I have a question regarding translating elaborate FSNs into your own languages, but also the increasing discrepancy between English FSNs and PTNs.
SNOMED has been adding elements into FSNs that were otherwise implied in concepts, such as 174651007 | Endoscopic retrograde pancreatography using fluoroscopic guidance with contrast (procedure), conform its modelling using fluoroscopic guidance and with contrast. The Preferred Term remains ‘endoscopic retrograde pancreatography’ in English.
We have translated this concept into Dutch without also translating ‘using fluoroscopic guidance with contrast’, as an ERP is by default fluoroscopic and uses contrast. Our medical expert stated that this procedure is not possible any other way, meaning it is redundant to also add the fluoroscopic and contrast elements into the (Dutch) translation.
In other situations, SNOMED has different PTs compared to the FSNs. Looking into concepts, such as those worded with ‘induced by’ seems to sometimes have PTs that contain ‘caused by’ instead. An example of such a concept is 704204003 | nephropathy induced by lead. There is not a clinical need for these, from what I can find.
I understand that in different cases the PT is more clinically relevant than FSNs, which is also why we sometimes decide upon PTs that differ from the FSN. However, sometimes, the meaning of concepts can get muddied or the FSN is very elaborate which hinders practical use (such as using fluoroscopic guidance with contrast when the procedure implies this).
Using Ole’s guiding matrix: this is not a semantics issue. It touches upon the issue of implementation- most of our decisions for PTs that differ from FSNs are based on what the medical field(s) ask(s) for. However, it is also a translation issue, as I suspect these differences are dealt with differently in different languages with different clinical/medical contexts. The issue I raise deals with a more ‘meta’ question, not with the exact translations you have given for the examples.
My question to you is: how do you at your NRC deal with these ‘differences’ between FSNs and PTs? Do you have specific guidelines or procedures in place to guide your decision(s)? Do you use the FSN or PT? Even in the case you don’t translate FSNs, which of the two do you use for your translation decision?
However, when translating the meaning of the concept, the FSN is crucial, together with the modelling. But this is difficult to communicate to the translators, and quite often the Norwegian preferred term is a literal translation of the FSN - rendering a horrible term. Sometimes, we find that an English synonym represents the clincal relevant term to be translated, but this requieres an evaluation for each concept.
No FSN translation in Belgium either, since we have three national languages. The FSN is kept as a common reference for everyone, which is also problematic in case of notorious false friends or terms that convey nuances that don’t translate into our languages, such as the lesion and transplantation/graft.
Our implementation approach, though not always consistently applied, at least with French (which we translate ourselves), is to choose the simpler/most common term as PT, and keep a translation of the FSN as an acceptable synonym. As you say, FSNs with redundant information are not practical and will thus never be preferred by clinicians.
Side note: Keeping track of FSN changes of translated concepts is quite the task it seems. I checked in October 2025 with a script and we have 15k concepts whose FSN has changed after the latest Dutch PT was added, and 8k+ for French. Since the meaning is the same, we’re not planning on updating these translations for the time being.
For the Canadian French version, we translate the FSN, even though it will never be used clinically. The FSN is very (too) explicit and very redundant, probably so that there is no confusion as to its meaning; it serves practically as a definition (but in that case, it might have been better to create a definition and an FSN that could be used clinically). In any case, in the Canadian French version, we align the translation of the FSN with the English FSN, but, as far as possible, we translate the PT to reflect the term actually used in clinical settings. The meaning is the same, but this means that the FSN and the PT are not always identical.
There are a lot of examples in the Editorial Guidelines as well when the PT is not the same as the FSN, but even when wedo not translate the FSN, it is so easy to re-use the FSN in the translation instead of the recommended practise to use what healthcare professionals are actually using for that specific concept.
I am also in favor of identifying where definitions are needed, as we as translators are experts at finding concepts where the FSN isn’t as transparent as it needs to be, and where we need a helping help identifying the differentiating marks so we can make the same translations in all foreign languages.
Hi Mirte, hi all,
in the German Translation Group, we decided not to translate the FSN (and neither the text definitions @klindve ).
There is a guideline that one synonym should reproduce the FSN as accurately as possible, but this doesn´t have to be the preferred term – or even shouldn´t be the PT since we want the PT to be “the synonym that best corresponds to clinical usage.”
See our guidelines (in German :)):