Dr. Mohammad Jalali (aka, ‘MJ’) is an Associate Professor at Harvard Medical School and a senior scientist at MGH Institute for Technology Assessment. He was previously a research faculty at MIT Sloan School of Management and a consultant at the World Bank. MJ uses analytics and simulation-based approaches to help policymakers identify and develop high-leverage policies that not only are effective over the long haul, but also are not thwarted by unanticipated side effects. To achieve this goal, he spends a great deal of time working with decision-makers and policymakers, doing fieldwork and collecting different types of data that can inform richer models and analyses.
MJ’s work has been featured by various national and international media outlets, including Associated Press, The Hill, Newsweek, Scientific American, Business Insider, and NPR. He is an associate editor of System Dynamics Review and is on the editorial board of the Journal on Policy and Complex Systems. He is the recipient of the 2015 Dana Meadows Award, the 2015 WINFORMS Excellence Award, and the 2014 Lupina Young Researcher Award. MJ received his PhD in Systems Engineering, with a concentration on management and health care systems, from Virginia Tech in 2015.
Research approach and areas:
In his research trajectory, MJ follows three goals. First, he conducts simulation modeling and informatics research for various population-based health policies, focusing on health outcomes and cost-effectiveness. In his modeling research—drawn on theories of optimization and strategy—he analyzes the impacts of large-scale policies for prevention, screening, and treatment. MJ has developed models for obesity, post-traumatic stress disorder, and depression. He is currently working with the FDA to develop an opioid systems model, informing opioid policies at the FDA and other government agencies. Other areas of his modeling research include drug-shortages in pharmaceutical supply chains, organizational cybersecurity in health care, and the diffusion of medical technologies.
Second, MJ focuses his research on mechanisms that connect human decision-making to health care systems, because that is where many important policy-resistant problems lie. In particular, he aims to understand how and why many health policies fail to produce lasting results or create results counter to their goals.
Third, he wants his research to rigorously connect models with quantitative data. The growing complexity of health care issues, combined with the ubiquity of large amounts of data, requires increasingly sophisticated analytical methods. MJ complements his phenomenological research with methodological contributions that build bridges across methodological and application domains. For example, he has contributed to adapting various simulation-optimization approaches for model calibration and parameter estimation in dynamic models (e.g., the method of simulated moments and indirect inference), improving systematic review techniques, and developing a novel method for aggregation of prior stochastic and heterogeneous statistical findings.
Selected media coverage:
New York Times: Will Hot Weather Kill the Coronavirus Where You Live?
Washington Post: Summer weather could help fight coronavirus spread but won’t halt the pandemic
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Selected Publications
Lim, Tse Yang; Dong, Huiru; Stringfellow, Erin; Hasgul, Zeynep; Park, Ju; Glos, Lukas; Kazemi, Reza; Jalali, Mohammad S.
Temporal and spatial trends of fentanyl co-occurrence in the illicit drug supply in the United States: a serial cross-sectional analysis Journal Article
In: The Lancet Regional Health - Americas, vol. 39, 2024, ISSN: 2667-193X.
@article{Lim2024,
title = {Temporal and spatial trends of fentanyl co-occurrence in the illicit drug supply in the United States: a serial cross-sectional analysis},
author = {Tse Yang Lim and Huiru Dong and Erin Stringfellow and Zeynep Hasgul and Ju Park and Lukas Glos and Reza Kazemi and Mohammad S. Jalali},
doi = {10.1016/j.lana.2024.100898},
issn = {2667-193X},
year = {2024},
date = {2024-11-00},
journal = {The Lancet Regional Health - Americas},
volume = {39},
publisher = {Elsevier BV},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Wongseree, Peeradon; Hasgul, Zeynep; Jalali, Mohammad S
Cost-Effectiveness of Increasing Access to Colorectal Cancer Diagnosis: Analysis From Thailand Journal Article
In: Value Health Reg Issues, vol. 43, pp. 101010, 2024, ISSN: 2212-1102.
@article{pmid38848611,
title = {Cost-Effectiveness of Increasing Access to Colorectal Cancer Diagnosis: Analysis From Thailand},
author = {Peeradon Wongseree and Zeynep Hasgul and Mohammad S Jalali},
doi = {10.1016/j.vhri.2024.101010},
issn = {2212-1102},
year = {2024},
date = {2024-09-01},
urldate = {2024-06-01},
journal = {Value Health Reg Issues},
volume = {43},
pages = {101010},
abstract = {OBJECTIVES: The purpose of this study is to evaluate the cost-effectiveness of increasing access to colorectal cancer (CRC) diagnosis, considering resource limitations in Thailand.nnMETHODS: We analyzed the cost-effectiveness of increasing access to fecal immunochemical test screening (strategy I), symptom evaluation (strategy II), and their combination through healthcare and societal perspectives using Colo-Sim, a simulation model of CRC care. We extended our analysis by adding a risk-stratification score (RS) to the strategies. We analyzed all strategies under the currently limited annual colonoscopy capacity and sufficient capacity. We estimated quality-adjusted life-years (QALYs) and costs over 2023 to 2047 and performed sensitivity analyses.nnRESULTS: Annual costs for CRC care will increase over 25 years in Thailand, resulting in a cumulative cost of 323B Thai baht (THB). Each strategy results in higher QALYs gained and additional costs. With the current colonoscopy capacity and willingness-to-pay threshold of 160 000 THB, strategy I with and without RS is not cost-effective. Strategy II + RS is the most cost-effective, resulting in 0.68 million QALYs gained with additional costs of 66B THB. Under sufficient colonoscopy capacity, all strategies are deemed cost-effective, with the combined approach (strategy I + II + RS) being the most favorable, achieving the highest QALYs (1.55 million) at an additional cost of 131 billion THB. This strategy also maintains the highest probability of being cost-effective at any willingness-to-pay threshold above 96 000 THB.nnCONCLUSIONS: In Thailand, fecal immunochemical test screening, symptom evaluation, and RS use can achieve the highest QALYs; however, boosting colonoscopy capacity is essential for cost-effectiveness.},
keywords = {},
pubstate = {published},
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OBJECTIVES: The purpose of this study is to evaluate the cost-effectiveness of increasing access to colorectal cancer (CRC) diagnosis, considering resource limitations in Thailand.nnMETHODS: We analyzed the cost-effectiveness of increasing access to fecal immunochemical test screening (strategy I), symptom evaluation (strategy II), and their combination through healthcare and societal perspectives using Colo-Sim, a simulation model of CRC care. We extended our analysis by adding a risk-stratification score (RS) to the strategies. We analyzed all strategies under the currently limited annual colonoscopy capacity and sufficient capacity. We estimated quality-adjusted life-years (QALYs) and costs over 2023 to 2047 and performed sensitivity analyses.nnRESULTS: Annual costs for CRC care will increase over 25 years in Thailand, resulting in a cumulative cost of 323B Thai baht (THB). Each strategy results in higher QALYs gained and additional costs. With the current colonoscopy capacity and willingness-to-pay threshold of 160 000 THB, strategy I with and without RS is not cost-effective. Strategy II + RS is the most cost-effective, resulting in 0.68 million QALYs gained with additional costs of 66B THB. Under sufficient colonoscopy capacity, all strategies are deemed cost-effective, with the combined approach (strategy I + II + RS) being the most favorable, achieving the highest QALYs (1.55 million) at an additional cost of 131 billion THB. This strategy also maintains the highest probability of being cost-effective at any willingness-to-pay threshold above 96 000 THB.nnCONCLUSIONS: In Thailand, fecal immunochemical test screening, symptom evaluation, and RS use can achieve the highest QALYs; however, boosting colonoscopy capacity is essential for cost-effectiveness.
Dong, Huiru; Stringfellow, Erin J; Russell, Alton; Jalali, Mohammad S
State Mandates On Naloxone Coprescribing Associated With Short-Term Increase In Naloxone Codispensing Journal Article
In: Health Aff (Millwood), vol. 43, no. 9, pp. 1319–1328, 2024, ISSN: 2694-233X.
@article{pmid39226505,
title = {State Mandates On Naloxone Coprescribing Associated With Short-Term Increase In Naloxone Codispensing},
author = {Huiru Dong and Erin J Stringfellow and Alton Russell and Mohammad S Jalali},
doi = {10.1377/hlthaff.2023.01667},
issn = {2694-233X},
year = {2024},
date = {2024-09-01},
journal = {Health Aff (Millwood)},
volume = {43},
number = {9},
pages = {1319--1328},
abstract = {In the midst of the opioid crisis in the US, efforts to mitigate overdose risks have become paramount, leading some states to introduce mandates for coprescribing the life-saving overdose reversal drug naloxone. These mandates were designed to specifically address people receiving opioid analgesics who had an elevated risk for overdose. This included people receiving high opioid dosages, those concurrently using benzodiazepines, or those with a history of substance use disorder or overdose. Using a nationally representative, multipayer cohort of patients receiving prescription opioids, we investigated how naloxone codispensing rates changed at the state level from 2016 to 2021 among patients with an elevated risk for overdose. Then we used controlled interrupted time series analyses to assess mandates' longitudinal impact on naloxone codispensing in ten states that implemented mandates. We observed an immediate and significant increase in the naloxone codispensing rates in eight states after the implementation of mandates. Nevertheless, in five of these states, the codispensing rates exhibited a subsequent downward trend after the initial increase. State mandates show potential for improving naloxone codispensing; however, mandates alone might not be adequate for sustained change. Further research is needed to identify strategies complementing and enhancing the impact of mandates in combating the overdose crisis.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
In the midst of the opioid crisis in the US, efforts to mitigate overdose risks have become paramount, leading some states to introduce mandates for coprescribing the life-saving overdose reversal drug naloxone. These mandates were designed to specifically address people receiving opioid analgesics who had an elevated risk for overdose. This included people receiving high opioid dosages, those concurrently using benzodiazepines, or those with a history of substance use disorder or overdose. Using a nationally representative, multipayer cohort of patients receiving prescription opioids, we investigated how naloxone codispensing rates changed at the state level from 2016 to 2021 among patients with an elevated risk for overdose. Then we used controlled interrupted time series analyses to assess mandates' longitudinal impact on naloxone codispensing in ten states that implemented mandates. We observed an immediate and significant increase in the naloxone codispensing rates in eight states after the implementation of mandates. Nevertheless, in five of these states, the codispensing rates exhibited a subsequent downward trend after the initial increase. State mandates show potential for improving naloxone codispensing; however, mandates alone might not be adequate for sustained change. Further research is needed to identify strategies complementing and enhancing the impact of mandates in combating the overdose crisis.
Lim, Tse Yang; Keyes, Katherine M; Caulkins, Jonathan P; Stringfellow, Erin J; Cerdá, Magdalena; Jalali, Mohammad S
Improving Estimates of the Prevalence of Opioid Use Disorder in the United States: Revising Keyes et al Journal Article
In: J Addict Med, 2024, ISSN: 1935-3227.
@article{pmid39221814,
title = {Improving Estimates of the Prevalence of Opioid Use Disorder in the United States: Revising Keyes et al},
author = {Tse Yang Lim and Katherine M Keyes and Jonathan P Caulkins and Erin J Stringfellow and Magdalena Cerd\'{a} and Mohammad S Jalali},
doi = {10.1097/ADM.0000000000001375},
issn = {1935-3227},
year = {2024},
date = {2024-09-01},
journal = {J Addict Med},
abstract = {OBJECTIVES: The United States faces an ongoing drug overdose crisis, but accurate information on the prevalence of opioid use disorder (OUD) remains limited. A recent analysis by Keyes et al used a multiplier approach with drug poisoning mortality data to estimate OUD prevalence. Although insightful, this approach made stringent and partly inconsistent assumptions in interpreting mortality data, particularly synthetic opioid (SO)-involved and non-opioid-involved mortality. We revise that approach and resulting estimates to resolve inconsistencies and examine several alternative assumptions.nnMETHODS: We examine 4 adjustments to Keyes and colleagues' estimation approach: (A) revising how the equations account for SO effects on mortality, (B) incorporating fentanyl prevalence data to inform estimates of SO lethality, (C) using opioid-involved drug poisoning data to estimate a plausible range for OUD prevalence, and (D) adjusting mortality data to account for underreporting of opioid involvement.nnRESULTS: Revising the estimation equation and SO lethality effect (adj. A and B) while using Keyes and colleagues' original assumption that people with OUD account for all fatal drug poisonings yields slightly higher estimates, with OUD population reaching 9.3 million in 2016 before declining to 7.6 million by 2019. Using only opioid-involved drug poisoning data (adj. C and D) provides a lower range, peaking at 6.4 million in 2014-2015 and declining to 3.8 million in 2019.nnCONCLUSIONS: The revised estimation equation presented is feasible and addresses limitations of the earlier method and hence should be used in future estimations. Alternative assumptions around drug poisoning data can also provide a plausible range of estimates for OUD population.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: The United States faces an ongoing drug overdose crisis, but accurate information on the prevalence of opioid use disorder (OUD) remains limited. A recent analysis by Keyes et al used a multiplier approach with drug poisoning mortality data to estimate OUD prevalence. Although insightful, this approach made stringent and partly inconsistent assumptions in interpreting mortality data, particularly synthetic opioid (SO)-involved and non-opioid-involved mortality. We revise that approach and resulting estimates to resolve inconsistencies and examine several alternative assumptions.nnMETHODS: We examine 4 adjustments to Keyes and colleagues' estimation approach: (A) revising how the equations account for SO effects on mortality, (B) incorporating fentanyl prevalence data to inform estimates of SO lethality, (C) using opioid-involved drug poisoning data to estimate a plausible range for OUD prevalence, and (D) adjusting mortality data to account for underreporting of opioid involvement.nnRESULTS: Revising the estimation equation and SO lethality effect (adj. A and B) while using Keyes and colleagues' original assumption that people with OUD account for all fatal drug poisonings yields slightly higher estimates, with OUD population reaching 9.3 million in 2016 before declining to 7.6 million by 2019. Using only opioid-involved drug poisoning data (adj. C and D) provides a lower range, peaking at 6.4 million in 2014-2015 and declining to 3.8 million in 2019.nnCONCLUSIONS: The revised estimation equation presented is feasible and addresses limitations of the earlier method and hence should be used in future estimations. Alternative assumptions around drug poisoning data can also provide a plausible range of estimates for OUD population.
Dong, Huiru; Stringfellow, Erin J; Jalali, Mohammad S
State-level racial and ethnic disparities in buprenorphine treatment duration in the United States Journal Article
In: Am J Addict, 2024, ISSN: 1521-0391.
@article{pmid39107678,
title = {State-level racial and ethnic disparities in buprenorphine treatment duration in the United States},
author = {Huiru Dong and Erin J Stringfellow and Mohammad S Jalali},
doi = {10.1111/ajad.13638},
issn = {1521-0391},
year = {2024},
date = {2024-08-01},
journal = {Am J Addict},
abstract = {BACKGROUND AND OBJECTIVES: National trends reveal a concerning escalation in racial and ethnic disparities in buprenorphine treatment duration for opioid use disorder. However, the extent of such disparities at the state level remains largely unexplored. This study aims to examine such disparities at the state level.nnMETHODS: We analyzed 9,040,620 buprenorphine prescriptions dispensed between January 2011 and December 2020 from IQVIA Longitudinal Prescription data. The primary outcome was the difference in median treatment duration between White people and racial and ethnic minorities. We also included a second outcome measurement to quantify the difference in median treatment duration among episodes lasting ≥180 days. Using quantile regressions, we examined racial and ethnic disparities in treatment duration, adjusting for the patient's age, sex, payment type, and calendar year of the treatment episode. All analyses were conducted at the state level.nnRESULTS: Our study revealed substantial statewide variations in racial and ethnic disparities. Specifically, 21 states showed longer treatment durations for White people across all episodes, and eight states displayed similar trends among episodes lasting ≥180 days. Five states exhibited longer treatment durations for White people in both overall and long-term episodes. Fifteen states showed no racial and ethnic disparities.nnCONCLUSION AND SCIENTIFIC SIGNIFICANCE: These results are among the first to indicate substantial statewide variations in racial and ethnic disparities in buprenorphine treatment episode duration, providing a critical foundation for targeted interventions to enhance buprenorphine treatment, especially in states confronting such pronounced racial and ethnic disparities.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND AND OBJECTIVES: National trends reveal a concerning escalation in racial and ethnic disparities in buprenorphine treatment duration for opioid use disorder. However, the extent of such disparities at the state level remains largely unexplored. This study aims to examine such disparities at the state level.nnMETHODS: We analyzed 9,040,620 buprenorphine prescriptions dispensed between January 2011 and December 2020 from IQVIA Longitudinal Prescription data. The primary outcome was the difference in median treatment duration between White people and racial and ethnic minorities. We also included a second outcome measurement to quantify the difference in median treatment duration among episodes lasting ≥180 days. Using quantile regressions, we examined racial and ethnic disparities in treatment duration, adjusting for the patient's age, sex, payment type, and calendar year of the treatment episode. All analyses were conducted at the state level.nnRESULTS: Our study revealed substantial statewide variations in racial and ethnic disparities. Specifically, 21 states showed longer treatment durations for White people across all episodes, and eight states displayed similar trends among episodes lasting ≥180 days. Five states exhibited longer treatment durations for White people in both overall and long-term episodes. Fifteen states showed no racial and ethnic disparities.nnCONCLUSION AND SCIENTIFIC SIGNIFICANCE: These results are among the first to indicate substantial statewide variations in racial and ethnic disparities in buprenorphine treatment episode duration, providing a critical foundation for targeted interventions to enhance buprenorphine treatment, especially in states confronting such pronounced racial and ethnic disparities.
Sung, Meekang; Rees, Vaughan W; Lee, Hannah; Jalali, Mohammad S
Assessment of Epidemiological Data and Surveillance in Korea Substance Use Research: Insights and Future Directions Journal Article
In: J Prev Med Public Health, vol. 57, no. 4, pp. 307–318, 2024, ISSN: 2233-4521.
@article{pmid38938049b,
title = {Assessment of Epidemiological Data and Surveillance in Korea Substance Use Research: Insights and Future Directions},
author = {Meekang Sung and Vaughan W Rees and Hannah Lee and Mohammad S Jalali},
doi = {10.3961/jpmph.24.171},
issn = {2233-4521},
year = {2024},
date = {2024-07-01},
journal = {J Prev Med Public Health},
volume = {57},
number = {4},
pages = {307--318},
abstract = {OBJECTIVES: Effective data collection and surveillance of epidemiological trends are essential in confronting the growing challenges associated with substance use (SU), especially in light of emerging trends and underreporting of cases. However, research and data are scarce regarding SU and substance use disorder (SUD) in Korea.nnMETHODS: We conducted a scoping review to identify data sources and surveillance methods used in SU research in Korea up to December 2023. This review was complemented by semi-structured consultations with experts in this area in Korea, whose feedback led to revisions of previously identified data sources and assessments.nnRESULTS: Our review identified 32 publications conducting secondary analyses on existing data to examine the epidemiology of SU and SUD in Korea. Of these, 14 studies utilized clinical databases to explore the prescription patterns of addictive substances, particularly opioids. Eleven data sources showed promise for advancing SU research; however, they face substantial limitations, including a lack of available data, missing data, the absence of key variables, the exclusion of marginalized populations not captured within the clinical system, and complexities in matching individual-level data across time points and datasets.nnCONCLUSIONS: Current surveillance methods for SU in Korea face considerable challenges in accessibility, usability, and standardization. Moreover, existing data repositories may fail to capture information on populations not served by clinical or judicial systems. To systematically improve surveillance approaches, it is necessary to develop a robust and nationally representative survey, refine the use of existing clinical data, and ensure the availability of data on treatment facilities.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES: Effective data collection and surveillance of epidemiological trends are essential in confronting the growing challenges associated with substance use (SU), especially in light of emerging trends and underreporting of cases. However, research and data are scarce regarding SU and substance use disorder (SUD) in Korea.nnMETHODS: We conducted a scoping review to identify data sources and surveillance methods used in SU research in Korea up to December 2023. This review was complemented by semi-structured consultations with experts in this area in Korea, whose feedback led to revisions of previously identified data sources and assessments.nnRESULTS: Our review identified 32 publications conducting secondary analyses on existing data to examine the epidemiology of SU and SUD in Korea. Of these, 14 studies utilized clinical databases to explore the prescription patterns of addictive substances, particularly opioids. Eleven data sources showed promise for advancing SU research; however, they face substantial limitations, including a lack of available data, missing data, the absence of key variables, the exclusion of marginalized populations not captured within the clinical system, and complexities in matching individual-level data across time points and datasets.nnCONCLUSIONS: Current surveillance methods for SU in Korea face considerable challenges in accessibility, usability, and standardization. Moreover, existing data repositories may fail to capture information on populations not served by clinical or judicial systems. To systematically improve surveillance approaches, it is necessary to develop a robust and nationally representative survey, refine the use of existing clinical data, and ensure the availability of data on treatment facilities.
Koiso, Satoshi; Gulbas, Eren; Dike, Lotanna; Mulroy, Nora M; Ciaranello, Andrea L; Freedberg, Kenneth A; Jalali, Mohammad S; Walker, Allison T; Ryan, Edward T; LaRocque, Regina C; Hyle, Emily P
Modeling approaches to inform travel-related policies for COVID-19 containment: a scoping review and future directions Journal Article
In: Travel Med Infect Dis, pp. 102730, 2024, ISSN: 1873-0442.
@article{pmid38830442,
title = {Modeling approaches to inform travel-related policies for COVID-19 containment: a scoping review and future directions},
author = {Satoshi Koiso and Eren Gulbas and Lotanna Dike and Nora M Mulroy and Andrea L Ciaranello and Kenneth A Freedberg and Mohammad S Jalali and Allison T Walker and Edward T Ryan and Regina C LaRocque and Emily P Hyle},
doi = {10.1016/j.tmaid.2024.102730},
issn = {1873-0442},
year = {2024},
date = {2024-06-01},
journal = {Travel Med Infect Dis},
pages = {102730},
abstract = {BACKGROUND: Travel-related strategies to reduce the spread of COVID-19 evolved rapidly in response to changes in the understanding of SARS-CoV-2 and newly available tools for prevention, diagnosis, and treatment. Modeling is an important methodology to investigate the range of outcomes that could occur from different disease containment strategies.nnMETHODS: We examined 43 articles published from December 2019 through September 2022 that used modeling to evaluate travel-related COVID-19 containment strategies. We extracted and synthesized data regarding study objectives, methods, outcomes, populations, settings, strategies, and costs. We used a standardized approach to evaluate each analysis according to 26 criteria for modeling quality and rigor.nnRESULTS: The most frequent approaches included compartmental modeling to examine quarantine, isolation, or testing. Early in the pandemic, the goal was to prevent travel-related COVID-19 cases with a focus on individual-level outcomes and assessing strategies such as travel restrictions, quarantine without testing, social distancing, and on-arrival PCR testing. After the development of diagnostic tests and vaccines, modeling studies projected population-level outcomes and investigated these tools to limit COVID-19 spread. Very few published studies included rapid antigen screening strategies, costs, explicit model calibration, or critical evaluation of the modeling approaches.nnCONCLUSION: Future modeling analyses should leverage open-source data, improve the transparency of modeling methods, incorporate newly available prevention, diagnostics, and treatments, and include costs and cost-effectiveness so that modeling analyses can be informative to address future SARS-CoV-2 variants of concern and other emerging infectious diseases (e.g., mpox and Ebola) for travel-related health policies.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Travel-related strategies to reduce the spread of COVID-19 evolved rapidly in response to changes in the understanding of SARS-CoV-2 and newly available tools for prevention, diagnosis, and treatment. Modeling is an important methodology to investigate the range of outcomes that could occur from different disease containment strategies.nnMETHODS: We examined 43 articles published from December 2019 through September 2022 that used modeling to evaluate travel-related COVID-19 containment strategies. We extracted and synthesized data regarding study objectives, methods, outcomes, populations, settings, strategies, and costs. We used a standardized approach to evaluate each analysis according to 26 criteria for modeling quality and rigor.nnRESULTS: The most frequent approaches included compartmental modeling to examine quarantine, isolation, or testing. Early in the pandemic, the goal was to prevent travel-related COVID-19 cases with a focus on individual-level outcomes and assessing strategies such as travel restrictions, quarantine without testing, social distancing, and on-arrival PCR testing. After the development of diagnostic tests and vaccines, modeling studies projected population-level outcomes and investigated these tools to limit COVID-19 spread. Very few published studies included rapid antigen screening strategies, costs, explicit model calibration, or critical evaluation of the modeling approaches.nnCONCLUSION: Future modeling analyses should leverage open-source data, improve the transparency of modeling methods, incorporate newly available prevention, diagnostics, and treatments, and include costs and cost-effectiveness so that modeling analyses can be informative to address future SARS-CoV-2 variants of concern and other emerging infectious diseases (e.g., mpox and Ebola) for travel-related health policies.
Collins, Reagan A; Herman, Tianna; Snyder, Rebecca A; Haines, Krista L; Stey, Anne; Arora, Tania K; Geevarghese, Sunil K; Phillips, Joseph D; Vicente, Diego; Griggs, Cornelia L; McElroy, Imani E; Wall, Anji E; Hughes, Tasha M; Sen, Srijan; Valinejad, Jaber; Alban, Andres; Swan, J Shannon; Mercaldo, Nathaniel; Jalali, Mohammad S; Chhatwal, Jagpreet; Gazelle, G Scott; Rangel, Erika; Yang, Chi-Fu Jeffrey; Donelan, Karen; Gold, Jessica A; West, Colin P; Cunningham, Carrie
Unspoken Truths: Mental Health Among Academic Surgeons Journal Article
In: Ann Surg, vol. 279, iss. 3, pp. 429-436, 2024, ISSN: 1528-1140.
@article{pmid37991182,
title = {Unspoken Truths: Mental Health Among Academic Surgeons},
author = {Reagan A Collins and Tianna Herman and Rebecca A Snyder and Krista L Haines and Anne Stey and Tania K Arora and Sunil K Geevarghese and Joseph D Phillips and Diego Vicente and Cornelia L Griggs and Imani E McElroy and Anji E Wall and Tasha M Hughes and Srijan Sen and Jaber Valinejad and Andres Alban and J Shannon Swan and Nathaniel Mercaldo and Mohammad S Jalali and Jagpreet Chhatwal and G Scott Gazelle and Erika Rangel and Chi-Fu Jeffrey Yang and Karen Donelan and Jessica A Gold and Colin P West and Carrie Cunningham},
doi = {10.1097/SLA.0000000000006159},
issn = {1528-1140},
year = {2024},
date = {2024-03-01},
urldate = {2024-03-01},
journal = {Ann Surg},
volume = {279},
issue = {3},
pages = {429-436},
abstract = {OBJECTIVE: To characterize the current state of mental health within the surgical workforce in the United States (US).nnSUMMARY BACKGROUND DATA: Mental illness and suicide is a growing concern in the medical community; however, the current state is largely unknown.nnMETHODS: Cross-sectional survey of the academic surgery community assessing mental health, medical error, and suicidal ideation. The odds of suicidal ideation adjusting for sex, prior mental health diagnosis, and validated scales screening for depression, anxiety, post-traumatic stress disorder (PTSD), and alcohol use disorder were assessed.nnRESULTS: Of 622 participating medical students, trainees, and surgeons (estimated response rate=11.4-14.0%), 26.1% (141/539) reported a previous mental health diagnosis. 15.9% (83/523) of respondents screened positive for current depression, 18.4% (98/533) for anxiety, 11.0% (56/510) for alcohol use disorder, and 17.3% (36/208) for PTSD. Medical error was associated with depression (30.7% vs. 13.3%, P\<0.001), anxiety (31.6% vs. 16.2%, P=0.001), PTSD (12.8% vs. 5.6%, P=0.018), and hazardous alcohol consumption (18.7% vs. 9.7%, P=0.022). 13.2% (73/551) of respondents reported suicidal ideation in the past year and 9.6% (51/533) in the past two weeks. On adjusted analysis, a previous history of a mental health disorder (aOR: 1.97, 95% CI: 1.04-3.65, P=0.033), and screening positive for depression (aOR: 4.30, 95% CI: 2.21-8.29, P\<0.001) or PTSD (aOR: 3.93, 95% CI: 1.61-9.44, P=0.002) were associated with increased odds of suicidal ideation over the past 12 months.nnCONCLUSIONS: Nearly 1 in 7 respondents reported suicidal ideation in the past year. Mental illness and suicidal ideation are significant problems among the surgical workforce in the US.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVE: To characterize the current state of mental health within the surgical workforce in the United States (US).nnSUMMARY BACKGROUND DATA: Mental illness and suicide is a growing concern in the medical community; however, the current state is largely unknown.nnMETHODS: Cross-sectional survey of the academic surgery community assessing mental health, medical error, and suicidal ideation. The odds of suicidal ideation adjusting for sex, prior mental health diagnosis, and validated scales screening for depression, anxiety, post-traumatic stress disorder (PTSD), and alcohol use disorder were assessed.nnRESULTS: Of 622 participating medical students, trainees, and surgeons (estimated response rate=11.4-14.0%), 26.1% (141/539) reported a previous mental health diagnosis. 15.9% (83/523) of respondents screened positive for current depression, 18.4% (98/533) for anxiety, 11.0% (56/510) for alcohol use disorder, and 17.3% (36/208) for PTSD. Medical error was associated with depression (30.7% vs. 13.3%, P<0.001), anxiety (31.6% vs. 16.2%, P=0.001), PTSD (12.8% vs. 5.6%, P=0.018), and hazardous alcohol consumption (18.7% vs. 9.7%, P=0.022). 13.2% (73/551) of respondents reported suicidal ideation in the past year and 9.6% (51/533) in the past two weeks. On adjusted analysis, a previous history of a mental health disorder (aOR: 1.97, 95% CI: 1.04-3.65, P=0.033), and screening positive for depression (aOR: 4.30, 95% CI: 2.21-8.29, P<0.001) or PTSD (aOR: 3.93, 95% CI: 1.61-9.44, P=0.002) were associated with increased odds of suicidal ideation over the past 12 months.nnCONCLUSIONS: Nearly 1 in 7 respondents reported suicidal ideation in the past year. Mental illness and suicidal ideation are significant problems among the surgical workforce in the US.
Smith, Niamh; Georgiou, Michail; Jalali, Mohammad S; Chastin, Sebastien
Planning, implementing and governing systems-based co-creation: the DISCOVER framework Journal Article
In: Health Res Policy Syst, vol. 22, no. 1, pp. 6, 2024, ISSN: 1478-4505.
@article{pmid38191430,
title = {Planning, implementing and governing systems-based co-creation: the DISCOVER framework},
author = {Niamh Smith and Michail Georgiou and Mohammad S Jalali and Sebastien Chastin},
doi = {10.1186/s12961-023-01076-5},
issn = {1478-4505},
year = {2024},
date = {2024-01-08},
urldate = {2024-01-01},
journal = {Health Res Policy Syst},
volume = {22},
number = {1},
pages = {6},
abstract = {BACKGROUND: Increasingly, public health faces challenges requiring complex, multifaceted and multi-sectoral responses. This calls for systems-based approaches that facilitate the kind of collective and collaborative thinking and working required to address complexity. While the literature on systems thinking, system dynamics and the associated methodologies is extensive, there remains little clear guidance on how to plan, govern and implement participatory systems approaches within a co-creation process.nnMETHODS: We used a three-step process to develop DISCOVER, a framework for implementing, and governing systems-based co-creation: Stage 1: We conducted a literature analysis of key texts to identify well-documented methods and phases for co-creation using a systems approach, as well as areas where gaps existed. Stage 2: We looked for the most appropriate methods and approaches to fill the gaps in the knowledge production chain. Stage 3: We developed the framework, identifying how the different tools and approaches fit together end-to-end, from sampling and recruiting participants all the way through to responding with an action plan.nnRESULTS: We devised DISCOVER to help guide researchers and stakeholders to collectively respond to complex social, health and wider problems. DISCOVER is a strategic research planning and governance framework that provides an actionable, systematic way to conceptualise complex problems and move from evidence to action, using systems approaches and co-creation. In this article, we introduce the eight-step framework and provide an illustrative case study showcasing its potential. The framework integrates complementary approaches and methods from social network analysis, systems thinking and co-creation literature. The eight steps are followed sequentially but can overlap.nnCONCLUSIONS: DISCOVER increases rigour and transparency in system approaches to tackling complex issues going from planning to action. It is being piloted in environmental health research but may be suitable to address other complex challenges and could be incorporated into research proposals and protocols for future projects.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
BACKGROUND: Increasingly, public health faces challenges requiring complex, multifaceted and multi-sectoral responses. This calls for systems-based approaches that facilitate the kind of collective and collaborative thinking and working required to address complexity. While the literature on systems thinking, system dynamics and the associated methodologies is extensive, there remains little clear guidance on how to plan, govern and implement participatory systems approaches within a co-creation process.nnMETHODS: We used a three-step process to develop DISCOVER, a framework for implementing, and governing systems-based co-creation: Stage 1: We conducted a literature analysis of key texts to identify well-documented methods and phases for co-creation using a systems approach, as well as areas where gaps existed. Stage 2: We looked for the most appropriate methods and approaches to fill the gaps in the knowledge production chain. Stage 3: We developed the framework, identifying how the different tools and approaches fit together end-to-end, from sampling and recruiting participants all the way through to responding with an action plan.nnRESULTS: We devised DISCOVER to help guide researchers and stakeholders to collectively respond to complex social, health and wider problems. DISCOVER is a strategic research planning and governance framework that provides an actionable, systematic way to conceptualise complex problems and move from evidence to action, using systems approaches and co-creation. In this article, we introduce the eight-step framework and provide an illustrative case study showcasing its potential. The framework integrates complementary approaches and methods from social network analysis, systems thinking and co-creation literature. The eight steps are followed sequentially but can overlap.nnCONCLUSIONS: DISCOVER increases rigour and transparency in system approaches to tackling complex issues going from planning to action. It is being piloted in environmental health research but may be suitable to address other complex challenges and could be incorporated into research proposals and protocols for future projects.
Deutsch, Arielle R; Jalali, Mohammad S; Stout, Sarah; Frerichs, Leah
Equitable Policies Need Equitable Practices: Alcohol- and Substance-Exposed Pregnancy as a Case Study Journal Article
In: Health Promot Pract, vol. 25, iss. 1, pp. 17-21, 2024, ISSN: 1524-8399.
@article{pmid35778898,
title = {Equitable Policies Need Equitable Practices: Alcohol- and Substance-Exposed Pregnancy as a Case Study},
author = {Arielle R Deutsch and Mohammad S Jalali and Sarah Stout and Leah Frerichs},
doi = {10.1177/15248399221107605},
issn = {1524-8399},
year = {2024},
date = {2024-01-01},
urldate = {2022-07-01},
journal = {Health Promot Pract},
volume = {25},
issue = {1},
pages = {17-21},
abstract = {There is clear need for more effective public health policies. Coupled with calls for more effective policies, increasing demand to address public health disparities experienced by systemically marginalized and historically oppressed groups emphasizes the long-standing need for policies that improve public health equity. Such need is highlighted when examining public health issues such as alcohol- and substance-exposed pregnancy (ASEP): Current policies are ineffective at reducing ASEP, and marginalized groups experience disproportionately lower benefits and higher negative consequences as a result of such policies. Powerful strategies to develop more effective policies that can account for the complexity of such issues, such as systems science methods (SSMs), are becoming popular. However, current best practices for such methods often do not emphasize the additional efforts that will be required to develop equitable, not just effective policies. Using ASEP as an example of a crucial complex issue requiring new policy, we suggest additional steps to include in SSM projects for developing more effective policies that will also help stakeholders determine high-equity policies to reduce health disparities. These steps include modeling structural differences experienced by marginalized groups via systemic racism and oppression, incorporating existing cultural and community sources of strength and resilience as key areas for policy development, and evaluating the sustainability of policies as a dimension of efficacy. We also discuss using community-based participatory approaches as a framework for all SSM processes to ensure that policy development itself is grounded in equitable shared decision-making for marginalized individuals.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
There is clear need for more effective public health policies. Coupled with calls for more effective policies, increasing demand to address public health disparities experienced by systemically marginalized and historically oppressed groups emphasizes the long-standing need for policies that improve public health equity. Such need is highlighted when examining public health issues such as alcohol- and substance-exposed pregnancy (ASEP): Current policies are ineffective at reducing ASEP, and marginalized groups experience disproportionately lower benefits and higher negative consequences as a result of such policies. Powerful strategies to develop more effective policies that can account for the complexity of such issues, such as systems science methods (SSMs), are becoming popular. However, current best practices for such methods often do not emphasize the additional efforts that will be required to develop equitable, not just effective policies. Using ASEP as an example of a crucial complex issue requiring new policy, we suggest additional steps to include in SSM projects for developing more effective policies that will also help stakeholders determine high-equity policies to reduce health disparities. These steps include modeling structural differences experienced by marginalized groups via systemic racism and oppression, incorporating existing cultural and community sources of strength and resilience as key areas for policy development, and evaluating the sustainability of policies as a dimension of efficacy. We also discuss using community-based participatory approaches as a framework for all SSM processes to ensure that policy development itself is grounded in equitable shared decision-making for marginalized individuals.