@AlexAIyer

MD student @HarvardMed via @NIHBioethics @BrownUniversity | he/him

Joined June 2020
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Is this patient having a heart attack? After 10+ years in the ER, it’s still an agonizing question for me I turned the angst into a long paper with @m_sendhil in @QJEHarvard—doi.org/10.1093/qje/qjab046 Tl;dr—machine learning can have *huge* benefit, and help fix docs' errors 🧵

Diagnosing Physician Error: A Machine Learning Approach to Low-Value Health Care*

Abstract. We use machine learning as a tool to study decision making, focusing specifically on how physicians diagnose heart attack. An algorithmic model o

academic.oup.com
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In this new paper, we took a deep dive into how to equitably provide patients with opportunities to participate in clinical trials, using COVID-19 as a case study. A research ethics 🧵 /1
The Hastings Center for Bioethics@hastingscenter16 Dec 2021
"Allocation of Opportunities to Participate in Clinical Trials during the Covid-19 Pandemic and Other Public Health Emergencies" now in Early View. By @KayteSB @HollyLynchez @ChandrosHull @MichelleNMeyer @ruqaiijah @profmohapatra et al #Covid19 #MedTwitter onlinelibrary.wiley.com/doi/…
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I argue here that the NIH's research agenda should better reflect public health needs. To accomplish this, the NIH should address disparities in which diseases are funded, which researchers are funded, and the types of research that are funded.
Petrie-Flom Center@PetrieFlom14 Oct 2021
"The NIH presently spends eighteen times as much on prostate cancer than ovarian cancer per person-years of life lost for every case," @leah_pierson writes. blog.petrieflom.law.harvard.…
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I'm curious whether this distinction is scientifically relevant, and struggling to see how it is ethically relevant. Re: science - What criteria make a vaccine dose 'part of the primary series'? How do we know that these criteria apply to 3rd dose, but not 4th or 5th doses? /1
Arthur Caplan@ArthurCaplan30 Sep 2021
Getting the description right at last! #FDA FDA's top vaccine leader explains why Covid-19 'boosters' may really just be the 3rd shot in the primary series Don’t call it a booster it’s the third dose of a three-dose vaccine, according to FDA’s top vaccine leader Peter Marks.
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Re: ethics - Whatever we call 3rd doses, we should evaluate benefits/risks of using them in different ways & choose the best option. Eg, if you think new vax supply should be used as *1st* doses abroad, calling boosters '3rd shot in the primary series' should not change this. /2
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tl;dr - Interested to know the science behind '3rd shot in the primary series,' but don't let this framing obscure real ethical trade-offs in how we allocate vaccines. Getting the latter right seems more important. /end
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My paper with @anetrid and terrific colleagues @NIHBioethics @NINDSnews is out! Ethical challenges for a new generation of early-phase pediatric gene therapy trials: nature.com/articles/s41436-0… /1
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-How should investigators engage with highly invested patient communities? -How should investigators navigate disagreements with patient communities that are engaged in a trial? /9
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Please feel free to DM me for a PDF! Extremely grateful to @anetrid, #SaskiaHendriks, and #ChristineGrady for two years of tireless mentorship. And to all of our @NINDSnews colleagues for their collaboration, insights, and inspiring approach to clinical research. /end
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‘We are witnessing a crime against humanity’: Arundhati Roy on India’s Covid catastrophe theguardian.com/news/2021/ap…

Arundhati Roy on India’s Covid catastrophe: ‘We are witnessing a crime against humanity’

The long read: It’s hard to convey the full depth and range of the trauma, the chaos and the indignity that people are being subjected to. Meanwhile, Modi and his allies are telling us not to complain

theguardian.com
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The Good Fit — Why Medical Applicants’ Personal Statements Are Anything but Personal | NEJM nejm.org/doi/full/10.1056/NE…

The Good Fit — Why Medical Applicants’ Personal Statements Are Anything but Personal | NEJM

Mental illness is so stigmatized that despite its disproportionate prevalence in the field I was entering, I had to pretend I’d never faced it. My personal statement was the first of many experienc...

nejm.org
Check out my editorial on why schools should play a part in disseminating the COVID-19 vaccine.
Slate
@Slate16 Mar 2021
History shows us schools have the ability to help disseminate vaccines quickly. slate.trib.al/sNEKpFG
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Excited to share this editorial on the ethics of multinational COVID-19 vaccine trials, co-authored with Joseph Millum, Christine Grady, and Dave Wendler @NIHBioethics. Two points worth clarifying: /1
The BMJ
@bmj_latest4 Mar 2021
"Even as safe and effective covid-19 vaccines are deployed, there remains substantial value in developing additional vaccines. With careful steps to avoid exploiting people in LMICs, multinational trials can offer an ethical way to accomplish this goal" ow.ly/ljVs50DQkxI

Avoiding exploitation in multinational covid-19 vaccine trials

Low and middle income countries must benefit, not just participate Highly efficacious vaccines for covid-19 are now being distributed in high income countries. At the same time, multinational...

bmj.com
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2) Some COVID-19 vaccine trials in LMICs are ongoing or already completed. While the requirements we defend would ideally be considered during trial design, some of them can be satisfied retroactively. For example: making safe & effective vaccines available in host countries. /3
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This editorial applies existing work on international research ethics to the case of multinational COVID-19 vaccine trials. Grateful to have these shoulders to stand on. Many thanks to the researchers & regulators (acknowledged in article) who helped us think this through. /end
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