ABSTRACT
BACKGROUND: Patients with limited English proficiency frequently receive substandard health care. Asynchronous telepsychiatry (ATP) has been established as a clinically valid method for psychiatric assessments. The addition of automated speech recognition (ASR) and automated machine translation (AMT) technologies to asynchronous telepsychiatry may be a viable artificial intelligence (AI)-language interpretation option. OBJECTIVE: This project measures the frequency and accuracy of the translation of figurative language devices (FLDs) and patient word count per minute, in a subset of psychiatric interviews from a larger trial, as an approximation to patient speech complexity and quantity in clinical encounters that require interpretation. METHODS: A total of 6 patients were selected from the original trial, where they had undergone 2 assessments, once by an English-speaking psychiatrist through a Spanish-speaking human interpreter and once in Spanish by a trained mental health interviewer-researcher with AI interpretation. 3 (50%) of the 6 selected patients were interviewed via videoconferencing because of the COVID-19 pandemic. Interview transcripts were created by automated speech recognition with manual corrections for transcriptional accuracy and assessment for translational accuracy of FLDs. RESULTS: AI-interpreted interviews were found to have a significant increase in the use of FLDs and patient word count per minute. Both human and AI-interpreted FLDs were frequently translated inaccurately, however FLD translation may be more accurate on videoconferencing. CONCLUSIONS: AI interpretation is currently not sufficiently accurate for use in clinical settings. However, this study suggests that alternatives to human interpretation are needed to circumvent modifications to patients' speech. While AI interpretation technologies are being further developed, using videoconferencing for human interpreting may be more accurate than in-person interpreting. TRIAL REGISTRATION: ClinicalTrials.gov NCT03538860; https://clinicaltrials.gov/ct2/show/NCT03538860.
ABSTRACT
OBJECTIVE: Investigating how the spatial and audiovisual conditions in video remote interpreting (VRI) shape communicative interaction in a language-discordant clinical consultation. METHODS: We conducted a multimodal analysis of an authentic VRI-mediated consultation with special reference to spatial arrangements, audiovisual conditions, and the healthcare professional's use of embodied communicative resources (body orientation, eye gaze, gestures). RESULTS: The physician is found to pursue his communicative goals for the consultation by first creating an appropriate spatial and technical environment and then supporting his information-giving and relationship-building actions through the use of nonverbal (embodied) resources like body orientation, gaze and gestures as well as specific turn-management behaviour. CONCLUSION: VRI allows healthcare professionals to access professional interpreters for language-discordant consultations but requires appropriate technical and spatial arrangements as well as users capable of adapting their communicative behaviour to spatial and audiovisual constraints. PRACTICE IMPLICATIONS: Alongside telephone interpreting, VRI is the solution of choice for language-discordant clinical encounters in times of the Covid-19 pandemic. Its use requires appropriate technical and spatial arrangements as well as specific skills on the part of healthcare professionals to cope with inherent audiovisual constraints.