Accepted for/Published in: JMIR Rehabilitation and Assistive Technologies
Date Submitted: Jun 14, 2025
Date Accepted: Dec 3, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Assessing the Role of Medical Caption Technology to Support Physician-Patient Communication for Patients with Hearing Loss: A Pilot Study
ABSTRACT
Background:
Speech recognition technology is widely used by D/deaf and hard-of-hearing (DHH) individuals in everyday communication, but its clinical applications remain underexplored. Communication barriers in healthcare can compromise safety, understanding, and autonomy for DHH individuals.
Objective:
This study evaluated a real-time speech recognition system (SRS) tailored for clinical settings, examining its usability, perceived effectiveness, and transcription accuracy among DHH users.
Methods:
We conducted a pilot study with 10 DHH adults participating in mock outpatient encounters using a custom SRS powered by Google’s speech-to-text API. Participants completed post-scenario surveys and structured exit interviews assessing distraction, trust, ease of use, satisfaction, and emotional response. Caption accuracy was benchmarked against professional Communication Access Realtime Translation (CART) transcripts using word error rate (WER).
Results:
Across 29 clinical scenario simulations, 86% of participants found captions non-distracting, 90% reported them easy to follow and trustworthy, and 76% were satisfied with the experience. Participants described the SRS as intuitive, emotionally grounding, and preferable to lipreading in masked settings. WER ranged from 12.7% to 22.8%, consistent with benchmarks for automated speech recognition systems. Interviews revealed themes of increased confidence in following clinical conversations and staying engaged despite masked communication, reduced anxieties about missing critical medical information, and strong interest in expanding the tool to real-world settings, especially for older adults or those with cognitive impairments.
Conclusions:
Our findings support the potential of real-time captioning to enhance accessibility and reduce the cognitive and mental burden of communication for DHH individuals in clinical care. Participants described the SRS as both functionally effective and personally empowering. While accuracy for complex medical terminology remains a limitation, participants consistently expressed trust in the system and a desire for its integration into clinical care. Future research should explore real-world implementation, domain-specific optimization, and the development of user-centered evaluation metrics that extend beyond transcription fidelity to include trust, autonomy, and communication equity. Clinical Trial: N/A
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