The chief of the Japan ME Association, Shinohara’s translation of the International Consensus Criteria contains a fair amount of inaccuracies. The translator is not just incompetent in maintaining accuracy required for a medical reference, but quite likely purposefully unfaithful; apparently she is trying to make the disease as severe as possible without regard for the original.
Disclaimer: I may be wrong in some parts, as I am just a layperson from Japan, not proficient in English (can’t even speak English fluently in real life). I didn’t have enough energy to scrutinize both the documents either. Correct me where I’m wrong.
My interpretation of the original passage is that although the grouping gives you the big picture of how signs and symptoms are located in regions of pathophysiology with respect to one another, it doesn’t mean the ones in each group exist in isolation from ones in other groups. General is used synonymously with broad/vague.
The translator, however, interpreted general as a synonym of common/widespread.
The clause "which may be minimal such as activities of daily living or simple mental tasks" makes it clear that exertion is used in the technical sense, in contrast to the ordinary usage, where it usually implies strenuousness, to prevent such misinterpretation as:
She is housebound and can’t exert herself; she gets fatigued even without any exertion; her condition has to be something else.
And the threshold of fatigability doesn’t have to be as low as can’t tolerate minimal exertion: "The pathological low threshold of fatigability of ME described in the following criteria often occurs with minimal physical or mental exertion […]"
By contrast, the corresponding translation allows no other interpretation than that it requires such a minimal threshold of fatigability.
Exhaustion in the literal sense is complete consumption (of one’s energy), whereas 消耗 literally means any amount of consumption/attrition (of one's energy). (消耗 is used here for lack of a better word.) One might argue 極度の (extreme) is necessary to compensate for this.
However, in reality, if you run out of energy in the literal sense, you will be dead. There is still some allowance of energy left after you get exhausted. This allowance can be as vast as the context and/or qualification dictates, and I assume the threshold where exhaustion becomes applicable would be just above negligible levels. This is also where 消耗 would usually start to be appropriate.
Therefore, even though their undertones can be different, they work almost in the same way unless the context prompts 消耗 to be interpreted as being (possibly) of a negligible level. It is clear from the context the severity has to be of pathological levels. The qualification of 消耗 with 極度の (extreme) is excessive by far.
I think this is a blatant falsification, as you can make it more accurate simply by replacing に見えるのである (looks as if … were) with でありうる (could be).
Again, exaggeration.
The above is not exhaustive, but I will stop here because I’ve been exhausted.
I emailed the Japan ME Association and told them that their translations are inaccurate and asked if I should suggest corrections. No reply so far.
I’m a little infuriated by her malpractice, but I don’t know what I should do about it. Maybe I should just stop caring?
JMEA’s website only lists the CCC and the ICC, both translated by Shinohara, as the diagnostic criteria, and treats them like bibles, in a way. This is problematic because, the way I understand it, no criteria are conclusive until the etiology and the pathophysiology are ascertained, and it can lead to false negative diagnoses, especially when the criteria are falsified such that they will exclude mildest cases, and can hinder early, prompt treatment, which the authors call for.
Disclaimer: I may be wrong in some parts, as I am just a layperson from Japan, not proficient in English (can’t even speak English fluently in real life). I didn’t have enough energy to scrutinize both the documents either. Correct me where I’m wrong.
My interpretation of the original passage is that although the grouping gives you the big picture of how signs and symptoms are located in regions of pathophysiology with respect to one another, it doesn’t mean the ones in each group exist in isolation from ones in other groups. General is used synonymously with broad/vague.
The translator, however, interpreted general as a synonym of common/widespread.
The clause "which may be minimal such as activities of daily living or simple mental tasks" makes it clear that exertion is used in the technical sense, in contrast to the ordinary usage, where it usually implies strenuousness, to prevent such misinterpretation as:
She is housebound and can’t exert herself; she gets fatigued even without any exertion; her condition has to be something else.
And the threshold of fatigability doesn’t have to be as low as can’t tolerate minimal exertion: "The pathological low threshold of fatigability of ME described in the following criteria often occurs with minimal physical or mental exertion […]"
By contrast, the corresponding translation allows no other interpretation than that it requires such a minimal threshold of fatigability.
Exhaustion in the literal sense is complete consumption (of one’s energy), whereas 消耗 literally means any amount of consumption/attrition (of one's energy). (消耗 is used here for lack of a better word.) One might argue 極度の (extreme) is necessary to compensate for this.
However, in reality, if you run out of energy in the literal sense, you will be dead. There is still some allowance of energy left after you get exhausted. This allowance can be as vast as the context and/or qualification dictates, and I assume the threshold where exhaustion becomes applicable would be just above negligible levels. This is also where 消耗 would usually start to be appropriate.
Therefore, even though their undertones can be different, they work almost in the same way unless the context prompts 消耗 to be interpreted as being (possibly) of a negligible level. It is clear from the context the severity has to be of pathological levels. The qualification of 消耗 with 極度の (extreme) is excessive by far.
I think this is a blatant falsification, as you can make it more accurate simply by replacing に見えるのである (looks as if … were) with でありうる (could be).
Again, exaggeration.
The above is not exhaustive, but I will stop here because I’ve been exhausted.
I emailed the Japan ME Association and told them that their translations are inaccurate and asked if I should suggest corrections. No reply so far.
I’m a little infuriated by her malpractice, but I don’t know what I should do about it. Maybe I should just stop caring?
JMEA’s website only lists the CCC and the ICC, both translated by Shinohara, as the diagnostic criteria, and treats them like bibles, in a way. This is problematic because, the way I understand it, no criteria are conclusive until the etiology and the pathophysiology are ascertained, and it can lead to false negative diagnoses, especially when the criteria are falsified such that they will exclude mildest cases, and can hinder early, prompt treatment, which the authors call for.
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