Michael Barnett Mar 3, 2012:

Hi Yang Your solution sounds good to me!
Regards.

CHEN-Ling (asker) Mar 3, 2012:

Hi Michael Thanks for your suggestion. In my case, I use "treat-to-target goal" to refer to "clinical remission of RA (disease activity score <1.6 )", and use "treat-to-prevent goal" to refer to "bone erosion". I think you are right concerning the definition of bone erosion. Currently " bone erosion" has not been defined as a goal to prevent. Actually there isn't a well defined goal to prevent in RA. In my case, the author is trying to discuss if bone erosion can be used as such a goal to prevent.

Michael Barnett Mar 2, 2012:

Not redundant. BTW, notice how I have used '"treat to target" goal' in paragraph 2 of my last message. Clearly it is not redundant. I think the source test used the expression in the same way.

Michael Barnett Mar 2, 2012:

Let's not mix up terminology. In your posting, the target is a disease activity score of 1.6.
"Treat to target" always refers to s specific value. The target value is determined by panels of experts that meet periodically and publish the "target" as a guideline.

In your case you wish to distinguish the "goal" of erosion prevention from the "treat to target" goal of 1.6.

If you use the term "goal", referring to erosion prevention, do not link it to "treat to target". Until your rheumatology experts define a specific target for bone erosion - be it a percentage of bone erosion from baseline, a bone density, or what have you, you cannot use the term "treat to target" to refer to that aspect of RA treatment since it has not been defined.

CHEN-Ling (asker) Mar 2, 2012:

Thanks you all for your comments. Please note the hyphens in " treat-to-target goal". Actually, I am not sure if there is any difference between "treat-to-target goal" and "treat to target goal". If the both terms are different, I would like to say there is redundancy in "treat to target goal", and it seems that "treat-to-target goal" is a well established term.
I totally agree with Charles and Michael. "treat-to-target goal" may make different senses in different places. I am a rheumatology clinician and currently doing translations conserning rheumatoid arthritis (RA). In RA, "treat-to-target goal" is defined as the clinical remission of the disease (disease activity score <1.6 ). This goal(clinical remission) usually guides clinicians to make their treatment plan. However, in RA, clinical remission is by no means a satisfying goal both for clinicians and patients. The poor outcome of RA, like bone erosion and disability, should be guarded and prevented beforehand. This is what I mean by "prevention goal".
So my question is, if "treat-to-target goal" is well-established term, how to word the prevention goal of RA?
clinical remission- "treat-to-target goal"; bone erosion- ?

Michael Barnett Mar 2, 2012:

This is a medical idiom. Reading these comments, I get the impression that not everyone understands what "treat to target" means nor what "treat to target goal" means. I am a physician and I live and breath this stuff every day.

I will use diabetes an an example:
In the context of diabetes, treating to target means achieving a fasting blood sugar under 7.0 and a HgbA1c under 7.0. Achieving a HgbA1c of 7.6 may not be such a bad thing, but it is not treating to target under current diabetes guidelines.

The "treatment to target" GOAL is the attempt to reach the target in all the patients treated. In some patient populations, that goal is not even attempted.

Note that treatment to target is not synonymous with curing the disease. A fasting blood sugar of 7.0 is still very abnormal, but it is the level currently considered to represent good management of the diabetes.

Other existing "targets" are blood pressures under 140/90 for hypertension, LDL cholesterol levels under 2.0 for high risk patients, etc.

As for "treatment against target" - there is no such idiom.

I am uncertain what the asker means by "prevention goal"? Does s/he mean 100% prevention, risk reduction by 50% or what?

Demi Ebrite Mar 1, 2012:

@Barb I agree entirely. It is only when the word "goal" or "goals" is used after " . . . target", that there is a shift of the "goal" being the treatment outcome and the "target" becomes the illness or the state of the illness.

B D Finch Mar 1, 2012:

@Demi As you say, "treat to goal" would be wrong if the established term is "treat to target". I was pointing out the redundancy to emphasise that it seems "to" is a preposition and "target" a noun and not the infinitive of the verb. The target seems to be the required treatment outcome, not the illness or condition being treated.

Demi Ebrite Mar 1, 2012:

"goals" is used once or twice . . . Ms. Finch, I think you are right about the redundancy of the use of "goal" in Yang's question and lorena's reference actually doesn't utilize the use of "goal" with the term "treat to target". "Goal" and "target" could be used interchangeably, but "treat to goal" is not a medical term I have seen anywhere. "Treat to target goals" is used remotely, but then, it refers to the goals (usually pharmaceutical) for treating the target illness. Again, clarification from Yang would be quite helpful.

B D Finch Mar 1, 2012:

Redundancy? I was struck by the oddness of "treat-to-target goal", which contains a redundancy "target" generally = "goal". This seems to be confirmed by lorenab23's reference, where "target" and "goal" seem to be used interchangeably, but not together. E.g. "Even though clinical remission is the primary target we want to hit, a level of low disease activity may be an alternative goal to pursue." Reading that and Demi's comment, makes me think she might be misreading "target" as a verb rather than as a noun. Doesn't "treat to target", mean treat to achieve a particular target (noun) or (interchangeably) goal? In which case, one could, for prevention use "prevention to target". Where a target could be e.g. X percent of a population being disease-free Y months after exposure to a risk.

Demi Ebrite Mar 1, 2012:

More . . . In searching Google UK, the examples of "treat to target" are more about treating to target an existing condition, as opposed to treating in advance or prevention of a condition. Also, the term "treatment as prevention" is widely used with regard to HIV, as it is in the US. @Yang: more information may help us help you with the correct usage of these terms.

Demi Ebrite Mar 1, 2012:

To all: It would be nice to get more detail from Yang, as if he is needing to differentiate, or encompass both sides of the treatment regimen in his translation, I have offered the alternative, or the yin to the yang,"treatment as prevention" which is specific to just that and as Charles has said, may have a different statement of terms across the pond.

Charles Davis Mar 1, 2012:

Hi Lorena The term probably means different things in different places, but the examples of "treat to target" I'm seeing are mostly not about prevention, but about achieving defined goals, particularly remission, in existing conditions, mostly chronic, such as diabetes or rheumatoid arthritis.

lorenab23 Mar 1, 2012:

not to confuse matters but here the description of treat-to-target is not for cure but for prevention, Am I not understanding your question?
The principle of ‘treat to target’ embraces an indispensable approach to the prevention of some of the most prevalent diseases: diabetes, arterial hypertension and coronary heart disease. These highly ubiquitous disorders account for most deaths and disabilities worldwide. Preventive treatment is thus a matter of paramount priority.
http://ard.bmj.com/content/69/4/629.extract