Publications by authors named "A K Walling"

Purpose: The perspective of all stakeholders involved in clinical trials is critical to addressing disparities in racial/ethnic minority (REM) clinical trial participation. Little is known about clinical trial investigator perspectives. To our knowledge, there are no published studies assessing differences in investigator perspectives on the basis of their primary role in clinical trials (ie, principal investigator [PI] or subinvestigator [sub-I]).

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Objectives: Health systems are increasingly accountable for patients and require accurate electronic health record (EHR) vital status. We recently demonstrated that 19% of seriously ill primary care patients in one system were not marked dead in the EHR and 80% of these decedents had an encounter or appointment outstanding after death. Herein we describe the mechanism of identifying decedents whose death is not captured at the level of the EHR, characterize these decedents, and describe medications refilled after death.

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Background: The Health Insurance Portability and Accountability Act (HIPAA) aims to safeguard patient information; however, complex legal language may lead to confusion and mistrust, and hinder enrollment in clinical trials.

Objective: To evaluate the effect of a standard HIPAA authorization included in mailed survey packets on study enrollment for a multi-site pragmatic trial.

Design: This study is nested within an advance care planning pragmatic trial at 50 primary care clinics across three University of California (UC) Health Systems.

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Article Synopsis
  • The study aimed to assess the effectiveness of an electronic health record (EHR) algorithm designed to identify patients with advanced solid cancer, originally developed at a single cancer center.
  • Researchers tested the algorithm against a human-coded reference standard in both the Veterans Health Administration and an academic cancer center, analyzing data from 2016 to 2019.
  • The results showed that the algorithm had high specificity (93% and 97%) and reasonable sensitivity (85% and 87%), indicating it can effectively identify advanced cancer patients and may help enhance palliative care across different healthcare environments.
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