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Background

SNOMED CT (Systematized Nomenclature of Medicine Clinical Terms) is a comprehensive clinical terminology used to code, query and analyze health data. The terminology system is maintained and distributed by SNOMED International, the trading name of the International Health Terminology Standards Development Organisation (IHTSDO), established in 2007.

SNOMED CT provides a basis on which health care organisations can plan and document health care processes, conduct outcome research, analyze health care quality and costs, and develop effective treatment recommendations. It is the result of the merger of SNOMED RT (Reference Terminology) and Clinical Terms Version 3. The terminology includes the concepts, terms and relationships necessary to accurately represent clinical information across the healthcare system. SNOMED CT contains more than 350,000 active concepts. Each concept can be represented by several descriptions. There are three types of Descriptions: Fully Specified Name (FSN), Synonym (Syn)  and Definition. The concepts are arranged in concept classes with different meanings called hierarchies, covering information required in a health record such as symptoms and signs, disorders, operations, treatments, medication, administrative elements, etc.

Purpose and scope of this document

The present guidelines are based on the SNOMED International Editorial Guide (http://snomed.org/eg) and are intended for translators of SNOMED CT. They have been developed by the members of the Translation User Group and summarise the main editorial principles of SNOMED International. They can be used as a starting point for the development of national guidelines for the translation of SNOMED CT from English into the national languages of the SNOMED CT member countries. Additional information on editorial rules can be found in the Confluence editorial templates (https://confluence.ihtsdotools.org/display/SCTEMPLATES/SCT+Modeling+Templates+and+description+patterns).

The present document is to be used in conjunction with the current version of the Guidelines for Management of Translation of SNOMED CT (see SNOMED CT Document Library https://confluence.ihtsdotools.org/display/DOC/SNOMED+CT+Document+Library) which contain recommendations for managing a translation project. Suggestions for amendments or additions to these guidelines should be sent to info@snomed.org.

It is essential that those involved in translation of SNOMED CT concepts and in the verification, validation and approval processes of new national descriptions are familiar with the terminological principles on which SNOMED CT is based. It is equally important that the translation work complies with the SNOMED CT Editorial Guide and that translators are aware of issues such as how to select terms and lexical variants, how to use the appropriate translation technique, and how to ensure linguistic consistency.

The present document also contains general recommendations on the steps involved in a translation workflow process, as well as information on source documents and references that are useful during translation.

Assessment of translation quality

Translation project owners (TPOs) should ensure that translations comply with the principles on which SNOMED CT was originally based: understandability, reproducibility and usefulness (URU). Understandable means that the meaning of a concept can be understood by most healthcare providers without reference to private or inaccessible information; reproducible means that several users apply the concept to the same situations; useful means that the concept has a practical value for the users that is self-evident or can be easily explained. Furthermore, the information contained in the translated concepts must be semantically equivalent to the information contained in the core source terminology (International Release). SNOMED International has developed a document that describes how to assess the quality of the translation and the degree of consistency. The document entitled A methodology and toolkit for evaluating SNOMED CT translation quality (2012) outlines and defines a set of requirements or “quality characteristics” (QCs) and related metrics.

There are three types of QCs for assessing translation quality:

• Structural QCs, which cover the management and organization of the translation project;
• Process QCs, which refer to the activities during the actual translation process;
• Result QCs, which refer to the translation result in the target language.

In this document, a shortlist of (9) QCs is drawn up and for each QC quality score (what and how to measure, how to evaluate, etc.) there are sample questionnaires (to support the evaluation) as well as a general “rating”.

It is recommended that TPOs refer to Annex A of the current document and to the Methodology and Toolkit document to ensure that they include all quality metrics identified as mandatory for use in their project and quality plans. Metrics for measuring translation quality can be reformulated as contractual clauses in formal agreements between a TPO and a Translation Service Provider (TSP) on the services to be provided and the level of service.

Change requests

Requests about inconsistencies, errors or proposed changes to the core terminology (International Release) should be submitted through Content Request Service (CRS) (https://confluence.ihtsdotools.org/display/SCTCR/Accessing+CRS).

Target group

The target group of this document are all persons directly involved in the translation of SNOMED CT into another language, i.e. translators, reviewers, domain experts, validators as well as managers and members of an editorial board or equivalent group of experts who define the linguistic and terminological guidelines for the specific translation of the target language.