Accuracy of Free Internet Based Translation Web Sites for Emergency Department Discharge Instructions

Background and Purpose:  Many of the patients we see in the emergency department and hospital based clinics are limited in their English proficiency or may even not speak English at all.  This has potential to detrimentally affect the care of these patients, and is particularly problematic in the emergency department and clinic settings, where patient volume is high and time for patient interaction limited.  The availability of human translators may overcome some of quality care issues related to the presence of a language barrier at the time of the patient’s visit.  However, these translation services do not typically provide written discharge instructions in the patients’ primary language.  This is significant since published data demonstrate that the addition of written discharge instructions to verbal instructions greatly improves patient understanding and compliance.  There exists several free, internet based sites that provide instantaneous translation of small paragraphs of text.  Since these are universally available at no cost, they represent a potentially cost-effective manner of providing written discharge instructions to non-English fluent patients in the emergency department or clinic settings.  Therefore, the objective of this study is to assess the accuracy and utility of these sites for emergency department discharge instructions across a broad range of languages. 

Methods:  This is an IRB exempt study.  We have selected six common chief complaints among emergency department and clinic patients for which we have standard discharge instructions.  All of the English discharge instructions were formatted in the same way, each divided into the following 4 sections: i) diagnosis; ii) treatment; iii) reasons to seek further medical attention from a PCP or return to the emergency department; and iv) follow-up.  These instructions have been entered into four different internet translation sites and the translated instructions printed. Each study participant will be given the original (English) instructions as well as the translation for each chief complaint from the four different websites.  Each participant will then review the translations and score them with regard to the accuracy of translation (see scoring instructions below).  Therefore each participant will be asked to perform 24 translations total across the varying chief complaints and websites. 

Scoring Instructions:
When reviewing the translations, please score each line, including the major headings, as correct or incorrect.  A correct translation is defined as one which accurately conveys the meaning of each sentence.  Simple grammatical errors would not be considered incorrect.  Circle “Yes” if all information on a given line in the English instructions are conveyed accurately.  Circle “No” if all information is not conveyed accurately.  If you believe the translation for a given line is inaccurate, on the English version, please circle the portion of the sentence that was conveyed incorrectly and provide an explanation of the specific error(s) on the blank line below the sentence.

Please use the following guidelines for scoring:

1. Each HEADING must be translated accurately.
2. For DIGANOSIS:  The name of the diagnosis must be correct and any explanation of cause, associated symptoms, or sequelae must be accurately conveyed.
3. For TREATMENT:
1. medications, doses and timing must be accurate.
2. medication side effects, when included, must be accurately conveyed.
3. nonpharmacologic treatment recommendations must be accurately conveyed.
4. For REASON TO SEEK FURTHER MEDICAL ATTENTION:  Each reason to seek follow-up must be accurately conveyed.
5. The recommended FOLLOW-UP, including time frame, if specified, must be accurately conveyed.

When you have completed this:
Place all materials in campus mail envelope and return to William Meurer. (Envelope should be addressed Taubman Center B1354 SPC/campus zip 5303)

If you have any additional questions please contact William Meurer a wmeurer@umich.edu or 734-936-1616

Thank you.