[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-427141-105":59,"doc-detail-427141-en":134},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":127,"head_meta":129,"extra_data":131,"updated_unix":133},105,"en","disparities-in-advance-care-planning-gaps-in-clinical-notes-on-comfort-vs-life-sustaining-treatment-preferences","DISPARITIES IN ADVANCE CARE PLANNING: GAPS IN CLINICAL NOTES ON COMFORT VS. - LIFE-SUSTAINING TREATMENT PREFERENCES","","Goal-concordant advance care planning remains essential, yet documented disparities persist. Using electronic health record free-text, a validated Priorities-BERT natural language processing model extracted care preferences from 3.6 million notes in 14,729 older adults with heart failure, cancer, or dementia. Preferences were categorized as comfort-only, life-sustaining treatment (LST)-only, mixed, or none. Logistic regression identified demographic and diagnosis-linked predictors, revealing significant cross-diagnosis gaps and lower LST documentation with increasing age. Targeted interventions are recommended to support equitable, timely ACP conversations.",{"@graph":69,"@context":126},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/disparities-in-advance-care-planning-gaps-in-clinical-notes-on-comfort-vs-life-sustaining-treatment-preferences/427141/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/disparities-in-advance-care-planning-gaps-in-clinical-notes-on-comfort-vs-life-sustaining-treatment-preferences/427141.png","ImageObject",300,407,{"name":92,"@type":93},"moss~","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-08","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118,122],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main objective of the study?","Question",{"text":112,"@type":113},"To identify predictors associated with documentation of specific advance care planning preferences among older adults with chronic conditions.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were patient preferences extracted from clinical records?",{"text":117,"@type":113},"A validated NLP model, Priorities-BERT, categorized free-text EHR notes into comfort-only, LST-only, mixed, or no documented preference.",{"name":119,"@type":110,"acceptedAnswer":120},"Which factors were associated with higher odds of having priorities of care documented?",{"text":121,"@type":113},"Female sex and diagnoses of heart failure and dementia were associated with higher odds of documenting at least some care priorities.",{"name":123,"@type":110,"acceptedAnswer":124},"What did the study conclude about disparities and interventions?",{"text":125,"@type":113},"Significant disparities existed across diagnoses in documenting ACP preferences, and targeted clinical and health-system interventions are needed to promote equitable and timely ACP conversations.","https://schema.org",{"og:url":83,"og:type":128,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":130,"canonical":83},"index,follow",{"doc_id":132,"site_id":62},427141,1791101613,{"code":4,"msg":5,"data":135},{"doc_id":132,"user_id":136,"nickname":92,"user_avatar":137,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":138,"file_id":139,"file_url":140,"file_type":141,"file_size":142,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":8,"language":143,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":144,"faqs":145,"seo_title":146,"seo_description":67,"update_tm":147,"read_time":81},962090895452,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Innovation in Aging, 2025, Vol. 9, No. S2 1061  \nAbstract citation ID: igaf122.3571  \nDISPARITIES IN ADVANCE CARE PLANNING: GAPSIN CLINICAL NOTES ON COMFORT VS.  \nLIFE-SUSTAINING TREATMENT PREFERENCES  \nYuwen Ji1, Alaa Albashayreh1, and Stephanie Gilbertson-White2,  \n1. University of Iowa, Iowa City, Iowa, United States,  \n2. University of Iowa, University of Iowa, Iowa, United States Background: Goal-concordant care is essential, yet disparities  \nin advance care planning (ACP) persist. Electronic health record (EHRs) documentation of specific preferences, such as comfort and life-sustaining treatments (LST) and natural language processing (NLP) to extract free-text data, provides real-world information to explore patterns. Objective: To identify predictors associated with documentation of specific preferences in a cohort of older adults with chronic conditions. Methods: In a dataset of records from 14,729 older adults with heart failure, cancer, or dementia from a large academic medical center, we used a validated NLP model, Priorities-BERT (accuracy= 90.91%), to categorize documented care preferences from 3.6 million EHR notes into four groups: comfort-only, LST-only, mixed, or none. Logistic regression identified factors associated with each preference category (vs. no preference). Results: The mean age of the sample was 78.67 years (SD = 6.05) . Female patients (vs. male)(OR = 1. 11, 95% CI: 1.04–1. 19), heart failure (OR =1 .59, 95% CI: 1.34–1. 89), dementia (OR = 1 .33, 95%CI: 1.25-1.43), were associated with higher odds of having any priorities of care documented. Increasing age was associated with lower odds of LST (OR = 0 .94, 95%CI: 0.94-0.95) . Patients with heart failure (OR = 1 .50, 95%CI: 1.39-1.61) or dementia (OR = 1 .56, 95% CI: 1.42-1.71) were more likely to have comfort preferences documented. Conversely, cancer patients were more likely to have LST documented (OR = 1 . 12, 95%CI: 1.03-1.21) . Conclusion: Significant disparities existed across these three diagnoses in documentationACP preferences. Targeted clinical and health-system interventions are needed to promote equitable and timely ACP conversations for patients likely to benefit from this care.","cbCaikXqAGc9jqIn","https://ap.wps.com/l/cbCaikXqAGc9jqIn","pdf",938550,"English","# Abstract\n## Background\n## Objective\n## Methods\n## Results\n## Conclusion","[{\"question\":\"What was the main objective of the study?\",\"answer\":\"To identify predictors associated with documentation of specific advance care planning preferences among older adults with chronic conditions.\"},{\"question\":\"How were patient preferences extracted from clinical records?\",\"answer\":\"A validated NLP model, Priorities-BERT, categorized free-text EHR notes into comfort-only, LST-only, mixed, or no documented preference.\"},{\"question\":\"Which factors were associated with higher odds of having priorities of care documented?\",\"answer\":\"Female sex and diagnoses of heart failure and dementia were associated with higher odds of documenting at least some care priorities.\"},{\"question\":\"What did the study conclude about disparities and interventions?\",\"answer\":\"Significant disparities existed across diagnoses in documenting ACP preferences, and targeted clinical and health-system interventions are needed to promote equitable and timely ACP conversations.\"}]","DISPARITIES IN ADVANCE CARE PLANNING: GAPS IN CLINICAL NOTES ON COMFORT VS. - LIFE-SUSTAINING TREATMENT PREFERENCES | PDF",1790642966]