Trial pre-screening

--- MRN-100291 ---
Most recent Hemoglobin A1c on file is 7.51% dated 2022-10-07, which is outside the 12-month window relative to recent encounters through 2025-10-31; the SQL pull may be using an older/mislabeled result. Patient also carries active anemia and is on ferrous sulfate, which can affect A1c reliability, and is on chronic NSAIDs (ibuprofen, naproxen) with no recent renal labs shown. PROCEED TO COORDINATOR / CHECK FIRST: confirm a valid A1c within the last 12 months and check renal function given chronic NSAID use.

--- MRN-100459 ---
Active problem list includes Diabetes mellitus type 2 (onset 2024-04-06) with A1c well-controlled at 6.92% (most recent 2026-04-18), but no oral antidiabetic medication appears anywhere in the active medication list — raising the question of whether he is actually on oral therapy or diet-controlled/untreated, which affects eligibility for an "oral-therapy" protocol. He also has significant cardiac history (CABG, ischemic heart disease) and a notably elevated creatinine (2.873 mg/dL, 2018), relevant to drug safety/dosing. PROCEED TO COORDINATOR / CHECK FIRST: verify current diabetes medication regimen (oral agent present or absent) and confirm current renal function.

--- MRN-100998 ---
No Hemoglobin A1c value appears in the recent abnormal results (only BMI and creatinine trends are shown), so the required "A1c in last 12 months" criterion needs source verification. Patient is on metformin despite a markedly elevated creatinine (2.978 mg/dL, most recent 2017), a classic contraindication/dose-limiting factor for metformin, and is also on multiple opioids (fentanyl, oxycodone, hydrocodone/acetaminophen) for chronic pain, which may affect informed consent/participation. PROCEED TO COORDINATOR / CHECK FIRST: confirm a qualifying recent A1c and reassess current renal function relative to metformin use.

--- CANDIDATE MRN-100739 ---
Furosemide 40 MG is listed "take as needed" rather than a standing daily order, which raises ambiguity about whether the patient is truly on active, ongoing loop diuretic therapy as SPEC 5.12 requires versus intermittent/PRN use. Active problem list also documents "Victim of intimate partner abuse" (onset 2020), which may warrant a safety check before any coordinator outreach/contact attempt. CHF encounters (2025-07, 2026-01) confirm active disease, supporting inclusion. PROCEED TO COORDINATOR / CHECK FIRST: confirm furosemide is scheduled/active (not PRN-only) and review IPV flag for safe-contact protocol before outreach.

--- CANDIDATE MRN-102195 ---
Furosemide 40 MG is also documented as "take as needed," so verify this reflects genuine ongoing chronic diuretic use given the otherwise robust cardiac regimen (metoprolol, ACEI/HCTZ, nitroglycerin). Notably, patient had an ICU admission for CHF as recently as 2025-08-03 and a CHF problem-focused encounter 2026-02-04, indicating active, possibly unstable disease — this argues strongly for study relevance and inclusion. Age (83) and multiple comorbidities (prior STEMI, ischemic heart disease) should be reviewed for any protocol-specific frailty/exclusion considerations not captured in the SQL screen. PROCEED TO COORDINATOR / CHECK FIRST: confirm current diuretic dosing status post-ICU admission and clinical stability for enrollment.

--- CANDIDATE MRN-104596 ---
Furosemide 40 MG is again "take as needed," so confirm active/chronic dosing status per protocol intent rather than intermittent use. Active problem list includes "Victim of intimate partner abuse" (onset 2021), which should be reviewed for safe-contact protocols before coordinator outreach. Recent ischemic heart disease onset (2026-04-08) and very high LDL (217.99 mg/dL, 2025-05-28) alongside CHF encounters support that this patient has active, clinically significant cardiac disease, arguing for inclusion. PROCEED TO COORDINATOR / CHECK FIRST: verify furosemide dosing schedule and confirm safe-contact plan given IPV history.

--- CANDIDATE MRN-101187 ---
Bryon Braun (age 50) has active COPD on a fluticasone/salmeterol and albuterol regimen, meeting core criteria, but is also on chronic hydrocodone/acetaminophen for chronic low back pain/chronic pain, which raises concern for respiratory depression risk in an obstructive airway study. Additionally, his most recent creatinine (2.587 mg/dL, 2024-06-07) suggests significant renal impairment that may affect drug dosing/eligibility and should be reconfirmed with a current value. CHECK FIRST: opioid use (respiratory depression risk) and current renal function status.

--- CANDIDATE MRN-106787 ---
Rodger Stanton (age 56) has active chronic obstructive bronchitis on fluticasone/salmeterol and PRN albuterol, with recent encounters through 2025-12-14, satisfying recency and diagnosis criteria without evident cardiopulmonary contraindications. No red-flag comorbidities or high-risk medications are noted, though chronic sinusitis and anemia are listed as active and should be confirmed as non-interfering with pulmonary function testing. PROCEED TO COORDINATOR / CHECK FIRST: confirm anemia severity is not symptomatic/exclusionary for exertional testing.

--- CANDIDATE MRN-108243 ---
Wilbert Leannon (age 63) has long-standing active COPD (onset 1995) on fluticasone/salmeterol and albuterol, but also carries active ischemic heart disease treated with metoprolol, clopidogrel, and nitroglycerin spray, raising concern that beta-agonist/inhaler therapy or study procedures (e.g., bronchoprovocation, exertional testing) could be contraindicated given cardiac status. His most recent encounter (2025-07-28, general exam) is within the 3-year window, but no recent pulmonary-specific visit or spirometry is documented to confirm current COPD activity/control. CHECK FIRST: cardiac clearance for respiratory study procedures and recency of pulmonary-specific evaluation.