Translating the abstracts of Cochrane Database Systematic Reviews (CDSR) into Chinese in Taiwan

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Translating the abstracts of Cochrane Database Systematic Reviews (CDSR) into Chinese in Taiwan Chiehfeng (Cliff) Chen MD MPH PhD Associate Director, Center for Evidence-Based Medicine, Taipei Medical University, Taiwan Assistant Professor, School of Medicine, TMU, Taiwan Director, Division of Plastic Surgery, Department of Surgery, Taipei Medical University Wan Fang Hospital, Taiwan Minds Seminar, January 28, 2012

Outlines The needs for translation How we translate the abstracts of CDSR Remaining challenges & future plan Conclusion

Background

Chiu YW, Weng YH, Lo HL, Shih YH, Hsu CC, Kuo KN. Impact of a nationwide outreach program on the diffusion of evidence-based practice in Taiwan, International Journal for Quality in Health Care 22(5): 430-436, 2010

Translating Cochrane Library into Spain - since 1997, Spanish Cochrane Center started to translate Cochrane Library. The Spanish version is published on La Biblioteca Cochrane Plus. different languages Japan - Medical Information Network Distribution Service (Minds), Japan Council for Quality Health Care (JCQHC) translated all abstracts of CDSR which were cited in Minds Clinical practice guidelines. Other countries - Selected abstracts have been translated into Germany, Italian, Swedish and other languages. Reference: Knowledge for Knowledge Translation: The Role of the Cochrane Collaboration Journal of Continuing Education in the Health Professions, Volume 26 Issue 1, Pages 55 620,http://minds.jcqhc.or.jp/index.aspx, http://www.update-software.com/clibplus/clibplus.asp

Translating Cochrane Library into Four Phases: Spanish Phase I: machine translation (computer assisted translation-cat) Phase II: correction and post-edition of the resulting text Phase III: review by specialists Phase IV: final correction Refenrence: Translating the Cochrane Library into Spanish. Bonfill X; 6 th International Cochrane Colloquium, 1998

Translating Cochrane Library into Four Phases: Spanish Phase I: machine translation (computer assisted translation - CAT) Phase II: correction and post-edition of the resulting text Phase III: review by specialists Phase IV: final correction Not helpful when translating into Chinese Refenrence: Translating the Cochrane Library into Spanish. Bonfill X; 6 th International Cochrane Colloquium, 1998

How we translate?

Cooperating with medical associations or hospitals? CDSR Group medical association CDSR Group Hospital CDSR Group medical association CDSR Group or Hospital CDSR Group medical association CDSR Group Hospital CDSR Group... CDSR Group CDSR Group

2007 2008 2009 2010 2011 CDSR translation workforce recruit September, established CDSR translation working committee January, contracted with John Willey & Sons Ltd May, the translation-aid platform was established 17 medical centers joined CDSR translation project November, Taiwan Society of Perinatology joined August, Chung Shan Medical University Hospital joined Recruited freelancers for translation Commissioned to professional translation agents December, more than 800 clinicians participated, with around 3500 CDSR abstracts had been translated

Content Licensing Agreement of translation

Team recruiting Cathay General Hospital Chang-Gung Memorial Hospital Kaohsiung Branch Chang-Gung Memorial Hospital Lin kou Branch Changhua Christian Hospital Chung Shan Medical University Hospital (2009.07) Chi Mei Medical Center China Medical University Hospital Kaohsiung medical University Chung-Ho Memorial Hospital Kaohsiung Veteran General Hospital Taiwan EBM Association Mackay Memorial Hospital National Cheng Kung University Hospital National Taiwan University Hospital Shin Kong Wu Ho-Su Memorial Hospital Taichung Veteran General Hospital Taipei Veteran General Hospital Taipei Medical University-WanFang Hospital Tri-Service General Hospital Tzu Chi General Hospital Taiwan EBM Association Taiwan Society of Perinatology (2008.11) Taiwan Society of Perinatology (2008.11) 18 medical centers, 2 medical associations and over 800 clinicians (mainly physicians) contributed to the project.

Forming Consensus Translation process Review criteria Translation interface Standardized format Terminology Supporting logistics

Translation Process (original design) Return Format error NHRI edit Passed Original abstract Translation Reviewer1 Format and content check No content and format error Open to the public Return Reviewer2 Passed Content error Modified by Reviewer 3

Translation platform - translator Chinese English Title background

Translation platform - reviewer misunderstanding, poor readability, wrong translation, incorrect wording, inconsistent with the glossary, unnecessary translation, or others Reviewer s comment

Translation platform - reviewer Reviewer s comments

Translation platform - English-Chinese glossary Reference: DOH bilingual medicine e- dictionary

Chinese CDSR sample Link to original abstract Translator/Hospital

http://clc.nhri.org.tw/admin/clcmain1.aspx

search new by year by CRG advanced search new abs hot abs http://clc.nhri.org.tw/admin/clcmain1.aspx

browse by year and group by year

Translation quality overview -- in average Each abstract was revised 2.3 times Each abstract needed 57 days to finish the review process. Only 17% abstracts passed by both reviewers in the first round. Over 43% abstracts required further revises after the first review process. Shen WH, Lo HL, Chiu YW, Chen CF, Kuo KN. Translating the abstract of Cochrane Database Systematic Review (CDSR) into Chinese, Abstracts of the 17th Cochrane Colloquium., October 11-14, 2009. Singapore.

The most common suggestions addressed by reviewers Miss understanding poor readability wrong translation incorrect wording inconsistent with the glossary others unnecessary translation n=196 title background objective search 5 57 6 20 18 30 1 14 83 19 27 23 42 1 9 64 16 24 17 26 2 6 49 13 11 2 30 5 selection 9 81 12 30 24 37 2 collection main result 13 65 13 20 10 34 4 18 106 19 55 17 44 6 author conclusion 13 85 10 23 19 33 2 plain language TOTAL 9 90 42 38 20 34 4 96 680 150 248 150 310 27 Shen WH, Lo HL, Chiu YW, Chen CF, Kuo KN. Translating the abstract of Cochrane Database Systematic Review (CDSR) into Chinese, Abstracts of the 17th Cochrane Colloquium., October 11-14, 2009. Singapore.

Accelerating translation progression Identifying barriers in each hospital and help to tackle Sharing useful strategies Visiting hospital for promotion Encouraging organizational leadership Regular reminding (for individual) Monthly analysis reporting (for organization) Identifying potential participants Awarding good performance

Remaining challenges & future plan

Challenges Clinicians are usually too busy to contribute their time Many medical terms have no standard translation Project expense far out of our original estimation Template of Cochrane reviews change over time Funding A sustainable operation model is needed

Translation Process (modified design) Return Format error NHRI edit Original abstract Translation Reviewer 1 Passed Format and content check No content and format error Open to the public (must be physician) Content error Modified by Reviewer 2

Sustainable operation model Cochrane Sponsors WILEY TMU Healthcare professions Local publisher Healthcare organizations Consumers

Conclusion

The benefits in translation Translation by junior dr. Reviewed by senior dr. Reviewed by senior dr. junior doctors senior doctors general public To learn evidence-based medical (EBM) and process To obtain the most updated EBM information To learn the current EBM information in Chinese To learn more about systematic review To obtain the updated EBM information To learn the way of explanation to patients in plain language To foster a climate of English scientific articles reading To apply EBM in clinical education To know junior doctors knowledge level on EBM

Kösters JP, Gøtzsche PC. Regular selfexamination or clinical examination for early detection of breast cancer. Cochrane Database of Systematic Reviews 2003, Issue 2. Art. No.: CD003373. (2008 updated)

The benefits of translation to Cochrane Disseminating Cochrane reviews to those health professions and the public who read Chinese Providing experience of translating to other languages Bringing more people in participating Cochrane reviews

Thanks for your attention!