Sample Student Projects and Publications

Bo Wang, HMS 2015:  With faculty members Aaron Kesselheim, Niteesh Choudhry, Joshua Gagne, and Jerry Avorn, Bo has conducted numerous projects related to pharmaceutical policy since beginning a long-term research relationship with the Division prior to starting his first year of medical school.  In his first summer, he studied the epidemiology of drug recalls and analyzed conflict of interest disclosures in whistleblower complaints relating to improper off-label marketing of drugs.

Output:

  • Kesselheim AS, Wang B, Studdert DM, Avorn J.  Conflict of interest reporting by authors involved in promotion of off-label drug use: an analysis of journal disclosures. PLoS Medicine 2012;9(8):e1001280.
  • Wang B, Gagne JJ, Choudhry NK.  The epidemiology of drug recalls in the United States.  Archives of Internal Medicine 2012;172(14):1109-1110.

 

Shuai (Steve) Xu, HMS 2014:  With faculty members Aaron Kesselheim and Jerry Avorn, Steve conducted a case study to investigate the sources of innovation for bare metal stents used in treating coronary artery disease, one of the most transformative medical devices in the past twenty-five years.  He employed combined methodologies of qualitative interviews and a systematic review of comprehensive patent databases.  At the same time, he also contributed to a comparison of current device regulation in the US and EU.  Steve’s abstract was one of four selected as a finalist for an oral presentation on the annual HMS Soma Weiss Medical Education day, 2011.

Output:

  • Xu S, Avorn J, Kesselheim AS. Origins of medical innovation: the case of coronary artery stents. Circulation: Cardiovascular Quality and Outcomes 2012 (in press).
  • Kramer DB, Xu S, Kesselheim AS. How does medical device regulation perform in the United States and the European Union? A systematic review. PLoS Medicine 2012;9(7): e1001276.
  • Kramer DB, Xu S, Kesselheim AS. Medical device regulation in the United States and European Union. New England Journal of Medicine 2012;366(9):848-855.

 

Kirsten Austad, HMS 2013: With faculty members Aaron Kesselheim and Jerry Avorn, Kirsten spent a year at the Division as fellow for the Edmond J. Safra Center for Ethics at Harvard University.  Her work addressed the role of pharmaceutical marketing in medical school education, and other ethical issues relating to financial relationships in medical education.  She conducted a systematic review of studies assessing the attitudes of medical trainees about pharmaceutical marketing and a national survey of medical students and residents to determine the extent of their interactions with pharmaceutical marketing representatives.

Output:

  • Kesselheim AS and Austad KE.  Residents: workers or students in the eyes of the law?  New England Journal of Medicine 2011;364:697-699.
  • Austad KE and Kesselheim AS.  Conflict of interest disclosure in early medical education: should medical students stay in the dark?  JAMA 2011;306:991-992.
  • Austad KE, Avorn J, Kesselheim AS.  Medical students’ exposure to and attitudes about the pharmaceutical industry: a systematic review. PLoS Medicine 2011;8(5):e1001037.

 

Devan Darby, HMS 2013: With faculty members Aaron Kesselheim, Jerry Avorn, and Robert Glynn, Devan investigated how major legal events during the DOJ investigation into fraudulent off-label promotion of the antiepileptic drug gabapentin (Neurontin) affected trends in prescribing and spending for approved and off-label indications.  She conducted an time series of gabapentin claims data and fitted a piecewise linear regression spline with a priori-defined breakpoints corresponding to key legal or regulatory proceedings in the course of the investigation.  She found that positive trends in new gabapentin prescriptions and spending continued unchecked during the investigation and were most robust for off-label indication categories.

Output:

  • Kesselheim AS, Darby DL, Studdert DM, Glynn RJ, Levin RL, Avorn J. False Claims Act prosecution did not deter off-label drug use in the case of Neurontin. Health Affairs 2011;30(12):2318-2327.
  • Kesselheim AS, Darby DL, Avorn J. Off-label use of Neurontin. Health Affairs 2012;31(2):460.

 

Daniel Lieberman, HMS 2013: With faculty members Michael Fischer, Jennifer Polinski, Niteesh Choudhry, and Jerry Avorn, Dan researched Medicaid policies to contain prescription drug spending and their impacts on drug use and clinical outcomes.  He gathered extensive policy data from state Medicaid agencies on the implementation of caps limiting the number of prescription medications that would be covered at a single point in time.  Using aggregate medication data, he demonstrated that when states implement policies limiting the number of prescriptions covered, medication patterns shift to reduce the use of preventive medications for conditions such as cardiovascular disease relative to the use of less effective medications that treat symptomatic conditions.  He is currently completing analyses using patient-level data to measure the impact of these policies on individual patients’ medication use patterns and clinical outcomes.

Output:

  • Lieberman DA, Polinski JM, Choudhry NK, Avorn J, Fischer MA.  Prescription caps: recent use by state Medicaid programs and impact on medication use. Journal of General Internal Medicine (Supplement) 2012; S280