WITHDRAWN: Developing an Electronic Search Strategy Algorithm for Detecting Professional Interpreter Use among Patients with Limited English Proficiency: A Derivation and Validation Study

Abstract

Background Evidence exists that disparities occur for patients with Limited English Proficiency (LEP) that impact the quality of medical services, outcomes, and patient satisfaction. Using interpreter services can reduce these negative impacts; therefore optimizing our understanding of interpreter use during patient care is important. Manual chart review is time-consuming. The objective of this study was to develop and validate a search strategy algorithm to detect patients who used professional interpreter services during their hospitalization. Methods We identified all adults who were admitted to the hospital who had at least one Intensive Care Units (ICU) admission during the hospital stay across the Mayo Clinic Enterprise between January 1, 2015, and June 30, 2020. Three random subsets of 100 patients were extracted from 60,268 patients admitted to an ICU to develop the search strategy algorithm. A physician reviewer conducted the gold standard manual chart review and these results were compared with the search strategy algorithm each time it was refined. Iterative modification of the search strategy was performed and sensitivity and specificity were calculated by comparing the results to the reference standard for both derivation cohorts and the final validation cohort. Any uncertainties were resolved by a second physician researcher. Results The first search strategy resulted in a specificity of 95.7% and a sensitivity of 93.5%. The second revised search strategy achieved a specificity of 96.7% and a sensitivity of 92.3%. The final version of the search strategy was applied to the validation subset and specificity and sensitivity were 92.6% and 100% respectively. Conclusion We successfully derived and validated a search strategy algorithm to assess interpreter use among hospitalized patients. Developing a search strategy algorithm with a high sensitivity can reduce the time required to abstract data from the medical record compared to manual chart review. This can be used to examine and understand patient needs for research and quality improvement initiatives.