Neck Structure

This raised the difficulty of language granularity. In English ‘neck’ has a broader meaning than in some other languages. In Dutch and Norwegian for example, ‘neck’ means the posterior part of the neck: ‘nek’ / ‘nakke’. And they have a separate term for the anterior part of the neck: ‘hals’.

What should the translator do?

Since there is not one term that captures the meaning of the English concept of ‘neck’, the translation is at risk for being ambiguous. The translator should report the issue to the translation project owner, to discuss a solution which takes into account terminological and linguistic considerations.

Which translation strategies could be adopted?

Strategy	Detail
Expert Consultation	One strategy could be to consult medical experts. You could ask how they would interpret and translate ‘neck structure’ in their language, and subsequently choose the term that is most often named by them. Pro: the health care professionals are the ones that will be using the translations, so collecting their opinion is vital for making a translation that will be correctly interpreted by them. Con: the medical experts you will be consulting are probably a small group, and the question is if their answers are representable for all health care professionals. ‘Neck’ is a concept that is used by a wide range of health specialties, so the translation should be clear for all those professionals.
Explanatory Description	Another strategy is to choose a more explanatory description as a translation, for example ‘hals and/or nek’ (Dutch) / ‘hals og/eller nakke’ (Norwegian). Pro: all possible descriptions are included, so it is sure that the concept will be correctly interpreted and not be missed by health care professionals. Con: the description ‘hals and/or nek’ / ‘hals and/or nakke’ does not align with how health care professionals would write it. They would always choose either ‘hals’ or ‘nek’. Health care professionals could feel a distance between what term they want to capture and what term is being exchanged.
Clinical Relevance	A third strategy is to consider how clinically relevant the concept is in the language/region that you are translating to. You could choose to only translate the more specific concepts, that are defined with respectively the anterior and posterior parts of the ‘neck’. Pro: no time is lost with translating irrelevant concepts. Con: grouper concepts can be useful for data analysis, like querying. Although in the moment you are translating there may not be a use case for the grouper concepts, there is a chance there will be in the future, since the neck structure is a common body structure that is affected by illness. If the chosen translations for the specific concepts do not allow a translation of the grouper concepts that aligns with those, you might need to retranslate the whole relevant hierarchy. If a grouper concept concerns a body structure that is less common to be affected, then chances are lower that a use case will arise in the future and not translating the concepts could be a good strategy. You can think of embryonic structures for example.

Proposal/Outcome

In the Netherlands we started with strategy 1 and based on the results of that we applied strategy 2. We approached our medical expert group of different medical specialties and put up a poll on social media on which is their preferred Dutch term for the definition of the English term ‘neck’ according to SNOMED International. We found that most experts / respondents preferred ‘hals’, but also a group that could not choose or that would use ‘nek’. To make sure the concept would be correctly interpreted we decided to use strategy 2. The risk of health care professionals finding this descriptive way if translating does not fit their daily practice could be taken away by using an interface that does align with their practice. Since the underlying SNOMED terms do not necessarily need to be shown to the health care professional.

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