Negative Patient Descriptors: Documenting Racial Bias In The Electronic Health Record.

Little is known about how racism and bias may be communicated in the medical record. This study used machine learning to analyze electronic health records (EHRs) from an urban academic medical center and to investigate whether providers' use of negative patient descriptors varied by patient race or ethnicity. We analyzed a sample of 40,113 history and physical notes (January 2019-October 2020) from 18,459 patients for sentences containing a negative descriptor (for example, resistant or noncompliant) of the patient or the patient's behavior. We used mixed effects logistic regression to determine the odds of finding at least one negative descriptor as a function of the patient's race or ethnicity, controlling for sociodemographic and health characteristics. Compared with White patients, Black patients had 2.54 times the odds of having at least one negative descriptor in the history and physical notes. Our findings raise concerns about stigmatizing language in the EHR and its potential to exacerbate racial and ethnic health care disparities.

COVID-19 Vaccination: Science, the Antidote for Misinformation

Perhaps nothing has consumed our practices more than the effect of COVID-19 and the disputes with patients over vaccination. Despite the miracle of modern science that multiple vaccines have been developed in an amazingly short time after the onset of the pandemic, so many Americans have been hesitant or actively resistant to vaccination. Never before has the authority and scientific integrity of such prestigious and respected organizations as the World Health Organization, U.S. Food and Drug Administration, and Centers for Disease Control and Prevention been so critically questioned. The conjunction of the politicizing of the science and the powerful influence of social media has powerfully propelled potential misinformation. * Concepts of the totality of the data and the quality of the data are discussed. * Multiple COVID-19 myths are deconstructed. * The challenges of the effectiveness of natural immunity vs. immunization are discussed. The Delta variant has evolved since the original development of the vaccines and, along with waning immunity, has continued to lead to re-infections. * The recent onset of the new Omicron variant currently is under investigation to assess its relative infectiousness, severity, and responsiveness to current vaccines and therapeutics. Introduction