Three Events in One Weekend!

By Raffaella Bushiazzo

This year our fall general meeting was a very special event, as translators and want-to-be translators were able to dedicate an entire weekend to increasing their professional knowledge and exchanging business cards and tips with fellow translators and agencies in an elegant environment.

To coordinate with ATA’s Medical Translation Seminar and our own NCTA MultiTerm Workshop for Trados users, we moved our quarterly meeting to Sunday, September 17th at the Embassy Suites Hotel in South San Francisco. The NCTA general meeting started with the traditional New Member Orientation, to help those who have recently joined NCTA learn more about the association.

Trials and questionnaires
Since the ATA seminar was on medical translation we chose to present on a connected topic. We invited David Himmelberger from Health Outcomes Group in San Francisco ( to explain how clinical trials and health care questionnaires are designed and translated for multinational use; the translators role in this process; and what is expected from translators. Dr. Himmelberger’s presentation was rich in practical examples, detailed guidelines, and, not least, hilarious anecdotes.

Since the mid-1970s, Mr. Himmelberger has been involved in analyzing the results of medical treatments in terms of cost and quality of life. After many years as a biostatistician at Stanford University and experience in the pharmaceutical industry in strategic planning, international marketing research, and outcomes evaluation, Mr. Himmelberger founded Health Outcomes Group in 1987.

Today, there are no medical tests to prove that a treatment for a disease is working. For this reason, questionnaires are needed, to calibrate medical procedures to a common standard. But often these questionnaires need to be translated before they can completed by patients in different environments.

The translated documents must be absolutely true to the source, but at the same time in readable, natural-sounding language. Typical projects involve twenty countries at a time, where English is almost always the source language translated into other target languages, and adapted to each culture. The translation process is usually lengthy, involves a number of people, and presents difficult challenges to be solved.

The person who writes the original questionnaire, the source author, has an interest in staying involved at each step of the translation process—both to ensure accuracy and to make sure he or she shares in any additional fees. Two translators will then translate the text, working independently of each other. The resulting translations are sent to a linguist living in Italy who combines the two versions into one. This version is then back-translated back into English. At this point the translation is reviewed by the author, as well as by doctors and experts for a linguistic validation.

They take a small sample of users and conduct a dialogue with the patients to see if they fully understand the questionnaire and all of its nuances.

To be effective, a translation of this kind needs to meet two nearly paradoxical requirements, which is what makes the task so challenging. First, the source text is fixed and unalterable; since the developer doesn’t want to change the questionnaire in the original language, the linguist has to work around that to come up with solutions. Second, the translation also needs to sound natural in all the target communities and cultures!

How do we know what patients understand when they answer a questionnaire? Several techniques are used, often involving putting the patient at ease, listening to the vocabulary he or she uses, watching for visual cues, having questions prepared that address issues identified in the translation process, and the use of different interview techniques. Lastly, the translation is sent back to the target language linguist for a final approval.

Networking and goodies
Dr. Himmelberger’s fascinating talk was followed by a treat—a buffet of delicious cheeses and exotic fruit, elegantly served on the hotels fine china. It was a landmark weekend for NCTA, because we were able to offer our members so many professional enrichment events in such a short time. I was pleased to see the enthusiasm shown, as well as the number of first-time NCTA attendees and attendees from outside Northern California who joined us for this first-class event and presentation.