Accurate, Not Literal, Translation for Medical Records: Syndrome Inflammatoire Biologique

Accurate translation of patient medical records for clinical trials is crucial for ensuring the reliability of research. Inaccuracies and erroneous translations can compromise patient safety and the validity of study outcomes. Precision in translation allows for a consistent understanding across languages, supporting informed decision-making by researchers and healthcare professionals while upholding ethical standards.
 
Today, I’d like to discuss the translation of a French term that I regularly see in patient medical records that is commonly MIStranslated - syndrome inflammatoire biologique (SIB). I’ve seen the literal/word-for-word translation (biological inflammation syndrome and biological inflammatory syndrome) in many translations and machine translation memories. Heck, I even used it when I was a new translator because I couldn’t find a definition or obvious equivalent! However, that translation 1) is not a medical term in English, and 2) does not express what the French term actually means. Thus, its mistranslation can stand in the way of reliable research and negatively impact study outcomes.

​Why does SIB get mistranslated?
The main source of confusion, in my opinion, is the word biologique. It doesn’t mean biological nor does it translate to an adjective in English. Well-meaning translators find it easy to just translate word-for-word, assuming healthcare professionals will understand what it means. However, the adjective actually means something along the lines of laboratory evidence. Another example using this adjective in French is bilan biologique, or laboratory tests in English. So, SIB means that inflammation is present based on laboratory evidence, not based on physical evidence, such as redness, swelling, or loss of function.

What laboratory evidence?
It is well known in the medical field that certain markers in the blood show when inflammation is present. Some examples are CRP, fibrinogen, and haptoglobin. When a patient presents certain symptoms, a doctor will take a blood sample and run laboratory tests on it to help diagnose the patient’s illness. When markers like I just mentioned are elevated, it is a sign of inflammation and that evidence can be used to rule out or support various diagnoses.
 
I found a French definition of SIB on the Tours University website: “Un syndrome inflammatoire biologique est défini par l’élévation d’au moins 2 protéines de l’inflammation, ou de la vitesse de sédimentation et d’une protéine de l’inflammation” - i.e. elevation of at least two inflammatory proteins OR elevation of erythrocyte sedimentation rate and one inflammatory protein. (I also find a definition here that re-iterates this: https://www.remede.org/librairie-medicale/pdf/e9782340004993.pdf).

​How should it be translated then?
The closest, but still inaccurate, English equivalent is systemic inflammatory response syndrome (SIRS). However, it includes different criteria. A 1999 journal article states, “As defined by the American College of Chest Physicians/Society of Critical Care Medicine consensus conference in 1992, SIRS is diagnosed if 2 or more of the following criteria are met: (1) temperature greater than 38°C or less than 36°C; (2) heart rate greater than 90 beats per minute; (3) respiratory rate greater than 20/min or a PaCO2 less than 32 mm Hg; or (4) white blood cell count greater than 12.0 × 109/L or less than 4.0 × 109/L or the presence of more than 10 immature bands.” There is no mention of inflammatory markers, just white blood cells. Hence, this would be a misleading translation as it would suggest to the healthcare professional that the patient met these criteria, when that is not necessarily true.
 
Thus, when I translate this term, I prefer using “laboratory evidence of inflammation” or “elevated inflammatory markers.” Both phrases express that inflammation is seen on the labs, not necessarily on physical examination. Now, any healthcare professional who reads that phrase will have a more accurate understanding of the patient’s medical situation.

Two key points
This example of SIB demonstrates two key points about translation work:

1. The accurate translation of French medical terms into English is crucial;
2. Medical terms must be researched before they are translated literally since the literal translation is not always the correct one.

Translators must grasp both of these points in order to provide their clients with high-quality work. Consequently, healthcare professionals need to work with translators who demonstrate a deep understanding of medical terms as well as the source and target language.
 
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