S

What you need in your first-aid kit:

How to survive abbreviations, symbols, and acronyms in medical translation

Sixth Annual ProZ.com Training and Conference – France

September 27th and 28th 2013 – Biarritz, France Erin M. Lyonsbiomednouvelle.com

Objectives

1. To identify strategies to dissect, expand, and re-contract medical abbreviations and acronyms to produce accurate translations;

2. To build a personalized “first-aid kit” of resources to research unknown medical terms and symbols;

3. To define strategies to create and maintain a medical term and symbol glossary across multiple language combinations.

QuizDrag picture to placeholder or click icon to add

Drag picture to placeholder or click icon to add

Drag picture to placeholder or click icon to add

1. In which of the following is the capitalization correct?

A. nairobi sheep disease

B. Nairobi sheep disease

C. nairobi Sheep Disease

D.Nairobi Sheep Disease

2. Which of the following is NOT a standard abbreviation of a word appearing in a journal title?

A. “Arch” for “Archives”

B. “Epidem” for “Epidemiology”

C. “Pharm” for “Pharmaceutical”

D. “Soc” for “Society”

***Epidemio

l is correct

***

3. Which of the following is defined correctly?

A. ATP: adenine tetrapyruvate

B. FUO: fatality of unknown origin

C. CPR: cardiopneumatic resuscitation

D. PET: position emission tomography

ATP is adenosine

triphosphate

fever of unknown

origin

cardiopulmonary resuscitation

4. To which common lab values do these numbers refer?

A. Reticulocyte count – Bleeding time – BUN

B. Red blood cells – Hematocrit – White blood cells

C. White blood cells – Haemoglobin - Platelets

D. Sodium – Chloride – BUN

5. R/O HIV & flu means:

A. Rule out human immunodeficiency virus and influenza

B. Rule out human intestinal virus and fluid restriction

C. Reduce output of hepatic intravenous volume and fluid restriction

D. Resume order of hepatic intravenous volume and fluid restriction

Getting

our feet wet

Drag picture to placeholder or click icon to add

Drag picture to placeholder or click icon to add

Drag picture to placeholder or click icon to add

Alphabet soup

A convenient time and space saver

A way to avoid potentiallymisspelling long, complicated words

Inherent problems

Various meanings of a single abbreviation OD can mean once daily, right eye (oculus dexter),

occupational disease, overdose, etc.

Various expressions of a single abbreviation AP, A.P., ap, and A/P all mean “anteroposterior”

Misinterpretation of handwriting/ambiguities

Wasted time researching

Abbreviations

Abbreviations are the shortened form of a word or phrase

Paediatr. = paediatrics

Infect. = infection

Not so fast!

Which is right Dr or Dr.?

In British English, abbreviations omit the period if the words end in the same letter as the full term. American English always uses the period.

pt = part (UK) vs. pt. = part (US)

clin. (UK) and (US) clinical

Initialisms and Acronyms

Initialisms are abbreviations consisting of the first letter of each word:

CSF = cerebrospinal fluid

Acronyms are initialisms pronounced

as words:

NICU = neonatal intensive care unit

Just to keep things interesting

Sometimes the abbreviation consists of selected letters from one long word or phrase

CMV = cytomegalovirus

JUPITER = justification for the use of statins in prevention: an intervention

trial evaluating rosuvastatinVery common for clinical trial

titles

… and keep you on your toes

Wait, is an electrocardiogram an EKG or an ECG?

Doctors have infamously bad handwriting:

ECG could be confused with EEGelectroencephalogram

electrocardiogram

Chicken scratches

Potential for disaster

A poorly written order for the diabetic medication, AVANDIA, bears a strong resemblance to the oral anticoagulant, COUMADIN.

The potential for this potentially disastrous medication substitution is accentuated by the fact that both drugs are available as 4 mg oral tablets.

Avandia 4 mg PO [per os = by mouth/orally]

qid [quater in die = four times per day]

Oy vey!

Handwritten abbreviations are easily misinterpreted:

Three drops in ® ear“right ear” misinterpreted as “rear”

HCT 250 mg (hydrocortisone 250 mg)

OR“HCTZ 50 mg” (hydrochlorothiazide 50

mg)

Essential translation strategy

Methodology:

source expanded source

expanded target target acronym

Inversions

Grammar dictates the order of nouns and adjectives, meaning acronyms in different languages often contain the same letters in a different order

AIDS (acquired immunodeficiency syndrome)

SIDA

(syndrome de l'immunodéficience acquise)

More inversion examples

English Acronym

English Expansion

French Acronym

French Expansion

MRI Magnetic Resonance

Imaging

IRM Imagerie par résonance

magnétique

TIA Transient Ischemic Attack

AIT Accident ischémique transitoire

CPR Cardiopulmonary resuscitation

RCP Réanimation cardio-pulmonaire

HJR Hepatojugular Reflux

RHJ Reflux hépato-jugulaire

Abandon ship

Some languages favor Latin-derived terms over the equivalents of English acronyms

CBC (complete blood count) Hémogramme (rather than NFS = numération et formule sanguine)

SOB (shortness of breath) Dyspnée

Sound-based acronyms

Some abbreviations are pronounced – allowing faster communication, but are the origin of potential errors: RALES (Randomized Aldactone Evaluation Study)

Easily misunderstood as “rales” = crackles or crepitant rales during pulmonary auscultation

CABG (coronary artery bypass graft), pronounced “cabbage” and commonly known as “bypass surgery”

le pontage aorto-coronarien (PAC) or CABG

il bypass aorto-coronarico (BAC) or CABG or cabbage

Medical argot

Less common in written communications, but still a reality of the medical profession—ranging from the painfully derogatory to more humorous and colloquial usages

VIP = very intoxicated person VCV = Very Close Veins = varicose veins TEETH = tried everything else, try homeopathy DCD (décédé) = dead PPH (ne passera pas l’hiver) = won’t make it through winter

A matter of numbers

Sometimes the number of units making up an acronym vary from one language to the next:English French Italian

Esophagogastro-duodenoscopy

(EGD)

Fibroscopie œsogastro-

duodénale (FOGD)

Esofago-Gastro-Duodeno-Scopia

(EGDS)

Multiple Sclerosis (MS)

Sclérose En Plaques (SEP)

Sclerosi Multipla (MS)

Right Bundle Branch Block

(RBBB)

Bloc de Branche Droit (BBD)

Blocco di Branca Sinistra (BBS)

Urinary Tract Infection (UTI)

Infection Urinaire (IU)

Infezione delle Vie Urinarie (IVU)

English retained in foreign text

Many common medical abbreviations and acronyms are normally left in English

when translating: BUN (Blood Urea Nitrogen)

EGF (Epidermal Growth Factor)

OKT4/OKT8 (euphemism for HIV+)

PSA (Prostate Specific Antigen)

TNF (Tumoral Necrosis Factor)

It’s all Greek to me! (Or, Latin)

In particular, prescriptions are known to be full of Latin-derived abbreviations

BID = bis en die (Latin) = twice a day h.s. = hora somni = at bedtime Q = quaque = every s.a. = secundum artum = use your

judgment ung. = unguentum = ointment

** These may be left in Latin and/or translated **

British vs. American Spelling

British and American spelling differences atthe beginning of words add to complexity Gastro-oesophageal Reflux Disease (GORD) (UK)

Gastroesophageal Reflux Disease (GERD) (US)

Oestrogen-replacement Therapy (ORT) (UK) Estrogen-replacement Therapy (ERT) (US)

Lower Extremity Oedema (LEO) (UK) Lower Extremity Edema (LEE) (US)

Uncertain Aetiology (US) (UK) Uncertain Etiology (UE) (US)

Symbols, shorthand, and signs

Some common symbols in medical reports:

* = birth, † = death ʌ = diastolic blood pressure, v = systolic pressure ā = before, = after = start of operation, = end of operation Ψ = psychologist () = possibly significant = right upper quadrant = plantar response, = extensor response M = murmur fʒ = fluid ounce # = fracture = pulse rate, = anesthesia

Getting to the

source

Drag picture to placeholder or click icon to add

Drag picture to placeholder or click icon to add

Drag picture to placeholder or click icon to add

Start with the source

Try to expand the source acronym

Look for clues in the source document

Search specialized dictionaries/term bases

Search linguistic communities

Translate & re-contract the acronym

Is it possible the acronym is already in

English?

OR

Advanced search techniques

If you can guess part of the acronym, restrict the term by adding “+” to your search

Advanced search techniques

Use a wildcard phrase search by inserting an asterisk (“*”) as a placeholder for unknown parts of the term

Advanced search techniques

Restrict your language choice: Search for your term in French (source), but restrict the language to target (English) under “Advanced Search”

Advanced search techniques

Restrict the search domain with “site: XXX” (while “.fr” is a good choice, “.ca” often leads to good bilingual Canadian sites)

A picture is worth 1,000 words

Tool Box For the Medical Translator

One of the most comprehensive lists of resources for novice or experienced medical translators

http://www.groupetraduction.ca/documents/ToolBox.pdf

Online resourcesResource Description Web site

EMA Frequently used non-standard abbreviations

http://www.ema.europa.eu/docs/en_GB/document_library/Regulatory_and_procedural_guideline/2009/10/WC500004439.pdf

MediLexicon Medical abbreviations dictionary (English with some French, German, and Spanish translations)

http://www.medilexicon.com

The Free Medical Dictionary

Authoritative descriptions of medical conditions, medications, anatomical terms, etc.

http://medical-dictionary.thefreedictionary.com

Medicalese

Terms that are not found in the standard medical references, such as clinical trial acronyms, herbal remedies, products available outside the US, discontinued drugs, and unapproved cancer therapies

http://www.medicalese.org

Lab Tests Online Resources on non-commercial clinical lab tests. http://www.labtestsonline.org

MeSH Medical Subject Headings http://www.nlm.nih.gov/mesh

Medical Glossary General medical glossary http://www.medicalglossary.org

MedlinePlus Dictionary

National Library of Medicine Dictionary http://www.nlm.nih.gov/medlineplus/mplusdictionary.html

Stedman’s Subscription-based online reference database http://stedmansonline.com

Essential print resources

Davis, Neil M. Medical Abbreviations: 15,000 Conveniences at the Expense of Communications and Safety, 10th ed. Huntington Valley, PA: Davis Associates, 2001.

Donaldson, Ross. Tarascon Medical Translation Pocketbook, 1 Mul. ed. Boston: Jones and Bartlett: 2009.

Maxwell, Robert. Maxwell Quick Medical Reference, 5th ed. Maxwell Pub. Co., 2006.

Sabatine, Marc S. Pocket Medicine: The Massachusetts General Hospital Handbook of Internal Medicine , 3rd ed. Philadelphia: Wolters Kluwer, 2008.

Stanaszek, Mary J. The Inverted Medical Dictionary. Lancaster, PA: Technomic, 1991.

Surf’s up!Drag picture to placeholder or click icon to add

Drag picture to placeholder or click icon to add

Drag picture to placeholder or click icon to add

Practical Example 1:SOAPs & Physical Exams

Practical Example 2:Cardiology Summary Sheet

Practical Example 3:Medical Consultation

Practical Example 4:Lab Tests

Thank you!!Drag picture to placeholder or click icon to add

Drag picture to placeholder or click icon to add

Drag picture to placeholder or click icon to add