Automated Translation Software Performs Unevenly in the Emergency Department

November 4, 2019

By Erik MacLaren

DENVER -- November 2, 2019 -- The ability of Google Translate to accurately translate discharge instructions in the emergency department (ED) varies widely between languages according to data presented here at the 2019 Annual Meeting of the American College of Emergency Physicians (ACEP).

EDs often see patients with limited English proficiency, but many hospitals lack formal translation policies or procedures. Translation software, such as Google Translate, is an attractive option for many ED providers as an inexpensive way to translate written medical instructions for patients.

Vanessa Kreger, MD, University of California Los Angeles, Los Angeles, California, and colleagues evaluated the performance of Google Translate in producing accurate written translations of common ED discharge instructions in 7 languages. The languages chosen included Spanish, Chinese, Vietnamese, Tagalog, Korean, Armenian, and Farsi.

Commonly used ED discharge instruction phrases to be tested were chosen by an expert panel that included 2 ED physicians and 1 internal medicine hospitalist. The study population consisted of a convenience sample of ED patients who were native speakers of the 6 of the 7 target languages, and 60% were women. Patients who were professional translators, linguists, interpreters, and those who worked in the healthcare industry were excluded from the study.

The researchers used Google Translate to translate 320 discharge statements for evaluation, including 100 in Spanish, 60 in Chinese, and 40 each in Tagalog, Korean, Armenian, and Farsi. A total of 264 of the 320 statements (82.5%) were determined to accurately convey the intended meaning. The variability between different languages was significant, and commonly spoken languages like Spanish, with 94% accuracy, were translated at high accuracy, while less commonly spoken languages were translated much less accurately, with Farsi translations scoring 55%.

Dr. Kreger identified lessons learned through this study such as the importance of considering language directionality when entering phrases for translation. She noted that Farsi is written and read right to left instead of left to right, as in English.

“If statements are entered into Google Translate in such cases without changing directionality, the subsequent translation will be incomprehensible and useless to the patient,” she said.

Ultimately, the authors urge caution when providers use automated translation software for communicating discharge instructions to patients who do not speak English. Many factors can affect the quality of the translation, translation performance is uneven across different languages.

[Presentation title: Google Translate as a Tool for Emergency Department Discharge Instructions? Not So Fast! Abstract 10]