The Use of Automated Machine Translation to Translate Figurative Language in a Clinical Setting: Analysis of a Convenience Sample of Patients Drawn From a Randomized Controlled Trial

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.

Genetic complementation and kinetic analyses of Rhodobacter capsulatus ORF1696 mutants indicate that the ORF1696 protein enhances assembly of the light-harvesting I complex

Rhodobacter capsulatus ORF1696 mutant strains were created by insertion of antibiotic resistance cartridges at different sites within the ORF1696 gene in a strain that lacks the light-harvesting II (LHII) complex. Steady-state absorption spectroscopy profiles and the kinetics of the light-harvesting I (LHI) complex assembly and decay were used to evaluate the function of the ORF1696 protein in various strains. All of the mutant strains were found to be deficient in the LHI complex, including one (deltaNae) with a disruption located 13 codons before the 3' end of the gene. A 5'-proximal disruption after the 31st codon of ORF1696 resulted in a mutant strain (deltaMun) with a novel absorption spectrum. The two strains with more 3' disruptions (deltaStu and deltaNae) were restored nearly to the parental strain phenotype when trans complemented with a plasmid expressing the ORF1696 gene, but deltaMun was not. The absorption spectrum of deltaMun resembled that of a strain which had a polar mutation in ORF1696. We suggest that a rho-dependent transcription termination site exists between the MunI and proximal StuI sites of ORF1696. A comparison of LHI complex assembly kinetics showed that assembly occurred 2.6-fold faster in the parental strain than in strain deltaStu. In contrast, LHI complex decay occurred 1.7-fold faster in the ORF1696 parental strain than in deltaStu. These results indicate that the ORF1696 protein has a major effect on LHI complex assembly, and models of ORF1696 function are proposed.