ArticleJournal of general internal medicine2019
Secure Messaging with Physicians by Proxies for Patients with Diabetes: Findings from the ECLIPPSE Study.
Article in Journal of general internal medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Demographic and Socioeconomic Disparities in Telemedicine Use Among Individuals With Type 2 Diabetes in Primary Care: Systematic Review and Meta-Analysis.Journal of medical Internet research · 2025Pooled it
- A Secure User Interface for Preclinical Evaluation of AI in Patient Portal Message Management: Tutorial.JMIR medical informatics · 2026Article
- A scoping review of studies on secure messaging through patient portals: persistent challenges and potential solutions.npj health systems · 2026Article
- Uptake and user characteristics of MyChart within a Canadian community hospital with a diverse patient population: A comparative study.PLOS digital health · 2025Article
- A Multisite Demonstration of Shared Access to Older Adults' Patient Portals.JAMA network open · 2025Article
- Care Partner Engagement in Secure Messaging Between Patients With Diabetes and Their Clinicians: Cohort Study.JMIR diabetes · 2024Article
- The State-of-the-Art of Patient Portals: Adapting to External Factors, Addressing Barriers, and Innovating.Applied clinical informatics · 2023Review
- Improving Cancer Care Communication: Identifying Sociodemographic Differences in Patient Portal Secure Messages Not Authored by the Patient.Applied clinical informatics · 2023Article
- Patient Portals to Support Care Partner Engagement in Adolescent and Adult Populations: A Scoping Review.JAMA network open · 2022Article
- Identifying Nonpatient Authors of Patient Portal Secure Messages in Oncology: A Proof-of-Concept Demonstration of Natural Language Processing Methods.JCO clinical cancer informatics · 2022Article
- Precision communication: Physicians' linguistic adaptation to patients' health literacy.Science advances · 2021Article
- Article
- Caregivers' Use of Patient Portals: Findings from a 2019 National Survey.Journal of general internal medicine · 2021Article
- Assessment of Prevalence of Adolescent Patient Portal Account Access by Guardians.JAMA network open · 2021Article
- Validity of a Computational Linguistics-Derived Automated Health Literacy Measure Across Race/Ethnicity: Findings from The ECLIPPSE Project.Journal of health care for the poor and underserved · 2021Article
- Employing computational linguistics techniques to identify limited patient health literacy: Findings from the ECLIPPSE study.Health services research · 2021Article
- Challenges and solutions to employing natural language processing and machine learning to measure patients' health literacy and physician writing complexity: The ECLIPPSE study.Journal of biomedical informatics · 2021Article
- Security and Privacy Risks Associated With Adult Patient Portal Accounts in US Hospitals.JAMA internal medicine · 2020Article
- Using natural language processing and machine learning to classify health literacy from secure messages: The ECLIPPSE study.PloS one · 2019Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundLittle is known about patients who have caregiver proxies communicate with healthcare providers via portal secure messaging (SM). Since proxy portal use is often informal (e.g., sharing patient accounts), novel methods are needed to estimate the prevalence of proxy-authored SMs.
objective(1) Develop an algorithm to identify proxy-authored SMs, (2) apply this algorithm to estimate predicted proxy SM (PPSM) prevalence among patients with diabetes, and (3) explore patient characteristics associated with having PPSMs.
designRetrospective cohort study.
participantsWe examined 9856 patients from Diabetes Study of Northern California (DISTANCE) who sent ≥ 1 English-language SM to their primary care physician between July 1, 2006, and Dec. 31, 2015. MAIN MEASURES: Using computational linguistics, we developed ProxyID, an algorithm that identifies phrases frequently found in registered proxy SMs. ProxyID was validated against blinded expert categorization of proxy status among an SM sample, then applied to identify PPSM prevalence across patients. We examined patients' sociodemographic and clinical characteristics according to PPSM penetrance, "none" (0%), "low" (≥ 0-50%), and "high" (≥ 50-100%). KEY
resultsOnly 2.3% of patients had ≥ 1 registered proxy-authored SM. ProxyID demonstrated moderate agreement with expert classification (Κ = 0.58); 45.7% of patients had PPSMs (40.2% low and 5.5% high). Patients with high percent PPSMs were older than those with low percent and no PPSMs (66.5 vs 57.4 vs 56.2 years, p < 0.001) had higher rates of limited English proficiency (16.1% vs 3.2% vs 3.5%, p < 0.05), lower self-reported health literacy (3.83 vs 4.43 vs 4.44, p < 0.001), and more comorbidities (Charlson index 3.78 vs 2.35 vs 2.18, p < 0.001).
conclusionsAmong patients with diabetes, informal proxy SM use is more common than registered use and prevalent among socially and medically vulnerable patients. Future research should explore whether proxy portal use improves patient and/or caregiver outcomes and consider policies that integrate caregivers in portal communication.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.