ArticleJournal of general internal medicine2018
Do Words Matter? Stigmatizing Language and the Transmission of Bias in the Medical Record.
Article in Journal of general internal medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 152 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
152 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Adherence to Updated Race and Ethnicity Reporting Guidance in Ophthalmology Journals.JAMA network open · 2025Pooled it
- Understanding Stigmatizing Language Lexicons: A Comparative Analysis in Clinical Contexts.AMIA ... Annual Symposium proceedings. AMIA Symposium · 2024Pooled it
- Does perceived stigma impact opioid use disorder treatment uptake? A cross-sectional secondary analysis of buprenorphine engagement among syringe service program participants.Addiction science & clinical practice · 2026Trial
- Effect of Exposure to Visual Campaigns and Narrative Vignettes on Addiction Stigma Among Health Care Professionals: A Randomized Clinical Trial.JAMA network open · 2022Trial
- Influence of a Multifaceted Nursing Practice Bundle to Support Hospitalised Adults With Cognitive Impairment: A Longitudinal Qualitative Study.Journal of clinical nursing · 2026Article
- A call for improvements in implementation of inclusive patient-first language in dermatologic care and research.International journal of women's dermatology · 2026Article
- An Environmental Scan of Alternate Level of Care (ALC) Policies in Ontario, Canada.Canadian geriatrics journal : CGJ · 2026Article
- Stigmatizing Language in Gender-Expansive Patient Records: Corpus Development, Disparity Analysis, and Natural Language Processing-Based Detection Study.Journal of medical Internet research · 2026Article
- Large Language Models for Mental Health Prediction: Scoping Review of Bias and Clinical Utility Documentation in 2019-2024.JMIR AI · 2026Review
- It's Not Really the Words; It's How They Land: Lived Experience Perspectives on the Use of Language and Labels in Mental Health.International journal of environmental research and public health · 2026Article
- Investigation of Differences in Tobacco Use Language Between Groups: Corpus-Assisted Analysis.JMIR infodemiology · 2026Article
- Does clinical documentation reflect how parents and clinicians share decisions about surgery?BMC medical informatics and decision making · 2026Article
- Exploring the Patient's Lifeworld: A Qualitative Study of Personalizing Language in Electronic Health Records.Journal of general internal medicine · 2026Article
- Language matters: Guidance for person-centred diabetes communication in Ireland.Diabetic medicine : a journal of the British Diabetic Association · 2026Review
- Re-Centering Clinical Documentation in the Age of AI Scribes: Four Aims of the Patient Chart Note.JMIR medical education · 2026Article
- Words and Language Matter: Improving Older Person's Healthcare Outcomes Through Use of Age-Positive Language.Emergency medicine Australasia : EMA · 2026Review
- How words discredit: A taxonomy of stigmatizing language in the electronic health record.Patient education and counseling · 2026Article
- A scoping review of implementation strategies to reduce stigma toward people who use substances in healthcare settings.Journal of substance use and addiction treatment · 2026Article
- Article
- Negative Descriptors of Patients With Sickle Cell Disease in the Electronic Health Record.JAMA network open · 2026Article
92 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
8 authors.
Funding
Abstract
backgroundClinician bias contributes to healthcare disparities, and the language used to describe a patient may reflect that bias. Although medical records are an integral method of communicating about patients, no studies have evaluated patient records as a means of transmitting bias from one clinician to another.
objectiveTo assess whether stigmatizing language written in a patient medical record is associated with a subsequent physician-in-training's attitudes towards the patient and clinical decision-making.
designRandomized vignette study of two chart notes employing stigmatizing versus neutral language to describe the same hypothetical patient, a 28-year-old man with sickle cell disease.
participantsA total of 413 physicians-in-training: medical students and residents in internal and emergency medicine programs at an urban academic medical center (54% response rate). MAIN MEASURES: Attitudes towards the hypothetical patient using the previously validated Positive Attitudes towards Sickle Cell Patients Scale (range 7-35) and pain management decisions (residents only) using two multiple-choice questions (composite range 2-7 representing intensity of pain treatment). KEY
resultsExposure to the stigmatizing language note was associated with more negative attitudes towards the patient (20.6 stigmatizing vs. 25.6 neutral, p < 0.001). Furthermore, reading the stigmatizing language note was associated with less aggressive management of the patient's pain (5.56 stigmatizing vs. 6.22 neutral, p = 0.003).
conclusionsStigmatizing language used in medical records to describe patients can influence subsequent physicians-in-training in terms of their attitudes towards the patient and their medication prescribing behavior. This is an important and overlooked pathway by which bias can be propagated from one clinician to another. Attention to the language used in medical records may help to promote patient-centered care and to reduce healthcare disparities for stigmatized populations.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.