Translating Health – Italian Medical Translators Exceeding Clients’ Expectations
Our added value - optimised source texts, not just Italian translations
In our daily translation work as Translating Health team members, we often receive draft English texts, documents that have not been finalised yet, or have been drawn up in haste, probably for urgency reasons. So it is not unusual for us to spot minor problems, inaccuracies, and - rarely - even serious errors, that might compromise legibility or, worse, put patients at risk. As an integral part of our services, we regularly report these problems, with suggestions for improvement. Our clients appreciate this service very much because they understand that an external review from an expert who has not been involved in the text creation process can be precious. The following are a few examples of issues we came across in our daily translation activities.
Text production issues
The most common types of problems we encounter are of ‘physical’ nature. In fact, it is not uncommon for an author to make mistakes during operations such as Cut & Paste or Delete. He or she may have forgotten to make appropriate changes after rearranging a sentence, or deleted too many or too few words.1
For example, in a GP letter we translated some time ago, we came across a list of adverse events that had been fully copied and pasted from an Informed Consent Form (ICF). Clearly, the author had forgotten to adapt it to the target reader, leaving explanations in parentheses that would be unnecessary for a general practitioner, e.g. ‘anaemia (a medical condition that can reduce the number of red blood cells)’. Obviously, a GP would not need this kind of clarification.
Clinical trial documents are often written by authors that are not using their mother tongue. Although investigators in general have an excellent command of their 2nd language, probably because they spend long periods abroad, they may occasionally stumble over 'false friends’, i.e. words that look similar in two languages but mean different things.
Some time ago, for example, we translated a protocol synopsis that had clearly been written by an Italian author, and we came across the following sentence:
The 5-year overall survival of the whole series was 48.5% […], slightly higher than expected, probably due to the consistent percentage of node-negative patients included.
Being Italian, we immediately understood that something was wrong about the word ‘consistent’. The author actually meant ‘a high, considerable percentage’, but had been misled by the Italian ‘consistente’, which indeed means ‘considerable’, whereas the English word ‘consistent’ means ‘coherent’. A typical faux ami. After asking for confirmation about the author’s intended meaning, we translated as ‘percentuale consistente di pazienti’, and the investigator thanked us for reporting the problem, so he could correct the source text as well.
Numbers, data, etc.
When we translate clinical trial protocols and ICFs, we often have to deal with numbers, doses, percentages, schedule charts, and so on. We are all sticklers for data, we inspect each and every figure, and it is not unusual for us to spot numerical inconsistences. In those cases, we go back to the customer and suggest to double-check.
Some of our clients sometimes challenge us with very complex sentences, with potentially ambiguous meanings. This is often the case in the contraception paragraph of ICFs, where you must take extra care, also to avoid hurting patients’ sensitivity:
If you or your partner can become pregnant, each one of you should use effective birth control methods every time you have sex.
In this case, we contacted the client. Considering that, as of today, pregnancies are still a women's business only… in our view it would have been better to change the sentence to something like:
If there is a pregnancy risk, both you and your partner should use effective birth control methods every time you have sex.
On some occasions we also encounter conceptual problems. For example, we recently spotted ‘Bilateral tubal occlusion’ in a list of exclusion criteria, which was a misleading expression. In fact, ‘occlusion’ can also be an anatomic tubal defect, whereas the trial design actually meant to exclude patients who had undergone a tubal sterilisation procedure.
After we proposed our interpretation to the client (a CRO), the Sponsor approved our suggestion for improvement (replacing ‘occlusion’ with ‘ligation’, which is still the most common sterilisation procedure), and was very pleased with our work.
Leaving actual errors aside, source texts often include cultural-specific concepts that require a different kind of changes/interventions. The most common examples are references to foreign regulatory agencies or committees, that must be localized with European/Italian equivalents. So for instance, after carefully evaluating the context and double-checking with the client, we often replace FDA with AIFA – the Italian medicines agency - , and IRB with Ethical Committee.
That is rather straightforward, but, in some cases, replacing names with country-specific equivalents is not enough. When we translate foreign Safety Data Sheets (SDSs) into Italian, for example, we often encounter references to foreign legislation (e.g. for US or Canadian products), which must either be adapted or localised.
Moreover, when we find the contact data of local poison centres, we do not simply suggest the client to replace the original names and addresses with those of the local Italian ‘centri antiveleni’, but we remind them that, according to ECHA Guidelines, poison centres must be contacted beforehand to submit information on the hazardous mixtures the SDS refers to2. So in these cases we go the extra mile, and our clients do appreciate that.
Italian translators exceeding clients’ expectations
To conclude, as the Italian writer Italo Calvino said, ‘Translating is the real way to read a text. […] For an author, reflecting on the translation of a text he has written, discussing it with the translator, is the real way to read his own work, to understand what he has written and why.’3,4 We couldn’t agree more, and, as medical translators, we are proud to help writers and clients optimise their work.
Maria Luisa Barbano, Translating Health
1. Brian Mossop, Understanding Poorly Written Source Texts, Terminology Update, Volume 28, Number 2, 1995, page 4.
2. Silvia Barra, La traduzione per l’industria chimica, 2019.
3. Italo Calvino, Tradurre è il vero modo di leggere un testo, in Saggi, vol. III, Meridiani Mondadori 1995).
4. Prof. Shlomit Yanisky - Ravid and Cynthia Martens, From the Myth of Babel to Google Translate: Confronting Malicious Use of Artificial Intelligence - Copyright and Algorithmic Biases in Online Translation Systems.
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