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. 2022 Sep-Oct;16(5):527-533.
doi: 10.1097/ADM.0000000000000960. Epub 2022 Apr 22.

Stigmatizing Terminology for Outcomes and Processes (STOP) in Alcohol Research: A Meta-epidemiologic Assessment of Language Used in Clinical Trial Publications

Micah Hartwell  1 , Vanessa Lin, Mackenzee Hester, Nicholas B Sajjadi, Kelly Dunn, James Morris, Katie Witkiewitz
Affiliations

Stigmatizing Terminology for Outcomes and Processes (STOP) in Alcohol Research: A Meta-epidemiologic Assessment of Language Used in Clinical Trial Publications

Micah Hartwell et al. J Addict Med. 2022 Sep-Oct.

Abstract

Introduction: Stigmatizing language used to describe patients and medical conditions is associated with poorer health outcomes. A recent investigation showed that approximately 80% of medical literature focused on alcohol use disorder (AUD) contained stigmatizing terms related to individuals; however, the quantification of stigmatizing terminology for outcomes and processes (STOP) among AUD research is unknown. Thus, our primary objective was to evaluate publications of clinical trials for their inclusion of STOP.

Methods: We performed a systematic search of PubMed for AUD clinical trials between January 1, 2017 and June 30, 2021. Article screening and data extraction were performed in a masked, duplicate manner by 2 investigators. We searched the full text of included manuscripts for STOP. We reported the frequency and percentage of manuscripts with STOP and individual terms. We evaluated associations between STOP usage and several clinical trial characteristics via logistic regression.

Results: Our search returned 1552 articles, which were then randomized and the first 500 were screened for inclusion. Of 147 included articles, 115 (78.2%) included STOP. The most common STOP were "drop out" (38.78%; 57/147), "relapse" (36.05%; 53/ 147), and "adherent, nonadherence" (35.37%; 52/147). No significant associations were found between STOP usage and trial characteristics.

Discussion: STOP was found in a majority of AUD clinical trial publications. As AUD is highly stigmatized, steps should be taken to eliminate usage of STOP in literature pertaining to AUD treatments. Many stigmatizing terms can be replaced by person-centered, more clinically accurate terms to further combat AUD stigma.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram.
FIGURE 2
FIGURE 2
Use of STOP in clinical trial publications. STOP indicates stigmatizing terminology for outcomes and processes.
See this image and copyright information in PMC

References

    1. Saitz R Miller SC Fiellin DA, et al. . Recommended use of terminology in addiction medicine. J Addict Med. 2021;15(1):3–7. - PubMed
    1. Kelly JF, Dow SJ, Westerhoff C. Does our choice of substance-related terms influence perceptions of treatment need? An empirical investigation with two commonly used terms. J Drug Issues. 2010;40(4):805–818.
    1. Ashford RD, Brown AM, Curtis B. Substance use, recovery, and linguistics: the impact of word choice on explicit and implicit bias. Drug Alcohol Depend. 2018;189:131–138. - PMC - PubMed
    1. P Goddu A O’Conor KJ Lanzkron S, et al. . Do words matter? Stigmatizing language and the transmission of bias in the medical record. J Gen Intern Med. 2018;33(5):685–691. - PMC - PubMed
    1. Ashford RD Brown AM Canode B, et al. . A mixed-methods exploration of the role and impact of stigma and advocacy on substance use disorder recovery. Alcohol Treat Q. 2019;37(4):462–480.