Alexandra L. Beck

Yiliang Zhou, Yawen Guo, Sairam Sutari et al.

Ambient artificial intelligence (AI) documentation tools are increasingly deployed to reduce clinician documentation burden, but their implications for biased language in clinical notes remain unclear. We conducted a large-scale comparison analysis of AI drafts and corresponding clinician finalized notes to quantify stigmatizing language changes pre- and post-editing. Using a lexicon-based natural language processing (NLP) pipeline, we measured (1) the prevalence of stigmatizing language in AI drafts, (2) the prevalence and term composition in final notes, and (3) the frequency of removal or introduction of stigmatizing terms. Across 66,297 paired note sections, 21.4% of AI draft sections contained at least one stigmatizing language mention, rising to 24.0% in clinician finalized versions. Introductions occurred more often than removals, suggesting clinician editing can be a net source of stigmatizing language entering the EHR with using Ambient AI.

Yiliang Zhou, Di Hu, Tianchu Lyu et al.

Stigmatizing language results in healthcare inequities, yet there is no universally accepted or standardized lexicon defining which words, terms, or phrases constitute stigmatizing language in healthcare. We conducted a systematic search of the literature to identify existing stigmatizing language lexicons and then analyzed them comparatively to examine: 1) similarities and discrepancies between these lexicons, and 2) the distribution of positive, negative, or neutral terms based on an established sentiment dataset. Our search identified four lexicons. The analysis results revealed moderate semantic similarity among them, and that most stigmatizing terms are related to judgmental expressions by clinicians to describe perceived negative behaviors. Sentiment analysis showed a predominant proportion of negatively classified terms, though variations exist across lexicons. Our findings underscore the need for a standardized lexicon and highlight challenges in defining stigmatizing language in clinical texts.