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Joshua Kueiyu Lin, M.D., Sc.D.

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Overview
Dr. Lin is a Pharmacoepidemiologist in the Division of Pharmacoepidemiology and Pharmacoeconomics at the Brigham and Women’s Hospital and a practicing hospitalist at the Massachusetts General Hospital. He is an Assistant Professor at Harvard Medical school and the Executive Director of the Mass General Brigham (MGB) Center for Integrated Healthcare Data Research. In this role, he has built a highly valuable research database, linking multiple health insurance claims data with a variety of clinical data from electronic health records of the MGB institutions. Leading a team of investigators, research scientists, and administrators, he has built an efficient infrastructure that makes these rich data sources readily available for researchers at Harvard Medical School to facilitate scientific discovery. This valuable database has led to multiple publications in high-impact journals and successfully competed NIH research grants. His research has focused on optimal prescribing in vulnerable populations using large routine-care databases and the development of analytical solutions to combat common biases in pharmacoepidemiology. As Principal Investigator (PI) of an NIH-funded R01 research project (1R01LM012594), he has developed and validated an algorithm to identify a high data-completeness cohort to reduce the information bias resulted from missing medical information recorded outside of the study electronic health record (EHR) system and demonstrated this sub-cohort is representative of the remaining population. He is also the PI of an NIH-funded research project (1RF1AG063381, originally 1R01AG063381) aiming to determine the optimal anticoagulation strategy to prevent stroke in older adults with dementia and other high-risk features. He has developed and validated the best-performed prediction score for anticoagulation quality, which can help reduce inappropriate prescribing of warfarin, a highly morbid anticoagulant, to patients susceptible for adverse outcomes. In addition, he is PI of an NIH-funded Ro1 project (1R01LM013204) to develop a data-adaptive analytical framework for reducing confounding bias in studies that leverages a large amount of patient information recorded in the free-text clinical notes and reports for confounding adjustment in comparative effectiveness research (CER). He has published extensively in pharmacoepidemiology methods to minimize common biases and robust CER findings using real-world data. Using a population-based electronic medical record database in the UK, he was among the first investigators who quantified the effectiveness of different gastroprotective strategies among patients on various antithrombotic therapies. He has also published novel methods to improve information bias and confounding adjustment for multi-center survey-based epidemiological studies and produced important evidence to inform the safe use of antibiotics during pregnancy. His long-term career goal is to establish a rigorous and generalizable framework to optimize validity and precision of comparative effectiveness research with detailed evaluation of treatment effect heterogeneity using electronic health records and insurance claims data.

Research
The research activities and funding listed below are automatically derived from NIH ExPORTER and other sources, which might result in incorrect or missing items. Faculty can login to make corrections and additions.
  1. R01AG081268 (LIN, JOSHUA K) Sep 1, 2023 - May 31, 2027
    NIH
    Deprescribing antipsychotics in patients with Alzheimers disease and related dementias and behavioral disturbance in skilled nursing facilities
    Role Description: The proposed research aims to determine the health outcomes of different deprescribing strategies of antipsychotics used for behavioral and psychological symptoms of dementia in a skilled nursing facility. It will generate direct evidence that facilitates timely deprescribing of potentially inappropriate medications in people living with dementia. It will also yield a novel analytical framework specializing in comparative safety and effectiveness analyses of discontinuing psychotropic treatments with detailed subgroup analyses informative for individualized deprescribing decisions.
    Role: Principal Investigator
  2. R01AG081412 (LIN, JOSHUA K) Aug 1, 2023 - Apr 30, 2027
    NIH
    A targeted analytical framework to optimize posthospitalization delirium pharmacotherapy in patients with Alzheimers disease and related dementias
    Role Description: The study aims to establish an integrated healthcare database and a novel analytical framework for causal analyses comparing continuation vs. different discontinuation strategies of antipsychotic medications (APMs) used to manage delirium due to hospitalization in persons living with dementia (PLWDs). The proposal will produce data reflecting routine-care delivery to optimize delirium pharmacotherapy management in PLWDs and a generalizable framework that facilitates evidence generation guiding deprescribing of potentially inappropriate medications in older adults.
    Role: Principal Investigator
  3. R01AG075335 (Lin, Joshua K) Aug 30, 2022 - Apr 30, 2026
    NIH/ National Institute on Aging
    Effectiveness and Safety of Transcatheter Left Atrial Appendage Occlusion vs. Anticoagulation in Older Adults with Atrial Fibrillation and Alzheimer's Disease and Related dementias
    Role Description: This grant aims to determine the treatment effects, utilization patterns, and potential barriers of transcatheter left atrial appendage occlusion devices and specific oral anticoagulants in persons living with dementia (PLWDs) and atrial fibrillation (AF), and how the net clinical benefits vary by dementia severity, frailty, fall risks, and advanced kidney disease. It will also produce a novel and generalizable prospective monitoring program for newly marketed medical devices and pharmacotherapies with detailed treatment effect heterogeneity evaluation needed for personalized prescribing decisions.
    Role: Principal investigator
  4. RF1AG063381-01S1 (Lin, Joshua K) Sep 8, 2021 - Apr 30, 2023
    NIH/ National Institute on Aging
    Developing dynamic prognostic and risk-stratification models for informing prescribing decisions in older adults with Coronavirus Disease 2019
    Role Description: This grant aims to develop and prospectively validated a prognostic tool incorporating dynamic changes of patient characteristics, biomarkers, and drug therapies, which can inform prescribing decisions and resource allocation.
    Role: Principal investigator
  5. R01LM013204 (LIN, JOSHUA K) Jun 1, 2020 - Mar 31, 2025
    NIH
    Developing scalable algorithms to incorporate unstructured electronic health records for causal inference based on real-world data
    Role Description: This grant aims to develop a highly flexible and effective analytical method for reducing confounding bias in studies that utilize routine-care data to compare effects of medical or surgical treatments. This method will enable researchers to leverage a large amount of patient information recorded in the clinical notes and reports that are contained within electronic health records to adjust for differences in background risks of different comparison groups.
    Role: Principal Investigator

Bibliographic
Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Faculty can login to make corrections and additions.
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Funded by the NIH National Center for Advancing Translational Sciences through its Clinical and Translational Science Awards Program, grant number UL1TR002541.