;   Medical Translation Insight: Back translations - tackling discrepancy in meaning - ForeignExchange Translations

Back translations - tackling discrepancy in meaning (medical translation)Our recent post on back translations generated a lot of questions on how to identify discrepancy in meanings - and what to do about them.

In the pharmaceutical industry, differences in the back translation and original English such as "dose" and "dosage" are common as are the terms "adverse effect", "adverse event" and "adverse reaction". In these instances, it is the reviewer's responsibility to research the terms and find out whether or not the meaning is different enough to warrant a change to the original translation.

When the source language is English, there is often discrepancy in the meanings between the original source and the back translation. Spanish, for example, has a notably smaller vocabulary, and many words that are used in English simply do not exist.

Below are a couple of examples of issues that arise in back translation (in this case, English into Spanish, and then Spanish into English). In each case, the meaning of the term in the back translation does equal the meaning of the original source.

English source: aches and pains
Spanish translation: rigidez
English back translation: ache

Two separate nouns for "aches" and “pains" do not exist in Spanish, resigning the first translator to use only one noun: "rigidez". As such, the back translator, with no access to the source, is unaware that there are two nouns exist in this text, and translates simply "ache". A comparison of the back translation and the source will reveal a missing noun, which will only become evident at the review stage.

English source: to impair
Spanish translation: afectar
English back translation: to affect

"Afectar" means not only "to affect", but "to harm, to influence unfavorably". The distinction is important, particularly when referring to drug effects. This kind of example seems on first review of the back translation to be a mistranslation, and must be clarified with the translator during the review.

Back translations are tricky business. They can point out clear-cut errors like the above example. But the purpose of a back translation is to show a native speaker of the source language how the message is being delivered to the target audience. The real work of deciphering any discrepancy in meaning comes in the next step - the back translation resolution process.

ForeignExchange Translations provides specialized medical translation services to the world's leading pharmaceutical and medical device companies.


  1. Publicat said...
    Hi. It is true that in Spanish there is not a specific word for "ache" as a dull, persistent painful sensation, the generic word for "pain" ("dolor") is used instead. But there are two comments related to your example. First, "rigidez" is a very close Spanish equivalent of the English "rigidity", not necessarily related to aches and pain (think, for example, that it is applied to corpse rigidity). Second, in English "ache" is a form of "pain", different from the spasmodic or sudden one. Not oranges and apples, rather oranges and citric fruits!
    Jessie said...
    I differ from your comment that "afectar" has a negative connotation and "impair" doesn't. "afectar" is a good translation for "impair" in many situations. Context, of course, is crucial.

    Furthermore, rigidity is not a good translation for aches and pain. "Dolor" is better, and "dolores y malestares" would be even better, to emphasize the general discomfort of "aches and pain"

    The above just goes to prove your point... how tricky translation and back translation can be!
    Anonymous said...
    I find "ACHAQUES" to be closer to aches and pains when dealing with older people and "MALESTARES" as more of a general descriptor.
    Jessie said...
    I agree, great word, just remember that "achaques" has a connotation of nausea and vomiting events in early pregnancy in some countries. As always, "context, context, context"!!
    Anonymous said...
    "Back translations are tricky business. They can point out clear-cut errors like the above example. But the purpose of a back translation is to show a native speaker of the source language how the message is being delivered to the target audience."

    This implies to a certain extent that the back translation is more trustworthy than the original translation. The problem remains that the client will always have to trust one person's opinion over another one's. What if translator A delivers a perfectly good translation, back-translator B makes mistakes in the back translation, the client enquires about the differences between the original text and the back translation, and B lays the blame on translation errors by A? The client has no way of knowing which of the two translators can be trusted more, other than asking yet another translator for advice.

    I really don't see how back translations add to the quality of final translations...
    Barbara Thomas said...
    This is a good example, not only of why back translation is such an ineffective tool, but of why translators with expert knowledge will always be in short supply.
    In first place, the term "aches and pain" in English is not highly technical, which makes its translation context-sensitive, which I assume is how it came to be translated as "rigidez," which may be a consequence of aches and pain but is not a translation of the term. The back translation of "rigidez" could be "stiffness" in a slightly colloquial register or, more technically, "rigidity," not pain. By this I do not intend to say that "rigidez" was necessarily the wrong translation choice. I simply assume that the translator made a short mental leap from a vague English expression to a slightly more concrete Spanish expression in the context, say, of a patient with symptoms of arthritis.
    Moreover, it is not true that there is no translation for "aches and pain" in Spanish. Options for "aches and pain" that could be used in Spain is "dolor sordo y agudo," la expresión habitual en el entorno médico, y "dolor crónico y agudo." Translations of "ache" include "dolorimiento," "dolor continuo," and "dolor latente."
    Steven Marzuola said...
    I understand why some people feel the need for backtranslations. One reason is to identify and avoid possible translation horrors, such as the infamous "bite the wax tadpole".

    However, the same purpose can be achieved by a team of competent reviewers instead of a full back translation.

    The premise behind backtranslation seems to be: each translator is a machine, or "black box". We are using the second machine to check the output of the first machine.

    Imagine that you are trying to study a car factory. You randomly pick one of the workers as he is entering the plant and stop him. Then you examine the cars that are produced that day. If they are missing windshield wipers, for example, then you "know" that the detained worker was supposed to install the wipers.

    Why not just ask the worker what he does? Or ask to tour the plant?

    Instead of a backtranslation, why not explain the purpose of the translation to a competent reviewer and ask them to identify errors?
    Krys said...
    Steven Marzuola wrote:

    "Instead of a backtranslation, why not explain the purpose of the translation to a competent reviewer and ask them to identify errors?"

    A couple of potential issues come to mind:
    1. Multiple translatability.
    2. The reviewer's level of language awareness.

    Back translation is a Quality control mechanism. For languages that have more extension for terms such as the ones in Spanish, it may be that the English term needs to be clarified in the target language if a specific word for the same term does not exist or if the extension of the term in the target language can present ambiguities about the author's intent.

    I am all in favour of back translation, I think it is a great mechanism to check quality and to identify any potential liability issues that may arise.

    The competent reviewer would need to have a very high level of language awareness to catch the subtle nuances multiple translatability can present.
    Kedar Desai said...
    The Back Translation step is an integral part of the translation process, and is more commonly done in documents concerning Medicine, Health Care and Pharmaceuticals.

    There has been a debate on whether the Back Translator should use his/her own judgment or discretion in back-translating any document.

    In my opinion, it is imperative that the Back Translator strictly adheres to the source document, and back-translates what is actually written. The Back Translator should NOT use his/her discretion, otherwise the probable mistakes in the translated version would not be pointed out to the Project Manager, and the very purpose of back-translating the document would be defeated.

    I write this for my English & Gujarati language pair, but I am sure that the above would be applicable for all language pairs as well...!!

    Kedar Desai


    Member: American Translators Association
    Tex said...
    Although back translations can expose errors, it is very inefficient. 50% of the potential errors have to do with the back flow, and are irrelevant but require analysis. Of the remaining differences to be resolved, some are not significant errors, just differences. Having incurred the cost of two translators, the repair requires additional translations.

    If instead there were two independent forward translations, a review of the differences could find the significant errors in interpretation and translation, and the preferred translation could be used, saving the third translation needed to repair back translations. In addition, back translation is useful only if the back translator is very high quality. However with two forward translators, if one is poor quality, the differences are still useful in exposing ambiguities and poor choices by either translator.

    Back translation does allow the original author to comment on the intended meaning, but they are likely to be disturbed by the result more than comforted.

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