Validation of an Automated Online Language Interpreting Tool - Phase Two.

NCT ID: NCT03538860

Last Updated: 2021-10-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

114 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-14

Study Completion Date

2021-07-31

Brief Summary

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There is a pressing national need to provide higher-quality, more effectively accessible language interpretation services to improve the health outcomes of Americans who have limited English proficiency (LEP). This project addresses a critical component of this problem: The need to improve access to high quality, mental health services for diverse populations by improving the flow of clinical work across care settings (primary care and specialty care) through the use of innovative online asynchronous methods of language interpretation and clinical communication. The investigators are conducting a two phase study. The first phase is completed and involved developing and testing the interpreting tool. The second phase of the research is a clinical trial to compare two methods of cross-language psychiatric assessment.

Detailed Description

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The investigators propose to develop and test a novel automated asynchronous interpretation tool. The proposed project builds on previous research, piloting the automated asynchronous interpretation tool. This 5-year project will be conducted in two phases. In Phase 1 the investigators iteratively evaluate and refine the automated asynchronous interpretation tool already developed in prior studies. In Phase 2, the investigators evaluate this tool using a two-group randomized cross-over trial. Investigators compare:

* Method A (current gold standard of in-person real-time interpreting practice). A Spanish-speaking patient is diagnostically assessed in-person by an English-speaking psychiatrist through a Spanish-speaking interpreter.
* Method B (comparative practice - ATP). A Spanish-speaking patient is interviewed in Spanish by a trained mental health interviewer. The interview is recorded in real time, translated into English using the automatic interpretation tool and adding sub-titles to the video file, and sent to an English-speaking psychiatrist to asynchronously - that is, at a later time - review the video and make a diagnosis.

All patients will undergo evaluation by both methods. Half of the patients will be randomized to be assessed by Method A first, followed by Method B and half to be assessed by Method B first, followed by Method A. The specific aims of the study are :

* Aim 1: To iteratively evaluate and refine the automated asynchronous interpretation tool already developed in prior studies.
* Aim 2: To compare patient satisfaction of Method A vs. Method B.
* Aim 3: To compare the diagnostic accuracy and psychiatrist inter-rater reliability of Method A vs. Method B and demonstrate psychiatrist inter-rater reliability for Method B.
* Aim 4: To compare the interview and language interpretation quality and accuracy of Method A vs. Method B.

Conditions

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Mood Disorder Anxiety Disorder Substance Use Disorder Chronic Medical Condition

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

NONE

Study Groups

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Method A first then Method B

Conventional in-person interview with a psychiatrist with a live human interpreter with crossover to asynchronous telepsychiatry

Group Type OTHER

Active comparator: Human interpreter

Intervention Type BEHAVIORAL

A Spanish-speaking patient is diagnostically assessed in-person by an English-speaking psychiatrist through a Spanish-speaking interpreter.

Intervention: Asynchronous Telepsychiatry

Intervention Type BEHAVIORAL

A Spanish-speaking patient is interviewed in Spanish by a trained mental health interviewer. The interview is video-recorded in real-time, automatically translated into English with sub-titles added to the video file, and sent to a psychiatrist and to 3 English-speaking psychiatrists to asynchronously review the video and make a diagnosis.

Method B first then Method A

Asynchronous telepsychiatry - that is, video-recorded interviews that are subsequently processed with automated speech recognition and machine translation technologies, with crossover to conventional in-person interview with a psychiatrist with a live human interpreter

Group Type OTHER

Active comparator: Human interpreter

Intervention Type BEHAVIORAL

A Spanish-speaking patient is diagnostically assessed in-person by an English-speaking psychiatrist through a Spanish-speaking interpreter.

Intervention: Asynchronous Telepsychiatry

Intervention Type BEHAVIORAL

A Spanish-speaking patient is interviewed in Spanish by a trained mental health interviewer. The interview is video-recorded in real-time, automatically translated into English with sub-titles added to the video file, and sent to a psychiatrist and to 3 English-speaking psychiatrists to asynchronously review the video and make a diagnosis.

Interventions

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Active comparator: Human interpreter

A Spanish-speaking patient is diagnostically assessed in-person by an English-speaking psychiatrist through a Spanish-speaking interpreter.

Intervention Type BEHAVIORAL

Intervention: Asynchronous Telepsychiatry

A Spanish-speaking patient is interviewed in Spanish by a trained mental health interviewer. The interview is video-recorded in real-time, automatically translated into English with sub-titles added to the video file, and sent to a psychiatrist and to 3 English-speaking psychiatrists to asynchronously review the video and make a diagnosis.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* aged 18 or older
* diagnosis of a mood disorder, anxiety disorder, or substance/alcohol abuse disorder(s)
* Diagnosis of a chronic medical condition
* referred by PCP or self-referral with PCP informed

Exclusion Criteria

* less than 18 years
* imminent suicidal ideation and/or plans
* immediate violent intentions or plans
* significant cognitive deficits
* patient who's PCP recommends not participating.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Agency for Healthcare Research and Quality (AHRQ)

FED

Sponsor Role collaborator

University of California, Davis

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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UC Davis Medical Center

Sacramento, California, United States

Site Status

Countries

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United States

References

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Tougas H, Chan S, Shahrvini T, Gonzalez A, Chun Reyes R, Burke Parish M, Yellowlees P. 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. JMIR Ment Health. 2022 Sep 6;9(9):e39556. doi: 10.2196/39556.

Reference Type DERIVED
PMID: 36066959 (View on PubMed)

Parish MB, Gonzalez A, Hilty D, Chan S, Xiong G, Scher L, Liu D, Sciolla A, Shore J, McCarron R, Kahn D, Iosif AM, Yellowlees P. Asynchronous Telepsychiatry Interviewer Training Recommendations: A Model for Interdisciplinary, Integrated Behavioral Health Care. Telemed J E Health. 2021 Sep;27(9):982-988. doi: 10.1089/tmj.2020.0076. Epub 2021 Jan 12.

Reference Type DERIVED
PMID: 33434453 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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R01HS024949

Identifier Type: AHRQ

Identifier Source: secondary_id

View Link

1131922

Identifier Type: -

Identifier Source: org_study_id