Areas of Research

The following areas of research are not exhaustive.

CLINICAL TRIALS

Hematology (sickle cell anemia, VTE, COVID-19-related coagulopathy), neurology (stroke, intracranial hemorrhage), cardiology (cardiac arrest, TTM), dermatology (cellulitis, urticaria), pulmonary (influenza, ARDS, pneumonia), infectious disease (COVID-19, sepsis, urinary tract infection). 

OBSERVATIONAL STUDIES

Educational interventions in HIV care, antibiotic stewardship, identification of substance abuse disorders in the ED, hand hygiene, health equity projects, vaccine effectiveness study, nutrition study, public health threat identification study.

DEVICE and Point-of-care research

Novel Point-of-Care (POC) testing devices, digital health intervention, patient-facing technology innovation, music intervention studies.

Behavioral health

Addiction and overdose, traumatic brain injury, post-traumatic stress disorder, behavioral health intervention in the ED.

serious illness and palliative care

Palliative care interventions, Advance Care Planning (ACP) in the ED, cancer-related pain studies.

Current Studies

Multiple disciplines, one team

Please see below for an overview of some of our current studies, ranging from drug overdose and cardiac arrest, to social determinants of health and innovative device trials. This is not an exhaustive list.

Food and Drug Administration (FDA) Toxicology Investigator’s Consortium (ToxIC) Drug Overdose Toxico-Surveillance (DOTS) Reporting Program

PI: Charlotte Goldfine, MD

The DOTS project is an FDA funded surveillance study that involves participants presenting with severe or life-threatening opioid, stimulant, and/or undifferentiated illicit substance overdoses to Emergency Departments across the United States. The study aligns with the FDA’s mission to learn more about missed opportunities for prevention, effective treatment of drug overdose, and targeted interventions of those groups that are at the highest risk of being affected by this crisis. Investigators will collect data via a structured patient interview, chart review of clinical information, and blood sample collection. The data will be utilized to gain a comprehensive understanding of current drug use and overdose, as well as to inform future regulatory activities and public health messaging.

Influence of Cooling duration on Efficacy in Cardiac Arrest Patients (ICECAP)

PIs: DaMarcus Baymon, MD, and Jong Woo Lee, MD, PHD

Using Targeted Temperature Management, this clinical trial aims to determine the ideal cooling duration to promote neurological recovery for adult comatose survivors of cardiac arrest. Participants are rapidly cooled to <34°C using a definitive temperature control device and are randomized to undergo 12, 24, or 48 hours of cooling. Assessment of neurological outcomes and patient recovery will elucidate the shortest cooling duration that can provide maximum treatment outcomes, as well as if these results vary between cardiac arrest presentations with shockable versus non-shockable rhythms.

Converting Behavioral Health Emergency Department (ED) Boarding Time into Treatment Time: Initiating Occupational Therapy in the ED

PI: Dana Im, MD, MPH, MPHIL

This cross-sectional study assesses the impact of psychiatric occupational therapy (OT) on the symptoms and experiences of patients presenting to the BWH ED for behavioral health emergencies. Psychiatric OT introduces coping skills and sensory modulation strategies using everyday activities with the goal of de-escalating patients and promoting self-management of symptoms that can extend beyond the hospital setting. This study hopes to demonstrate how the introduction of psychiatric OT in the ED can convert boarding time to active treatment time to ultimately promote patient outcomes.

Rapid Antibiotic Profiling and Pathogen IDentification (RAPPID) Study

PIs: Michael Filbin, MD, MSc, and Peter Hou, MD

This study assesses the performance of a whole genome sequencing centered diagnostic approach, compared to standard blood culture, using blood samples from patients with or suspected to have bacteremia, fungemia, or sepsis. Current assays depend on a positive blood culture to initially isolate pathogenic bacteria. This approach takes at least 12-36 hours. To accelerate this process, the company Day Zero Diagnostics (DZD) developed an approach using whole genome sequencing (WGS) and machine learning to rapidly identify circulating organisms and predict antibiotic resistance based on genomic data. By offering identification and antimicrobial resistance (AMR) profiling within hours of presentation instead of days, these methods hold the promise to improve the care of bacteremic patients.

Developing Therapies in Critical Care (DTCC)

PI: Edy Kim, MD, PHD

The aim of DTCC is to develop a database of clinical and biologic information in subjects with critical illness and cardiac arrest of varying etiology, in order to provide information about the biology, outcomes, risk factors, prognostic indicators and response to therapy during a period of critical illness and cardiac arrest. Secondly, it aims to develop a library of tissues (blood cells, plasma, RNA, DNA etc…) with the purpose of performing future analyses of disease pathogenesis and markers of disease progression in subjects with cardiac arrest. 

Mapping Oral health and Local Area Resources (MOLAR)

PIs: Margaret Samuels-Kalow, MD, and Regan H. Marsh, MD, MPH

NCT Number: NCT05688982

MOLAR is an NIH-sponsored study that seeks to determine how to best connect adult and pediatric patients with unmet dental needs with social and dental resources after leaving the BWH and BWFH EDs. Participants are randomized to one of three arms in the study, in which they will receive general resources, geographically targeted resources, or will be connected with a Patient Care Navigator to help address their social and dental needs. Participants will self-report their dental health, resource utilization, and ability to schedule dental care appointments through follow-up surveys, which will elucidate the long-term impacts of each intervention.  

Perceptions of Digital Health Interventions for Alcohol Use Disorder

PIs: Charlotte Goldfine, MD, and Peter Chai, MD, MMS

This semi-structured qualitative interview study explores the perceptions of various digital health interventions among adult patients with alcohol use disorder (AUD). These technologies include a digital pill system (DPS): an ingestible sensor measuring medication adherence; wearable alcohol sensors: a patch or device that measures real-time alcohol levels via sweat; and smartphone apps that track risk behavior or connect patients with resources. Interviews with 30 patients admitted to the Addiction Recovery Program (ARP) and Brigham and Women’s Faulkner Hospital (BWFH) provides investigates perceptions towards digital health technologies for AUD treatment, explores the most beneficial aspects, and examines the behaviors each intervention may motivate among individuals with AUD.

Ketamine for the treatment for alcohol use disorder in the emergency department: A pilot double-blind, placebo-controlled randomized clinical trial (STARK-ED)

PIs: Joji Suzuki, MD, and Peter Chai, MD, MMS

NCT Number: NCT05661669

STARK-ED is a pilot double-blind clinical trial that aims to assess the safety and tolerability of ketamine for patients with severe Alcohol Use Disorder presenting to the BWFH ED for inpatient detoxification admission to the Addiction Recovery Program. Participants are randomized to receive a single-dose ketamine infusion or a saline placebo. This study will follow participants for 12 months to monitor the long-term safety of ketamine administration for AUD and to elucidate the preliminary efficacy of ketamine for alcohol-related outcomes, including abstinence, engagement with outpatient treatment, and other behavioral changes.   

Acute Traumatic Events (ATE) Study: Multimodal Sensory and Threat Process after Trauma

PI: Nathaniel Harnett, PhD

In partnership with the NATELab at McLean Hospital, we are referring patients who may qualify for this study on the development of post-traumatic stress disorder following qualifying traumatic events such as motor vehicle accidents, falls, etc. NATELab explores whether neuroimaging following trauma may be predictive of PTSD development and/or indicate appropriate treatments.  

Preventing Emerging infections through Vaccine Effectiveness Testing (PREVENT II)

PI: Peter Hou, MD

This is a CDC-sponsored public health surveillance study to assess the effectiveness of the SARS-CoV-2 vaccine boosters among healthcare personnel at BWH. This study is also being conducted at 18 other U.S. hospitals. Through review of self-reported surveys, along with participants’ vaccination, testing, and healthcare utilization records, this project aims to elucidate how SARS-CoV-2 vaccination can reduce COVID-19 infection, duration, and severity. 

Specimen Collection of the Evaluation of Alere NT-proBNP for Alinity i System in an Emergency Department Setting for Heart Failure (LANER-HF)

PI: Christopher Baugh, MD, MBA

This study is evaluating the clinical utility of Alere NT-proBNP for Alinity I system assay as an aid in the diagnosis and assessment of severity of individuals suspected or having heart failure.

An advance care planning intervention in the emergency department: a pilot randomized controlled trial (ED GOAL)

PI: Kei Ouchi, MD, MPH

This is an ED clinician-led, behavioral intervention designed to engage seriously ill yet clinically stable older adults in the ED to address advance care planning (ACP) with their outpatient clinicians. This study is a randomized controlled trial that assesses the effect of ED GOAL on increasing ACP engagement (self-reported and/or in the electronic record) one month after leaving the ED. Participants who are randomized into the ED GOAL intervention group also receive semi-structured interviews in order to identify the patient-perceived benefits and obstacles of ACP conversations after ED GOAL.

Deep Learning Assisted Scoring of Point of Care Lung Ultrasound for Acute Decompensated Heart Failure in the Emergency Department

PI: Andrew Goldsmith, MD, MBA

This study hypothesizes that pulmonary congestion (i.e. B-lines) will decrease after diuresis and correlate with other commonly used pulmonary congestion markets (i.e. weights). The goal of this study is to create automatic quantification of total B-lines on point-of-care ultrasound (POCUS) using retrospective lung ultrasound data available. Simultaneously patients are enrolled in the emergency department for observational study by performing a lung POCUS on patients with volume overload both pre and post lung ultrasound.

A Validation Study of the Lab Clasp Device, a Point-of-Care Sepsis Risk Monitor – Phase 1

PI: Guruprasad Jambaulikar, MBBS, MPH

This is a Phase-1, prospective, single-arm, open-label study to evaluate the performance of Clintech Operation and Molecular Biomarker Measurement Device (Lab Clasp) device as compared to venous lactate values from concurrently collected blood samples.

Wishes and the Power of Positive Thinking

PI: Peter Chai, MD, MMS

This study is a prospective cohort study that recruits residents enrolled in the Harvard Affiliated Emergency Medicine Residency Program (HAEMR) and attending physicians in the Department of Emergency Medicine of Massachusetts General Hospital and Brigham and Women’s Hospital. At the time of enrollment, participants complete a baseline sociodemographic survey and establish a goal, or “wish”, to be realized within three months. Pairs of participants later engage in a wishbone contest, where the person who ends up with the bigger half of the bone is the designated “winner.” Participants are then followed forward for three months to determine if their previously specified wishes are realized.

Upcoming studies

our work continues

Please see below for a selection of some of our upcoming studies.

Evaluation of the Syntis Bio Gastrointestinal Synthetic Epithelial Lining (GSEL) Device for Treatment of Obesity

PI: Peter Chai, MD, MMS

This first-in-humans study is to confirm the initial safety profile of the gastrointestinal epithelial lining (GSEL) device and its ability to prevent glucose absorption for the treatment of obesity through evaluation of an escalating liner application procedure. This study will enroll up to 15 healthy study patients. GSEL is non-systemic and works directly and locally in the GI tract. The GSEL will be endoscopically placed and its safety and efficacy will be monitored for the participants

A Single-Dose, Three-Way, Three-Sequence, Crossover Bioavailability Study of Azithromycin Oleogel

PI: Peter Chai, MD, MMS

NCT Number: NCT05796362

This is an exploratory study to describe the pharmacokinetics of the azithromycin oral and rectal oleogel in humans compared to the reference oral drug to (Zithromax) assess the impact of the novel formulation on bioavailability. The investigators will perform a randomized, balanced, single dose, three-treatment, three-period, crossover oral bioavailability study under fasted conditions to evaluate the safety and tolerability of azithromycin oleogel and compare the bioavailability of the azithromycin oleogel to the reference drug.

Seeking Help: An assessment of the experiences, priorities, and interests of patients presenting to the ED for Alcohol Detoxification

PIs: Charlotte Goldfine, MD, and Peter Chai, MD, MMS

With this single arm observation trail we are hoping to gain a better understanding of the preferences and experiences of individuals who present to the Emergency Department with alcohol use disorder to better evaluate them during their care. The main study aim is to identify barriers in linkage to treatment, evaluate their preferences and goals for their ED visit, and assess their impressions of and interest in alcohol detoxification programs. Our secondary aim is to assess how those goals, preferences, and ability to access detoxification program impact ED revisit rates. To better understand these factors, we are asking interested participants to consent to a blood draw, urine sample collection, and to fill out a survey questionnaire.

Select former work

our extensive record

Please see below for a selection of some of our recently completed studies.

Assessing Perceptions of Social Determinants of Health (SDoH) Screening in the Emergency Department (ED) among Patients and Providers

PI: Scott Weiner, MD, MPH

This prospective survey and qualitative interview study assessed how patients and emergency department staff perceive screening for social determinants of health (SDoH). The study consisted of surveys of patients, physicians, physician assistants, nurses, and social workers, along with a series of semi-structured interviews of ED staff, including physicians, physician assistants, nurses, and social workers, working in the Massachusetts General Hospital (MGH), Brigham and Women’s Hospital (BWH), and Brigham and Women’s Faulkner Hospital (BWFH) EDs.

Assessing Co-Occurring Psychosocial Conditions Driving HIV Risk in the Emergency Department (Syndemics)

PI: Peter Chai, MD, MMS

This is a single-site cross-sectional survey study that involves participants at the ED who have had a sexually transmitted infection (STI) test within the last 6 months. This study aimed to assess the prevalence and severity of various co-occurring psychosocial conditions that enhance the risk for HIV through a survey form.