Stigmatizing language (SL) is widespread throughout medical documentation.¹ It is more likely to be found in the records of Black patients,^2,3 patients with public insurance,² and patients with certain comorbidities.³ We investigated associations between SL, errors in the diagnostic process, and demographics for hospitalized patients.

This multicenter, retrospective cohort study was conducted as part of the Utility of Predictive Systems for Diagnostic Errors (UPSIDE) study.⁴ Using a structured adjudication tool, UPSIDE assessed the presence of diagnostic errors and diagnostic process errors among patients who died while hospitalized (with the exception of people who died <48 hours of admission for trauma, burn, or out-of-hospital arrest) or were transferred to the intensive care unit more than 48 hours after admission at 29 hospitals from January to December 2019. Diagnostic errors were defined as missed opportunities to make a correct or timely diagnosis. Diagnostic process errors were diagnostic failure points occurring across the Diagnostic Error Evaluation and Research categories.⁵ Race, ethnicity, and other demographic variables were collected administratively at study sites. Full UPSIDE methods are described elsewhere.⁶ This study was approved by the University of California San Francisco institutional review board; informed consent was waived because of use of retrospective data.