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An example is the translation of |Pericardium| to Norwegian (Figure 11). Medical dictionaries and encyclopedias list “perikard” and “hjertesekk” (literally “heart sac”) as synonyms and valid translations. For most practical uses, this would be true. However, the translator should keep in mind the fine granularity of the SNOMED CT concept hierarchy, in which the |Pericardium| is a superordinate concept that includes several subordinate concepts, including the |Pericardial sac|. Considering the concepts in the hierarchy, the proper translation of |Pericardium| is “perikard”, while “hjertesekk” is equivalent to |Pericardial sac|.
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SNOMED CT translations are required for the implementation of the terminology in non-English speaking countries. The most important goal when translating is to ensure semantic equivalence between the source (International Release) and target language (National Releases). Therefore the principle of concept-based translation must be applied: Translations should never be literal (i.e. should not start from the term to be translated), but should always be based on the Fully Specified Name (FSN), which describes the meaning of the term in natural language. The next step is to look at the position of the concept in the ontology (i.e. the formal concept model) to investigate the formal definition of the concept
An example is the translation of |Pericardium| to Norwegian (Figure 11). Medical dictionaries and encyclopedias list “perikard” and “hjertesekk” (literally “heart sac”) as synonyms and valid translations. For most practical uses, this would be true. However, the translator should keep in mind the fine granularity of the SNOMED CT concept hierarchy, in which the |Pericardium| is a superordinate concept that includes several subordinate concepts, including the |Pericardial sac|. Considering the concepts in the hierarchy, the proper translation of |Pericardium| is “perikard”, while “hjertesekk” is equivalent to |Pericardial sac|.
Figure 11 – Example of concept-based vs literal translation approach
For each target language national linguistic guidelines, including syntactic, morphological and orthographic rules, are developed to support this approach
SNOMED CT is a comprehensive terminology designed to meet the needs of a broad group of health care professionals in a range of settings. Translations should comply with the principles on which SNOMED CT was originally based:understandability, reproducibility and usefulness (URU). Therefore, the translation should adhere to the principles elaborated by Terminology Science for useable terms: terms should be transparent and reflect the essential characteristics of the designated concept; terms should satisfy the requirements of the users’ needs, i.e. they should be in accordance with clinical usage and they must be equally well understood by the different health professionals who use them. For each target language
4.1 Basic approach
In practice, this means that a number of basic principles must be followed with regard to the morpho-syntactic structure of terms to ensure consistency, but in cases where there are serious conflicts with everyday clinical language, clinical use should have priority.
The following sections address the main issues that translators may face. The goal of any translation is to achieve consistent, usable, and clinically acceptable translation equivalents in the target language.
4.1.1 The principle of concept based translation
The translation of complex terms requires a relatively high level of domain knowledge to ensure that each translation (term or phrase) is an accurate representation of the original concept. Therefore, the translation team must carefully check that the meaning of each source concept is clearly understood, including the hierarchical position of the concept and its relationship to other concepts. In Dutch, for example, the literal translation of the English term “arthrosis” without prior analysis of its meaning (“disorder of one or more joints”) generates the incorrect term “arthrosis”( which is the Dutch term for |Osteoarthritis|) instead of the correct concept-based translation "arthropathie".
It is recommended to follow the translation workflow steps illustrated in Figure 12:
Figure 12 – Recommended translation workflow steps
4.2 General linguistic principles
The following paragraphs deal with general aspects of translation that are relevant for all languages.
For each target language, national linguistic guidelines, including syntactic, morphological and orthographic rules, must be provided to describe the specific rules of the target language.are developed to support this approach
4.
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Since the target group of the national edition of SNOMED CT are professionals, high quality language for specific purposes terms should prevail. It is recommended to establish some preliminary general principles for the choice of lexical variants before starting the translation work.
In Danish and German, for example, it is common to use pure Latin or Greek in the field of anatomy, while diagnostic terms or terms describing procedures are often hybrids or mixed forms (so called neoclassical compounds such as gastroenteritis and mammography), or, in some cases, also general language terms.
Colloquial expressions (medical slang words such as blue pipes for veins or cabbage for a coronary artery bypass graft or CABG) should be avoided; if needed, they can be added as synonyms.
Recommendations or guidelines issued by a national language council, authority or body should generally be followed. However, it may be necessary to formulate specific morphological and spelling rules that apply to the terminology of the target language. Specific practices related to the construction of medical terms published in national medical journals should also be taken into account.
4.2.2 Ambiguities in the source language
As mentioned in the previous sections, all translations should start with a thorough analysis of the conceptual meaning of the FSN and the concept's formal definition.
It is possible that the conceptual meaning is not correctly reflected by the formal definition in the International Edition. In this case, it is recommended that the NRC reports the error to SNOMED International via the Content Request Service (CRS) (http://snomed.org/crs). Licensed organisations from non-member countries can report directly through CRS. Issues can also be raised for discussion in the JIRA SNOMED CT Translation Feedback Group prior to submitting a CRS request to see how the concept's meaning has been interpreted in other countries. The correct translation can then be produced after a response is received.
4.2.3 Selection of the right term
The term (i.e. a word, a group of words or compound, or an expression) is the essential component of communication in a specialised subject field. The primary meaning in a language for specific purposes is therefore conveyed in its specialised vocabulary, which should consist of terms that meet the following requirements:
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1 Basic approach
Interdisciplinary cooperation in terminology work is crucial (Infoterm 2005). The ideal approach to the translation process should therefore be close collaboration between healthcare professionals, terminologists, linguists, and professional translators. This ensures conceptual equivalence between source and target terms and linguistic correctness. In contrast, literal term-based translations based on purely linguistic morphologic-syntactic analysis may provide terms that appear correct at first glance, but which do not correctly reflect the true meaning of the underlying concept. At the same time, the observance of linguistic, systematic and orthographic principles is absolutely necessary to ensure the consistency and practicability of the terminology as well as the predictability of the translations, which improves findabilityIn practice, this means that a number of basic principles must be followed with regard to the morpho-syntactic structure of terms to ensure consistency, but in cases where there are serious conflicts with everyday clinical language, clinical use should have priority.
In practice, this means that a number of basic principles must be followed with regard to the morpho-syntactic structure of terms to ensure consistency, but in cases where there are serious conflicts with everyday clinical language, clinical use should have priority.
The following sections address the main issues that translators may face. The goal of any translation is to achieve consistent, usable, and clinically acceptable translation equivalents in the target language.
4.1.1 The principle of concept based translation
The translation of complex terms requires a relatively high level of domain knowledge to ensure that each translation (term or phrase) is an accurate representation of the original concept. Therefore, the translation team must carefully check that the meaning of each source concept is clearly understood, including the hierarchical position of the concept and its relationship to other concepts. In Dutch, for example, the literal translation of the English term “arthrosis” without prior analysis of its meaning (“disorder of one or more joints”) generates the incorrect term “arthrosis”( which is the Dutch term for |Osteoarthritis|) instead of the correct concept-based translation "arthropathie".
It is recommended to follow the translation workflow steps illustrated in Figure 12:
Figure 12 – Recommended translation workflow steps
4.2 General linguistic principles
The following paragraphs deal with general aspects of translation that are relevant for all languages.
For each target language, national linguistic guidelines, including syntactic, morphological and orthographic rules, must be provided to describe the specific rules of the target language.
4.2.1 Language for Specific Purposes
Since the target group of the national edition of SNOMED CT are professionals, high quality language for specific purposes terms should prevail. It is recommended to establish some preliminary general principles for the choice of lexical variants before starting the translation work.
In Danish and German, for example, it is common to use pure Latin or Greek in the field of anatomy, while diagnostic terms or terms describing procedures are often hybrids or mixed forms (so called neoclassical compounds such as gastroenteritis and mammography), or, in some cases, also general language terms.
Colloquial expressions (medical slang words such as blue pipes for veins or cabbage for a coronary artery bypass graft or CABG) should be avoided; if needed, they can be added as synonyms.
Recommendations or guidelines issued by a national language council, authority or body should generally be followed. However, it may be necessary to formulate specific morphological and spelling rules that apply to the terminology of the target language. Specific practices related to the construction of medical terms published in national medical journals should also be taken into account.
4.2.2 Ambiguities in the source language
As mentioned in the previous sections, all translations should start with a thorough analysis of the conceptual meaning of the FSN and the concept's formal definition.
It is possible that the conceptual meaning is not correctly reflected by the formal definition in the International Edition. In this case, it is recommended that the NRC reports the error to SNOMED International via the Content Request Service (CRS) (http://snomed.org/crs). Licensed organisations from non-member countries can report directly through CRS. Issues can also be raised for discussion in the JIRA SNOMED CT Translation Feedback Group prior to submitting a CRS request to see how the concept's meaning has been interpreted in other countries. The correct translation can then be produced after a response is received.
4.2.3 Selection of the right term
The term (i.e. a word, a group of words or compound, or an expression) is the essential component of communication in a specialised subject field. The primary meaning in a language for specific purposes is therefore conveyed in its specialised vocabulary, which should consist of terms that meet the following requirements:
- Unambiguity: the term should be understood in the same way by any professional that uses it.
- Linguistic accuracy: a term should conform to the language-specific morphological, syntactic, orthographical and phonotactic conventions.
- Transparency/motivation: a term should be systematic and self-explanatory, i.e. it should reflect the characteristics of the underlying concept.
- International recognizability: terms based on Latin and Greek word elements may be preferred; e.g. universal scientific terms such as “hepatocystis”, “nephritis”, “appendectomy”, “hepatitis”, etc.).
- Psychological acceptability: term usability should be taken into account whenever possible (in accordance with the rules of standard language, and not slang).
- Systematicity and consistency: semantically similar concepts should be expressed by terms with similar morphological and syntactical structures. It may be interesting to consider the use of translation templates to enhance consistency of translation across similar concepts (see Section 4.3).
- Conciseness: a term should be concise and in keeping with the principle of linguistic One should be aware that descriptions of the type FSN and Synonym are technically limited to 255 characters (definitions are limited to 4096 characters).
These general requirements apply to all specialized knowledge fields, including medicine. When translating the clinical terminology SNOMED CT the equivalents in the target language should be carefully selected, especially with regard to the Fully Specified Names (FSNs) and the Preferred Terms (PTs) intended for clinical use. The terminological rules for well-formed terms are less strict with regard to Acceptable Synonyms that may reflect clinical jargon (e.g. the language use of clinical care providers, specialists, nurses, physiotherapists, and others) and support search queries (e.g. “heart attack” as synonym for “myocardial infarction”).
However, it is important that only full (and not near) synonyms are made available. For instance, it is not helpful for understanding/translating a concept if the PT of one concept is the synonym of another (within the same hierarchy). There should be a balance between expressivity on the one hand (through sufficient synonym coverage) and accuracy on the other
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In terminological practice, it is not possible to meet all requirements simultaneously in any language. Psychological acceptance, in particular, often hampers compliance with some of the principles. For example, commonly used eponyms such as “Apgar Score” or “Down's Syndrome” contradict the search for transparency and also challenge the principles of international recognition. Also the simultaneous use of different term types for the same concept (e.g. terms consisting of noun + noun vs. noun + prepositional phrase vs. noun + adjective combinations) challenge systematicity and consistency (e.g. “incision of brain” vs “intracerebral incision”).
The creation of language-specific rules for the translation of SNOMED CT should therefore be carried out with the greatest possible thoroughness and care and should take into account not only linguistic and terminological aspects but also psychological ones. The needs and expectations of the users remain the primary concern and clinical acceptance of the terminology is of crucial importance.
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