Michael J. Fine, MD, MSc is a Professor of Medicine at the University of Pittsburgh School of Medicine and Director of the Center for Health Equity Research and Promotion (CHERP), a VA Center of Innovation in Health Services Research at the VA Pittsburgh Healthcare System. His research focuses on ways to improve the quality and equity of medical care for patients with common medical problems, such as pneumonia, diabetes, and pulmonary embolus. As Director of CHERP, he is particularly interested in conducting research to detect, understand, and eliminate disparities in health and health care among vulnerable patient populations. His past research employed retrospective and prospective cohort designs, with extensive emphasis on assessment of patient-centered outcomes. His research has also utilized randomized clinical trial design to test the effectiveness and safety of implementing medical practice guidelines to improve the quality and efficiency of care for patients with common medical illnesses.
Education & Training
- BA (Anthropology), Dartmouth College, 1979
- MD, Hahnemann Medical School, 1983
- Internship (Internal Medicine), UPMC Presbyterian, 1983
- Residency (Internal Medicine), UPMC Presbyterian, 1984
- Residency (Internal Medicine), UPMC Presbyterian, 1985
- Chief Medical Resident (Internal Medicine), UPMC Presbyterian 1986
- Fellowship for Faculty Development (General Internal Medicine), Massachusetts General Hospital, 1987
- MSc (Epidemiology), Harvard School of Public Health, 1989
Gellad WF, Thorpe JM, Zhao X, Thorpe CT, Sileanu FE, Cashy JP, Hale JA, Mor M, Radomski T, Hausmann LRM, Donohue JM, Gordon A, Suda K, Stroupe K, Hanlon J, Cunningham F, Good CB, Fine MJ. Impact of dual use of Department of Veterans Affairs and Medicare Part D benefits on potentially unsafe opioid use. American Journal of Public Health. 2018;108(2):248-55.
In a cohort of 539,473 US veterans enrolled in both VA and Medicare Part D filling 1 or more opioid prescriptions, dual use of opioids from both health care systems was associated with more than 2 to 3 times the risk of high-dose opioid exposure -- defined as receiving high-dose daily (>100 MME/day) or chronic high-dose (>120MME for 90 or more days) prescriptions.
Huang DT, Yealy DM, Filbin MR, Brown AM, Chang CH, Doi Y, Donnino MW, Fine J, Fine MJ, Fischer MA, Holst JM, Hou PC, Kellum JA, Khan F, Kurz MC, Lotfipour S, LoVecchio F, Peck-Palner OM, Pike F, Prunty H, Sherwin RL, Southerland L, Temdrup T, Weissfeld LA, Yabes J, Angus DC; ProACT Investigators. Procalcitonin-guided use of antibiotics for lower respiratory tract infection. New England Journal of Medicine. 2018;379(3):236-249.
In a multicenter randomized-controlled trial testing the effect of procalcitonin-guided use of antibiotics on antibiotic treatment for suspected lower respiratory tract infection, provision of procalcitonin assay results, along with instructions on their interpretation, to emergency department and hospital-based clinicians did not result in less use of antibiotics than did usual care.
Metlay JP, Waterer GW, Long AC, Anzueto A, Brozek J, Crothers K, Cooley LA, Dean NC, Fine MJ, Flanders SA, Griffin MR, Metersky ML, Musher DM, Restrepo MI, Whitney CG; on behalf of the American Thoracic Society and Infectious Disease Society of America. Diagnosis and treatment of adults with community-acquired pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. American Journal of Respiratory and Critical Care Medicine. 2019;200(7): e45-e57.
Under the auspices of the American Thoracic Society and the Infectious Diseases Society of America, a multidisciplinary panel conducted pragmatic systematic reviews of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology to develop evidence-based clinical practice guidelines on the management of adult patients with community-acquired pneumonia. The panel developed recommendations for 16 PICO questions spanning diagnostic testing, determination of site of care, selection of initial empiric antibiotic therapy, and additional subsequent management decisions.
Primack BA, Shensa A, Sidani JE, Tulikangas MC, Roberts MS, Colditz JB, Mor MK, James AE, Fine MJ. Comparison of toxicant load from waterpipe and cigarette tobacco smoking among young adults in the USA. Tobacco Control. 2019;28:60-66.
Using survey data from a nationally representative sample of 3,254 US young adults to assess the frequency and volume of WTS and cigarette smoking, we used Monte Carlo analyses to estimate the proportions of toxicants originating from waterpipe tobacco smoking (WTS) and cigarette smoking. WTS accounted for over half of the tobacco smoke volume consumed among young US adult waterpipe and cigarette smokers. Toxicant exposures to tar, carbon monoxide and nicotine were lower, albeit substantial for WTS alone compared with WTS and cigarette smoking. Public health and policy interventions to reduce harm from tobacco smoking in young US adults should explicitly address WTS toxicant exposures.
- Health equity
- Patient-centered outcomes
- Randomized clinical trials
- Practice guideline implementation