From Context to Care: Rethinking Stigma Detection in Clinical Language Models
Bibliographic record
Abstract
Unlabelled: Natural language processing techniques are useful for identifying stigmatizing language in electronic health records but require careful consideration. This commentary article builds on "Efficient Detection of Stigmatizing Language in Electronic Health Records via In-Context Learning" by Chen et al, which highlights the importance of incorporating situational and temporal contexts in annotation and modeling efforts. We emphasize the need for researchers to explicitly articulate their paradigms and positionality, particularly when working with populations disproportionately affected by stigmatizing language. We also explore the differences arising from conflicting preferences across communities about what constitutes destigmatizing language. We discuss participatory and trust-centered approaches for model development to work toward unbiased impact. Such strategies have a crucial role in raising awareness and fostering inclusive health care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.105 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.004 |
| Scholarly communication | 0.008 | 0.009 |
| Open science | 0.003 | 0.006 |
| Research integrity | 0.002 | 0.006 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".