Using corpora to query cardiology terminology

Earlier this month, Fernando A. Navarro* published an interesting article in Revista Española de Cardiología (REC), entitled “Cardiopatía isquémica y cardiopatía coronaria: ¿son lo mismo?”, encouraging authors to write with clarity, using precise, specific terminology rather than catch-all options.

He explained, for example, that it’s more accurate to use a descriptive term such as atherosclerotic coronary heart disease instead of coronary artery disease, which doesn’t indicate the cause or clinical impact.

Shortly before the article was published, I enjoyed a brief email exchange with Fernando and María González Nogal, REC Language Coordinator, about the challenges and possible solutions for translating terms such as arterioesclerosis coronaria into English in Atrium, authored by REC Editor-in-Chief, Ignacio Ferreira-González. Later, with my interest piqued, I went a little deeper into the usage of these terms in Spanish and English, beyond the context of the REC article. Here are my findings on the terms listed below:

  • arterio(e)sclerosis coronaria
  • arteriopatía coronaria
  • arteriopatía coronaria ateroesclerótica
  • cardiopatía arterioesclerótica
  • cardiopatía coronaria
  • cardiopatía isquémica
  • coronariopatía
  • coronariopatía arterioesclerótica
  • enfermedad arterial coronaria

Spanish usage in practice

Having elucidated the meaning of these terms from Fernando’s article, I then investigated their usage in Spanish. I searched REC for mentions in Spanish articles published between 1997 and 2017. Some terms had almost no hits at all (e.g., cardiopatía arterioesclerótica and arterioesclerosis coronaria). Cardiopatía isquémica was by far the most commonly-used term. However, the REC corpus mainly reflects usage in clinical research; more specific terminology may have a greater weight in clinical practice and individual patient reports.

English translation and corpus

To translate the Spanish terms into English, I referred to my own translation memories and Cosnautas. The table at the end of this post shows the ES terms translated into EN.

Equipped with the English translations, I turned to my cardiology corpus to investigate real-life usage of these terms. The corpus has 780 files—some five million words—and is compiled from articles published in NEJM, Circulation and JAMA. It also contains all the clinical practice guidelines published by the European Society of Cardiology (ESC) between 2007 and 2016. I used AntConc, a free concordance program, to answer my queries.

Rarity

Unsurprisingly, the English translations of the rarer Spanish terms are virtually non-existent. My corpus confirms that in practice, atherosclerotic coronary artery disease, atherosclerotic heart disease and coronary arteriosclerosis are never—or almost never—used in English.

Atherosclerosis versus arteriosclerosis

I compared usage of atherosclerosis and arteriosclerosis in my corpus, finding almost 30 times more hits for the former than the latter (867 and 31, respectively). This marked preference for atherosclerosis reflects Fernando’s note in Cosnautas that the terms are incorrectly used as synonyms in practice.

Excerpt from the entry on ‘atherosclerosis’ in cosnautas.com. Click the image to enlarge.

Nouns versus adjectives

I then investigated usage of atherosclerosis versus atherosclerotic, finding that the noun appears twice as often as the adjective. I sorted by keyword to the left and right, and saw that coronary is the most frequent collocate of atherosclerosis (67 instances). Switching to a cluster search, I discovered that atherosclerotic collocates with plaques, lesions and (cardiovascular) disease.

Plain versus technical register

With regard to register, English differs notably from Spanish, with a clear preference for plain language. In English, we talk about “heart disease” rather than “cardiopathy” at all levels of written and spoken English, for patient information leaflets and research articles alike. In the corpus, heart disease appears 2395 times, whereas cardiopathy has just 3 hits. Quite the opposite of enfermedad del corazón (9) and cardiopatía (2281) in REC.

Note that the 2395 instances of heart disease are confounded by conditions such as valvular heart disease, structural heart disease, rheumatic heart disease and congenital heart disease, but even after filtering out these n-grams, heart disease as a standalone term still has over 1000 hits.

Abbreviations

Finally, I looked at the thorny subject of abbreviations. Needless to say, there are no standard abbreviations for rare terms. CAD (coronary artery disease) is the most common abbreviation of all the terms listed above, with a total of 1283 hits. In the case of such frequent abbreviations, their presence in a corpus actually brings down instances of fully-glossed terms, and so “isch(a)emic heart disease” has just 173 hits in my corpus, but IHD has 218. Figures for abbreviations can be misleading in any case, because, for example, CHD (coronary heart disease) has 746 hits, but this result also includes the same abbreviation for congenital heart disease.

Summary of ES-EN translations

Below is the list of the Spanish terms I investigated and their possible English translations. The numbers beside each term show hits in REC (for ES terms) and in my corpus (for EN).

arterio(e)sclerosis coronaria (35)
atero(e)sclerosis coronaria (130)
coronary atherosclerosis (67)
arteriopatía coronaria (28) coronary artery disease (877)
arteriopatía coronaria aterosclerótica (0) atherosclerotic coronary artery disease (4)
cardiopatía arterio(e)sclerótica (0) atherosclerotic heart disease (2)
cardiopatía coronaria (57) coronary heart disease (465)
cardiopatía isquémica (1575) isch(a)emic heart disease (173)
coronariopatía (93) coronary artery disease (877) or coronary disease (169)
coronariopatía arterio(e)sclerótica (1) coronary atherosclerosis (67)
enfermedad arterial coronaria (144) coronary artery disease (877)
*Fernando Navarro is a doctor and English to Spanish medical translator, author of Diccionario de dudas y dificultades de traducción del inglés médico, available at www.cosnautas.com
Image attribution: © 7activestudio – Fotolia.com
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