Guidance on which descriptions to translate

So let me kick off! I think this question can be interpreted in two ways: which English descriptions do you use as source, and which description types do you create as translations?

On the second score: In the Netherlands we decided at first to merely create a Dutch preferred term and optionally add synonyms. As the FSN is not shown to end users and all Dutch people who are likely to see the FSN, speak English to some extent, we figured there was no need for a separate Dutch FSN.

However, when we switched to TermSpace, it was recommended (and easier) to start creating Dutch FSNs as well. And we have noticed it does have the following benefits:

1. We can check for identical FSN's. With this check and our current rate of translation, we are detecting 5 to 10 duplicate concepts per week now. 
2. We are pretty rigid about following our own translation guidelines (e.g. no acronyms) in the FSN, then put whatever is most recognisable (CT-scan) in the PT. 

Adding synonyms, we discovered, can in some instances be less work than not adding them. It is frankly impossible to find a description that is preferred for all medical specialisations in the Netherlands. The GP's and nurses use a vocabulary that differs enormously from the hospital-based specialists. With synonyms you can ensure that everyone can at least find their term, even if the preferred term is not what they'd call it, and it saves a lot of debate  So I would strongly advise against creating only a preferred term. The end result won't be nearly as useful.

So in the end, I recommend creating at least a preferred term and synonyms, and I think creating an FSN is scarcely more effort and brings a number of benefits. 

As for which English descriptions we use as source: we have found many cases where English synonyms do not mean quite the same as the FSN, preferred term and definition. In quite a few of these cases, Snomed contained another concept that they should have been synonym of. So I would not advise someone to translate every synonym. Besides, not every English term has its equivalent in Dutch, and those languages are closely related: you couldn't do it if you wanted to.

On the other hand, sometimes synonyms help us to interpret the concept. E.g. in the case of eponyms, which can be obscure or on the other hand much more well-known than the descriptive FSN. So I wouldn't ignore them either. 

Finally, sometimes a single word in English has two or three synonymous ways to express it in Dutch. So what we do is: we use all descriptions and the concept's definition to determine the meaning. Then we create the FSN based on our translation guidelines, add all descriptions which are commonly used in Dutch healthcare to denote the concept, and make the most usual term preferred. That means sometimes we have 0 synonyms where the core has 6, and sometimes we have 6 synonyms where th core has 0. We use all English descriptions, but only to interpret the concept.