Hidden in Plain Sight: Stigmatizing Language in Patient Medical Records
隐藏在众目睽睽之下:患者病历中的污名化语言
基本信息
- 批准号:10365551
- 负责人:
- 金额:$ 69.23万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2022
- 资助国家:美国
- 起止时间:2022-01-01 至 2026-11-30
- 项目状态:未结题
- 来源:
- 关键词:AffectAgeAlgorithmsAreaAttentionAttitudeBehaviorBypassCanis familiarisCaringClinicalComputerized Patient RecordsConsensusDrug PrescriptionsEducationElderlyFeedbackFocus GroupsGenderGoalsHealth ProfessionalHealth systemHealthcareHealthcare SystemsImpairmentIndividualJudgmentLanguageMeasuresMedicalMedical RecordsMethodsNatural Language ProcessingObesityOralPathway interactionsPatientsPatternPersonsPhysiciansPoliticsQuality of CareRaceReadingRecordsRoleSickle Cell AnemiaSocial ClassSocial statusSpeechStereotypingStigmatizationSubstance Use DisorderTaxonomyTestingVisionWorkWritingbasedisparity reductionethnic identityhealth care qualityhealth literacyimplementation scienceimplicit biasimprovedindividual patientmedical specialtiespatient health informationpilot testracial and ethnicracial disparitysexsubstance abuser
项目摘要
ABSTRACT
Our healthcare system does not treat patients equally: some receive poorer quality care based on their racial/
ethnic identity, social class, health literacy, age, gender or medical conditions such as obesity, sickle cell disease,
and substance use disorders. While there may be many factors that contribute to these disparities, implicit bias
among clinicians is one important factor that remains difficult to measure. Clinicians may convey and acquire
bias towards patients from each other when communicating orally or when writing/reading medical records.
Although medical records are an integral method of communicating about patients, few studies have evaluated
patient records as a means of transmitting bias from one clinician to another. Our own preliminary work has
found that language used in medical records has a direct influence on subsequent clinicians who read the notes,
both in terms of their attitudes towards the patient and their medication prescribing behavior; that there are racial
disparities in the use of stigmatizing language; and that this language reflects actual attitudes held by the
clinicians. This is an important and overlooked pathway by which bias can be passed from one clinician to
another, further impairing healthcare quality for the individual patient as well as exacerbating disparities overall
for those who are stigmatized. Our overarching goal is to improve the quality and equity of care for persons who
are disrespected and stigmatized in healthcare. The specific aims of this proposal are: (1) to define and develop
a taxonomy of stigmatizing language in medical records using qualitative analyses with input from clinicians and
patients across 5 different medical specialty areas, (2) to measure and test for bias in the use of stigmatizing
language in medical records using natural language processing (NLP) that can efficiently detect and quantify
stigmatizing language in electronic patient records, and then (3) to reduce stigmatizing language in medical
records using proven implementation science (IS) strategies (stakeholder engagement, education, audit and
feedback, and champions) to motivate and enable health system change. Every encounter with a patient is
documented in the medical record. Because language may have a powerful role in influencing subsequent
clinician attitudes and behavior, attention to the language used in medical records could have a large impact on
the promotion of respect and reduction of disparities for stigmatized groups.
摘要
我们的医疗保健系统并没有平等对待病人:有些人根据种族/性别接受质量较差的护理。
种族认同、社会阶层、健康素养、年龄、性别或医疗状况,如肥胖、镰状细胞病,
和物质使用障碍。虽然可能有许多因素导致这些差异,但内隐偏见
是一个仍然难以衡量的重要因素。临床医生可以传达和获取
在口头交流或书写/阅读病历时,彼此对患者的偏见。
虽然医疗记录是沟通患者的一种不可或缺的方法,但很少有研究评估
患者记录作为将偏见从一个临床医生传递到另一个临床医生的手段。我们的初步工作
发现医疗记录中使用的语言对后来阅读笔记的临床医生有直接影响,
无论是在他们对病人的态度和他们的药物处方行为方面;有种族
在使用侮辱性语言方面的差异;这种语言反映了
临床医生这是一个重要的和被忽视的途径,通过它,偏见可以从一个临床医生传递到
另一方面,进一步损害了个别患者的医疗保健质量,并加剧了整体差异
对于那些被污名化的人。我们的首要目标是提高以下人员的护理质量和公平性:
在医疗保健方面不受尊重和歧视。本建议的具体目标是:(1)界定和发展
使用临床医生输入的定性分析对医疗记录中的污名化语言进行分类,
5个不同医学专业领域的患者,(2)测量和测试使用污名化的偏倚
使用自然语言处理(NLP)的医疗记录中的语言,可以有效地检测和量化
电子病历中的污名化语言,然后(3)减少医疗记录中的污名化语言
使用经过验证的实施科学(IS)战略(利益相关者参与、教育、审计和
反馈和倡导者),以激励和促进卫生系统的变革。每次遇到病人
记录在医疗记录中。因为语言可能在影响随后的
临床医生的态度和行为,注意医疗记录中使用的语言可能有很大的影响,
促进对遭鄙视贬斥群体的尊重,减少他们之间的差距。
项目成果
期刊论文数量(0)
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{{ truncateString('MARY CATHERINE BEACH', 18)}}的其他基金
Hidden in Plain Sight: Stigmatizing Language in Patient Medical Records
隐藏在众目睽睽之下:患者病历中的污名化语言
- 批准号:
10538612 - 财政年份:2022
- 资助金额:
$ 69.23万 - 项目类别:
Hidden in Plain Sight: Stigmatizing Language in Patient Medical Records
隐藏在众目睽睽之下:患者病历中的污名化语言
- 批准号:
10791987 - 财政年份:2022
- 资助金额:
$ 69.23万 - 项目类别:
Developing Novel Linguistic Analytic Methods to Optimize Relationship Quality and Equity in HIV Care
开发新的语言分析方法以优化艾滋病毒护理中的关系质量和公平性
- 批准号:
10410565 - 财政年份:2021
- 资助金额:
$ 69.23万 - 项目类别:
Developing Novel Linguistic Analytic Methods to Optimize Relationship Quality and Equity in HIV Care
开发新的语言分析方法以优化艾滋病毒护理中的关系质量和公平性
- 批准号:
10252171 - 财政年份:2021
- 资助金额:
$ 69.23万 - 项目类别:
Communication Quality and Patient Outcomes in HIV/AIDS and Substance Abuse
艾滋病毒/艾滋病和药物滥用方面的沟通质量和患者结果
- 批准号:
9000684 - 财政年份:2015
- 资助金额:
$ 69.23万 - 项目类别:
Maximizing respect and improving outcomes in HIV and substance abuse (MaRIPOHSA)
最大限度地尊重艾滋病毒和药物滥用并改善其结果 (MaRIPOHSA)
- 批准号:
8708312 - 财政年份:2014
- 资助金额:
$ 69.23万 - 项目类别:
Maximizing respect and improving outcomes in HIV and substance abuse (MaRIPOHSA)
最大限度地尊重艾滋病毒和药物滥用并改善其结果 (MaRIPOHSA)
- 批准号:
9037635 - 财政年份:2014
- 资助金额:
$ 69.23万 - 项目类别:
Maximizing respect and improving outcomes in HIV and substance abuse (MaRIPOHSA)
最大限度地尊重艾滋病毒和药物滥用并改善其结果 (MaRIPOHSA)
- 批准号:
9462761 - 财政年份:2014
- 资助金额:
$ 69.23万 - 项目类别:
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