Why Reading Levels Matter

Translating medical documents is often the right thing to do from an ethics perspective. In many cases, these translations are mandated by the law or required for regulatory approval. In addition, successful outcomes to medical treatment are strongly influenced by linguistic and cultural access to care.

For example, in the United States translation of medical documents is required to comply with current laws protecting the rights of Limited English Proficiency (LEP) patients. The translation of clinical and regulatory documents during the drug approval process is required and regulated by agencies around the globe. International regulations require medical device companies to localize labeling – including software, manuals and instructions – into multiple languages.

One of the primary goals in medical translation is matching the source file content and reading register to accurately convey the content in the translations. What follows are some of Welocalize Life Sciences’ recommendations for preparing source and translated documents for use in medical and clinical settings.

Consider the target audience. Understanding the target audience’s educational background, age, and language skill set is important for effective communication and comprehension of the material both in English and in the target language.  Lowering the reading level of the source content for audience comprehension is recommended when the target audience has a lower educational background, as well as for younger audiences. However, according to the U.S. Institute of Medicine (IOM) even highly skilled individuals may find the medical documents too complicated to understand, especially when these individuals are made more vulnerable by poor health.

Find out more…Medical concepts and language can be complex. People need easily understandable health information regardless of age, background or reading level. MedlinePlus offers guidelines and resources to help you create easy-to-read health materials.

Localize the translations based on the audience’s country of origin. Localization includes text, graphics and currency adaptations. Linguistic adaptations in the target language can be necessary to ensure audience comprehension. For example, many words in Spanish have different meanings or connotations in different cultural backgrounds and countries. If the English text refers to x-rays, the best term for the Spanish translation might be radiografías for Mexican readers, but placas would be better for Cuban or Puerto Rican readers. Your language services provider can better evaluate the translations needs for dialect adaptations and localization by reviewing the document type and the intent of the communication.

Consider the implications for the various document types and how these influence the reading level. Legal and technical healthcare documents such as Disclosure Forms, Evidence of Coverage, Summary of Benefits and business correspondence is usually set at a higher register, and linguistic adaptation in the target languages can be very limited. Marketing material to employers and consumers is expected to be at a higher reading register.  However, patient facing documents such as Heath Education (patient health goals, patient instructions, etc.), Informed Consent Forms (ICFs) and/or website content tend to usually be at lower reading levels.  Provide your translation agency the target population and audience’s reading level specifications when submitting your initial request. This will ensure that the end deliverable is culturally appropriate and easily comprehensible.

Choose the simplest word when there is more than one good choice in the target language. Just as in English, the target language may include multiple words with similar meaning. Faced with choices of this type, translators should pick the simplest words that stay true to the English text, to avoid making the translated text harder for people with low literacy skills to understand and use. For example, a translator who specializes in technical translations may not appreciate what it takes to communicate effectively with less skilled readers.

Contact Welocalize Life Sciences for information on how we can help with translation of PROs, IFUs and other medical and clinical documents.