Are there 1 or 2 medical translators working on my document? Why does it matter to me?


19th Oct 2015 – Allow us to first start off by saying that medical translations are fundamentally performed by experienced, certified, human medical translators. As such, this article covers what we at MediqTrans consider as the most essential step attributing towards high quality medical translations –> the post-translation audit (commonly/loosely termed as “translation review”) by a 2nd medical translator.

This entire article covers:


How is “Translation Audit” defined?

There are only 2 ways in which translation audit has been defined – the correct way, and the incorrect way.

The correct definition is best illustrated by using the example of an external accounting auditor. An auditor’s key role would be to ensure that the company’s financial statements are accurate and well-represented, and in so doing, eliminating incompetence and risk to stakeholders, giving stakeholders the assurance that the company is engaging in the business activities that it represents itself to be doing. A medical translation audit does the same thing – it is performed to ensure that the initial medical translation is accurate and well formed. In so doing, the content user is not exposed to risks arising from non-compliance to the quality expectations of the document, regardless of the initial translator’s assurance of quality (which is to be expected).

“Translation audit … is performed to ensure that the initial medical translation is accurate and well formed”

Almost as a cruel twist of fate unto itself, the incorrect definition actually originates from the generalist (i.e. non-medical and multi-industry) translation service providers. From as early as almost 2 decades ago, generalist translation service providers would process every document in such a way that it ideally passes through an initial Translation phase, followed by an Editing phase, and ending off with a Proofread phase. Many generalist translation service providers refer to this as the TEP process, and the Editing and Proofread stages are performed (not always done by linguists, and often by internal non-linguist QA personnel instead) with the objective of capturing and correcting fairly obvious linguistic housekeeping flaws, such as spelling errors, numerical translations, incomplete translations or even missing translations. This is unlike a translation audit, which looks into the accuracy of the translation, and seeks to identify a clearer, better representation of the source content.

Unfortunately, over time, the Editing and Proofreading stages became loosely termed by the generalist service providers as a “review” step. A scan of websites belonging to different generalist translation service providers, quickly confirms this widespread confusion, be it intentional or otherwise. Worse still, is that generalist translation service providers claiming to offer medical translations, also knowingly/unknowingly join into the confusion, the guilty ones doing so for the sole purpose of profiteering. The most unfortunate outcome of all this confusion, is that most medical enterprises and organizations use the term “medical translation review”, and only receive standard TEP translation, when they actually expect and pay for the service level of a “medical translation audit”.

“most medical enterprises and organizations use the term “medical translation review”, and only receive standard TEP translation, when they actually expect and pay for the service level of a “medical translation audit” “

Hence at MediqTrans, and for the avoidance of any doubt, we prefer to use the term “medical translation audit” versus “translation review”. A translation audit is a more accurate and less ambiguous way to describe the process of having an unrelated, unbiased examiner, as compared to an internal final scan meant to help progress the completion and delivery of the translation back to the customer.


Why is it needed?

Based on our experience handling medical translation services (previously as a sub-contractor to global translation leaders for several years, and now as a direct provider to medical enterprises), the wealth of industry experience from our team members (approximately 2 decades) who have joined us from various global translation leaders, and further adding to these what some medical enterprises have shared with us, the general observation is that initial medical translation without subsequent translation audit is often far from being error-free. The typical error occurrences called out during the audit stage is categorized as follows:

Error typePercentage of content
Critical errors (inaccurate translation of sentences and key terminology, changes to values e.g. numbers, missing content, etc.)0 – 1.5%
Major errors (translation is accurate – but the entire sentence can be rephrased to facilitate better understanding for the reader; also untranslated text, etc.)3 – 4.5%
Minor errors (translation is accurate – but partial rephrasing can be performed to facilitate better understanding to the reader)4-8%
Preferential changes – no clear advantage of using either the existing translation or the listed change5-10%

While the listed percentages represent an observed average range of errors per document, it does not necessarily mean that every document translated but not audited must have errors. However, what this data shows is that every document translated but not undergoing further audit has a very high probability of having a significant percentage of errors ranging from basic to critical errors.

A separate translation audit is not only needed, it is also the only way in which these errors can be fully captured. As an additional layer of quality assurance, MediqTrans deploys QA software to augment the error identification and translation improvement efforts of the translation auditor.

“A separate translation audit is not only needed, it is also the only way in which these errors can be fully captured.”


Which medical organizations adopt such best practice?

As we have been fortunate enough to acquire significant experience in the medical translation industry across multiple facets, we know this as a fact: global market leaders within the medical industry adopt translation SOPs which mandate that each medical document that undergoes translation experiences (1) an initial translation by a qualified medical translator, and (2) a full audit/review of the initial translation by a second, preferably more qualified, medical translator.

“Fact: global market leaders within the medical industry adopt translation SOPs which mandate that each medical document that undergoes translation experiences (1) an initial translation by a qualified medical translator, and (2) a full audit/review of the initial translation by a second, preferably more qualified, medical translator.”

We’re deeply sorry if you thought that we would default on agreed confidentiality terms with our customers, and reveal the identities of these organizations! To make up for it, we’d like to share with you a few highly descriptive, albeit unnamed, real-life examples:

  • 1)  An International CRO Market Leader

    Counting more than 25 large sponsors as customers, while they themselves operating more than 30 offices globally, this massive CRO has adopted translation audit as part of its global translation SOP. Being part of their SOP, translation audit is mandatorily applied to all global clinical research studies conducted on behalf of their sponsors.

  • 2)  Various Pharmas, Biotechs and Med Device Companies

    Consider the implication of what this global translation SOP means for the multiple sponsors/customers of this market-leading CRO – these sponsors, several of whom are leaders in the medical industry themselves, have mostly and if not all, accepted this best practice of having a translation audit. Which is why they are paying their CROs to ensure that it happens.

  • 3)  eAuction Trend in the United States

    Yet another indicator of the growing prevalence of this best practice is a trend observed with eAuctions held by a number of large pharmaceuticals in the United States in recent years. We have noticed that several pharmaceuticals have simplified their buying terms with translation service providers by asking that the price for an initial medical translation, followed by a separate translation audit, be represented by a singular, blended price per word. Traditionally, each translation task is priced by calculating the total word count charged at a price per word, and then adding to it the number of hours for translation audit charged at the auditor’s hourly rate. Having a blended rate in essence means that these pharmaceuticals already expect that all translations for their organization must include a translation audit by default, or otherwise be considered as non-compliant with their organizations’ SOP.

We’d like to end this section by sharing a general observation that the adoption of the translation audit is highly prevalent in Europe and the United States, while Asia experiences a lag. Notwithstanding, the gap is fast diminishing – Western medical enterprises continually improve on standardizing their international operations, and Asia’s accelerated growth leaves management with little choice but to ensure good governance within their Asia operations.


Do all translation service providers adopt this best practice?

The answer to the million dollar question from what we have witnessed so far – far from it. Let’s take this moment to study the key drivers why translation service providers either do not adopt this best practice, or claim that they provide translation audit/review, when in reality they don’t:

1) Confusion abounds!

Medical enterprises expect translation audits, yet the commonly used term is “review”. Review is a word that is ambiguous in itself, there is widespread confusion amongst translation service providers as to what it means and they often mistake it for proofreading instead, and larger translation service providers are often misled by their own contractors and vice versa, etc. It’s a confusion minefield out there!

2) Plain Unawareness

Unlike MediqTrans and our roots as medical translation sub-contractors, and transitioning to serve medical organizations directly while led by a management team that is highly experienced in medical translations, a large majority of translation service providers do not have much opportunity to service medical enterprises directly, or indirectly through larger translation service providers. As such, their sensitivity towards the handling of medical documents, and the awareness of SOPs and best practices for translating medical documents, have not reached maturity level.

“A large majority of translation service providers do not have much opportunity to service medical enterprises directly, or indirectly through larger translation service providers … their sensitivity towards the handling of medical documents … have not reached maturity level”

The industry is also highly competitive, with seemingly (but don’t you fall for it, especially if you want to produce high quality translations!) low barriers of entry. This accentuates employee turnover, causing a dearth in knowledge retention and management. All of these exacerbate the problem of unawareness.

3) Integrity Issues

As shared, the translation industry is highly competitive. Several “opportunistic entrepreneurs” enter the industry when tempted by the seemingly low barriers to entry, bearing mindsets such as:

  • “Translation mistakes do not matter, the market is big enough for us to replace our customers when we lose them”
  • “We’re actually performing low-cost proofreading, and the customer cannot tell the difference between proofreading and audit/review. Let’s state in our quotations that we perform audit/review, and enjoy the larger margins.”
  • “Let’s win over budget-conscious customers by offering low translation rates, since the client doesn’t know that translation audit is not actually performed.”
  • “Since our sub-contractors have promised us top quality (even though they do not even seem to know what a translation audit/review constitutes), therefore there’s no real necessity to perform a separate audit/review. Our customer don’t know anyways.”

It’s terrifying to work in a highly regulated industry, when multiple loopholes and risks are so easily introduced into your medical organization by the wrong suppliers!

In summary, it is a rarity that translation service providers do everything as they claim. You really need to be able to protect yourself and your organization, and the only way to do so is by appointing a medical translation service provider that has been carefully validated, and one whom you can trust.


In conclusion …

There are several pitfalls and associated risks each time you appoint a supplier. For organizations that have not closely assessed their existing suppliers, there is a real high risk of process lapses as well.

Implementing a post-translation audit/review isn’t just a best practice, statistically it is an absolute necessity towards ensuring that high quality translation outputs are achieved, so that your medical organization does not become exposed to serious business risks.

“Post-translation audit/review isn’t just a best practice, statistically it is an absolute necessity”

In our upcoming article, we will share a tips as to how non-experienced translation buyers may be able to successfully validate translation service providers before deciding to work with them. But for now (warning, shameless plug ahead), you may like to consider us at MediqTrans. We are often shortlisted alongside the larger global translation leaders as approved suppliers for medical organizations. Most importantly, we are passionate and serious about our business, and we understand that integrity, reputation and relationships are key to long term success in this industry, there are simply no shortcuts.

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MediqTrans is a medical translation specialist, and our services are 100% dedicated to the medical industry only. Connect with us at askme@mediqtrans.com for a fast, non-obligatory quote, or if you would like to understand more about how our team can help your business.

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