of terms from the source language into the target text. They should check medical symbols and special characters.

Back Translation (Reverse Translation)

Back translation is a way to verify a translation, whereby a translated text is translated by another person back into the source language and then compared with the original source text. Any distance between the original and back-translated text will reveal shortfalls. 

This method may not actually be a very reliable method. There could be an error in the reverse translation and hence may not necessarily reflect errors in the original translation.

Secondly, idiomatic expressions that the first translator may have correctly conveyed in the target text may have been literally translated during reverse translation. The same applies for cultural adaptations of technical terms.

Parallel Translation and Reconciliation

This method is more suited in locating and removing errors in translation. The process entails the translation by two independent translators, which are reviewed by a third translator, who reconciles the differences. This takes place in  close collaboration with each other to even out differences of opinion and rule out ambiguity. 

Regulatory Compliance in Medical Translation

Clinical protocols require statutory compliance. Medical translators (or reviewers) are expected to have knowledge of local laws, regulations and statutory compliances. If not all translators, at least one such consultant must be present on the team. 

Medical Translation At WordPar International

At WordPar we painstakingly take steps to implement best practices as mentioned above. The hallmarks of our medical translation processes are research, regulatory compliance and subject matter expertise. Our team of translators include life science professionals, specialised translators and legal consultants. Our clients include CROs, pharma and biotechnology companies.

Expectations of clients may vary depending on the implications and intended audience of the translation. Simple consent forms and advisories may require lesser levels of review than a clinical trial report. The levels of verification are discussed before a project plan and cost estimate are prepared.

We work hand-in-hand with our clients to assess their needs and explain to them the benefits of investing in accurate and quality translation considering the risks of error and the advantages of good translation.