Evaluating the Accuracy of Google Translate in Emergency Department Discharge Instructions

Most emergency departments (EDs) don't have interpreter services bandwidth to translate written discharge instructions in a timely manner for patients with limited English proficiency (LEP). Prior studies evaluating the accuracy of Google Translate have been variable across languages.

We aimed to evaluate if translations of ED discharge (DC) instructions by Google Translate are acceptable to patients and if there are language characteristics that can predict accuracy.

We prepared DC instructions for three hypothetical ED visits. Reviewers with self-identified fluency in English and a non-English language were asked to indicate "Yes" or "No" to instruction-specific queries about translation accuracy. Accuracy was analyzed across different DC instruction domains and across different language categories. Comparisons between language groups were executed using nonparametric Kruskal-Wallis testing.

We identified a 95% overall quantitative success rate for ED DC instruction translation by Google Translate across 26 languages. In 16 of 26 languages (61.5%, 95% CI 40.6-79.8%), at least one of the four DC instruction arenas scored 90 or less. The total score was less than 90% in 5 (Amharic, French, Oromo, Portuguese, and Yoruba) of 26 languages (19.2%, 95% CI 6.6-39.4%). There were no differences by DC instruction domain or across different language categories.

Using Google Translate for DC instructions found an overall error rate of 5% across all languages. Specific languages for which Google Translate functions better are not easily identified. Further investigation into the safety of routine use of Google Translate in medical contexts with limited interpreter availability is warranted.