Louise C. Walter, MD

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Louise C. Walter, MD

Assistant Professor, Department of Medicine (Geriatrics), UCSF

louise.walter@ucsf.edu

Phone: (415) 221-4810 x3052 (voice)
Box 181G VAMC, San Francisco, CA 94121-0520

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Cancer Center Membership

Associate Member » Breast Oncology» Prostate Cancer

Research Summary

Dr. Walter was appointed Chief of the UCSF Division of Geriatrics in July 2013 after serving as interim division chief since August 2012.

Dr. Walter is a clinician-researcher who is a national leader in evaluating the real-world risks and benefits of cancer screening in older patients. Dr. Walter received her MD from Stanford University in 1995. She completed a residency in internal medicine and a fellowship in geriatrics at UCSF. Dr. Walter joined the UCSF faculty in July 2001, and she is a geriatrician at the San Francisco VA Medical Center.

Dr. Walter has transformed our approach to cancer screening in older adults. She has developed novel methodology demonstrating the fundamental importance of life expectancy rather than age in determining benefits and risks of screening. Virtually every cancer screening guideline cites her research. Further, her studies of older adults in poor health documented the extent to which screening can lead to clinical harm. Her approach also forms the basis for the management of other chronic diseases (e.g., diabetes) in older adults.

In addition, Dr. Walter led a series of seminal studies demonstrating decisions to screen older adults for cancer are often dictated more by age than health such that many patients in poor health continue to undergo screening while many healthy older patients fail to get screened. Also, she discovered that cancer screening frequently leads to significant harms without benefit in patients in poor health and developed a taxonomy and quantification of screening harms. This research changed national VA quality indicators and convinced California state auditors to abandon their mandatory mammography policy for health plans that care for frail elders.

Dr. Walter is Principal Investigator of a $1.8 million R01 grant from the National Cancer Institute to investigate outcomes of prostate-specific antigen screening in older men and Principal Investigator of a K24 mentoring award from the National Institute on Aging. Dr. Walter is strongly committed to mentoring the next generation of clinical investigators as evidenced by her receipt of the 2010 UCSF Academic Senate Distinction in Mentoring Award (given annually to one Associate Professor who provides exceptional mentoring) and her receipt of the Society of General Internal Medicine's Research Mentor of the Year Award in 2013.

Dr. Walter is the Associate Director of the UCSF Clinical and Translational Science Institute Career Development (KL2) Program, an Associate Editor for the JAMA series, "Care of the Aging Patient: From Evidence to Action," and Director of the San Francisco VA’s Health Services Research and Development Program to Improve Care for Veterans with Complex Comorbid Conditions. She also is the Core Leader of the Research Career Development Core (RCDC) for the UCSF Pepper Center for Aging Research.

Education

Stanford University, Stanford, CA, B.S., 1990, Biology
Stanford University School of Medicine, Stanford, CA, M.D., 1995, Internal Medicine
University of California, San Francisco (Advanced Training in Clinical Research Program), Certificate, 1999, Clinical Epidemiology


Professional Experience

  • 1989-1990
    Research Assistant, Department of Nuclear Medicine, Stanford University School of Medicine
  • 1992-1993
    Research Assistant, Department of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine
  • 1995-1998
    Medical Resident, University of California, San Francisco
  • 1998-2001
    Fellow in Geriatrics, University of California, San Francisco
  • 2001-present
    Staff Physician, San Francisco Veterans Affairs Medical Center
  • 2001-present
    Assistant Professor of Medicine, Geriatrics Division, University of California, San Francisco

Honors & Awards

  • 1990
    Phi Beta Kappa, Stanford University
  • 1990
    Scholastic Honors with Distinction, Stanford University
  • 1995
    Dean's Award for Outstanding Community Service, Stanford University School of Medicine
  • 1995
    Dean's Award for Outstanding Teaching, Stanford University School of Medicine
  • 1999
    Hartford/AFAR Pilot Grant: "Outcomes of Screening Mammography in Frail Elderly Women."
  • 1999
    Journal of General Internal Medicine, top 10% of reviewers
  • 2002
    VA Career Development Award in Health Services Research and Development

Selected Publications

  1. Tang VL, Shi Y, Fung K, Tan J, Espaldon R, Sudore R, Wong ML, Walter LC. Clinician Factors Associated With Prostate-Specific Antigen Screening in Older Veterans With Limited Life Expectancy. JAMA Intern Med. 2016 Apr 4.
    View on PubMed
  2. Breslau ES, Gorin SS, Edwards HM, Schonberg MA, Saiontz N, Walter LC. An Individualized Approach to Cancer Screening Decisions in Older Adults: A Multilevel Framework. J Gen Intern Med. 2016 May; 31(5):539-47.
    View on PubMed
  3. Braithwaite D, Walter LC, Izano M, Kerlikowske K. Benefits and Harms of Screening Mammography by Comorbidity and Age: A Qualitative Synthesis of Observational Studies and Decision Analyses. J Gen Intern Med. 2016 May; 31(5):561-72.
    View on PubMed
  4. Suskind AM, Walter LC, Jin C, Boscardin J, Sen S, Cooperberg MR, Finlayson E. Impact of frailty on complications in patients undergoing common urological procedures: a study from the American College of Surgeons National Surgical Quality Improvement database. BJU Int. 2016 May; 117(5):836-42.
    View on PubMed
  5. Oeffinger KC, Fontham ET, Etzioni R, Herzig A, Michaelson JS, Shih YC, Walter LC, Church TR, Flowers CR, LaMonte SJ, Wolf AM, DeSantis C, Lortet-Tieulent J, Andrews K, Manassaram-Baptiste D, Saslow D, Smith RA, Brawley OW, Wender R. Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society. JAMA. 2015 Oct 20; 314(15):1599-614.
    View on PubMed
  6. Perissinotto CM, Walter LC. Capsule Commentary on Wolff, et al., A Look at Person- and Family-Centered Care Among Older Adults: Results from a National Survey. J Gen Intern Med. 2015 Oct; 30(10):1536.
    View on PubMed
  7. Duralde ER, Walter LC, Van Den Eeden SK, Nakagawa S, Subak LL, Brown JS, Thom DH, Huang AJ. Bridging the gap: determinants of undiagnosed or untreated urinary incontinence in women. Am J Obstet Gynecol. 2016 Feb; 214(2):266.e1-9.
    View on PubMed
  8. Hoffman RM, Shi Y, Freedland SJ, Keating NL, Walter LC. Treatment patterns for older veterans with localized prostate cancer. Cancer Epidemiol. 2015 Oct; 39(5):769-77.
    View on PubMed
  9. Lewis CL, Adams J, Tai-Seale M, Huang Q, Knowles SB, Nielsen ME, Pignone MP, Walter LC, Frosch DL. A Randomized Controlled Effectiveness Trial for PSA Screening Decision Support Interventions in Two Primary Care Settings. J Gen Intern Med. 2015 Jun; 30(6):810-6.
    View on PubMed
  10. Huang AJ, Gregorich SE, Kuppermann M, Nakagawa S, Van Den Eeden SK, Brown JS, Richter HE, Walter LC, Thom D, Stewart AL. Day-to-Day Impact of Vaginal Aging questionnaire: a multidimensional measure of the impact of vaginal symptoms on functioning and well-being in postmenopausal women. Menopause. 2015 Feb; 22(2):144-54.
    View on PubMed
  11. Hsu A, Nakagawa S, Walter LC, Van Den Eeden SK, Brown JS, Thom DH, Lee SJ, Huang AJ. The burden of nocturia among middle-aged and older women. Obstet Gynecol. 2015 Jan; 125(1):35-43.
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  12. Partin MR, Burgess DJ, Burgess JF, Gravely A, Haggstrom D, Lillie SE, Nugent S, Powell AA, Shaukat A, Walter LC, Nelson DB. Organizational Predictors of Colonoscopy Follow-up for Positive Fecal Occult Blood Test Results: An Observational Study. Cancer Epidemiol Biomarkers Prev. 2015 Feb; 24(2):422-34.
    View on PubMed
  13. Shi Y, Boscardin WJ, Walter LC. Reply. Urology. 2014 Nov; 84(5):1065.
    View on PubMed
  14. Shi Y, Fung KZ, Freedland SJ, Hoffman RM, Tang VL, Walter LC. Statin Medications Are Associated With a Lower Probability of Having an Abnormal Screening Prostate-specific Antigen Result. Urology. 2014 Nov; 84(5):1058-65.
    View on PubMed
  15. Lee SJ, Leipzig RM, Walter LC. Lag time to benefit for preventive therapies--reply. JAMA. 2014 Apr 16; 311(15):1567-8.
    View on PubMed
  16. Walter LC, Schonberg MA. Screening mammography in older women: a review. JAMA. 2014 Apr 2; 311(13):1336-47.
    View on PubMed
  17. Uhlig K, Leff B, Kent D, Dy S, Brunnhuber K, Burgers JS, Greenfield S, Guyatt G, High K, Leipzig R, Mulrow C, Schmader K, Schunemann H, Walter LC, Woodcock J, Boyd CM. A framework for crafting clinical practice guidelines that are relevant to the care and management of people with multimorbidity. J Gen Intern Med. 2014 Apr; 29(4):670-9.
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  18. Espaldon R, Kirby KA, Fung KZ, Hoffman RM, Powell AA, Freedland SJ, Walter LC. Probability of an abnormal screening prostate-specific antigen result based on age, race, and prostate-specific antigen threshold. Urology. 2014 Mar; 83(3):599-605.
    View on PubMed
  19. Hurria A, Wildes T, Blair SL, Browner IS, Cohen HJ, Deshazo M, Dotan E, Edil BH, Extermann M, Ganti AK, Holmes HM, Jagsi R, Karlekar MB, Keating NL, Korc-Grodzicki B, McKoy JM, Medeiros BC, Mrozek E, O'Connor T, Rugo HS, Rupper RW, Silliman RA, Stirewalt DL, Tew WP, Walter LC, Weir AB, Bergman MA, Sundar H. Senior adult oncology, version 2.2014: clinical practice guidelines in oncology . J Natl Compr Canc Netw. 2014 Jan; 12(1):82-126.
    View on PubMed
  20. Lee SJ, Leipzig RM, Walter LC. Incorporating lag time to benefit into prevention decisions for older adults. JAMA. 2013 Dec 25; 310(24):2609-10.
    View on PubMed

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