Michael J. Fine, MD, MSc

  • Professor of Medicine, University of Pittsburgh School of Medicine
  • Director, VA HSR&D Center for Health Equity Research and Promotion (CHERP)

Michael J. Fine, MD, MSc is a Distinguished 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 at-risk and marginalized 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.

Dr. Fine is a strong proponent of striving for work-life balance and developing passions outside of work. His current non-work interests include tennis, skiing, travel, gardening, cooking, and spending time with friends and family.

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

Representative Publications

Essien UR, Kim N, Hausmann LRM, Mor MK, Good CB, Magnani JW, Litam TMA, Gellad WF, Fine MJ. Disparities in anticoagulant therapy initiation for incident atrial fibrillation by race/ethnicity among patients in the Veterans Health Administration system. JAMA Netw Open. 2021 Jul 1;4(7):e2114234.

In a cohort of 111,666 Veterans managed in the VA Healthcare System with new onset atrial fibrillation (AF), the adjusted odds of initiating any anticoagulant therapy were significantly lower for Asian and Black patients than White patients, controlling for baseline sociodemographic and clinical characteristics. Among individuals who initiated anticoagulant therapy, the adjusted odds of initiating direct oral anticoagulant therapy were significantly lower for Hispanic, Native American/Alaskan Native, and Black patients. Understanding the reasons for these disparities is essential to achieving equitable management of AF for racial and ethnic minority patients treated in the VA Healthcare System. 

Radomski TR, Decker A, Khodyakov D, Thorpe CT, Hanlon JT, Roberts MS, Fine MJ, Gellad WF. Development of a metric to detect and decrease low-value prescribing in older adults. JAMA Netw Open. 2022 Feb 1;5(2)e2148599.

Using a Delphi consensus building process, this study identified 18 low-value medication prescribing practices for older adults deemed to have high scientific validity and clinical usefulness from 527 potential low-value prescribing practices found in the medical literature. Applying the derived EVOLV-Rx metric among older adults may enhance the detection of low-value prescribing practices, reduce polypharmacy, and facilitate receipt of high-value care across the full spectrum of health services.

Barlas RS, Clark AB, Loke YK, Kwok CS, Angus DC, Uranga A, España PP, Eurich DT, Huang DT, Man SY, Rainer TH, Yealy DM, Myint PK, Mor MK, Fine MJ. Comparison of the prognostic performance of the CURB-65 and a modified version of hte pneumonia severity index designed to identify high-risk patients using the International Community-Acquired Pneumonia Collaboration Cohort. Respir Med. 2022 Aug-Sep;200:106884.

In individual level meta-data for 13,874 patients with community-acquired pneumonia from 6 patient cohorts and 4 countries, this study reengineered a version of the Pneumonia Severity Index (PSI), termed the PSI High-Risk (PSI-HR), that better identified patients at the higher end of the severity spectrum. PSI-HR demonstrated superior prognostic accuracy to CURB-65 at the lower end of the illness severity spectrum and identified high-risk patients with non-significantly higher mortality at the higher end.

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. Diagnosis and treatment of adults with community-acquired pneumonia: An official clinical practice guideline of the American Thoracic Scoiety and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019 Oct 1;200(7):e45-e67.

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.

Select the following links for a more complete bibliography of Dr. Fine's more than 300 original peer review publications, reviews, editorials, and commentaries.



Research Interests

  • Quality of care
  • Equity of care
  • Patient-centered outcomes
  • Practice guideline implementation