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Assessment of Artificial Intelligence-based Translation Tools for Emergency Department Discharge Instructions
Estee Wu1, Cassandra Mackey2, Simi Jandu2
1Upstate Medical University Norton College of Medicine, Syracuse, New York.
The Western Journal of Emergency Medicine
|June 8, 2026
Summary
Artificial intelligence (AI) translation tools like ChatGPT-4 show promise for improving emergency department (ED) discharge instructions for patients with limited English proficiency (LEP). However, human oversight is still essential for accuracy and patient safety.
Area of Science:
- Medical informatics
- Natural Language Processing
- Health Communication
Background:
- Limited English proficiency (LEP) affects 8% of US residents, increasing risks of poor care quality and safety due to language barriers.
- Miscommunication during emergency department (ED) discharge can lead to adverse health outcomes, including medication errors and readmissions.
Purpose of the Study:
- To evaluate the quality and safety of AI-generated translations of physician-written ED discharge instructions.
- To assess AI translation performance across varying levels of linguistic complexity.
Main Methods:
- Physician-written ED discharge instructions for four conditions were translated into Albanian, Brazilian Portuguese, and Vietnamese using ChatGPT-4, Microsoft Copilot, and Google Translate.
- Professional medical translators assessed translations for semantic accuracy, fluency, meaning, severity, preference, and formality on 5-point and 3-point scales.
Main Results:
- Overall translation quality scores were similar across AI models, with no statistically significant differences.
- ChatGPT-4 demonstrated superior performance in translating instructions into Albanian and was rated highest for Albanian and Brazilian Portuguese.
- Microsoft Copilot and Google Translate each produced five potentially harmful translation errors, while ChatGPT-4 produced none.
Conclusions:
- AI translation tools offer potential for improving ED discharge instructions for LEP patients.
- ChatGPT-4 exhibited the best overall performance and safety profile among the evaluated AI models.
- Despite AI advancements, human oversight remains critical to ensure accuracy and mitigate risks in medical translation.
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