Medical Practice Evaluation Center (MPEC)

The Medical Practice Evaluation Center (MPEC) is an interdivisional center dedicated to improving clinical outcomes, increasing value in health policy, and informing global public health through innovative research, collaboration, and education.

Overview

The Medical Practice Evaluation Center (MPEC) became a formalized interdivisional center within the Department of Medicine at Massachusetts General Hospital in 2011, housing faculty and staff from the Divisions of General Medicine and Infectious Disease. The multidisciplinary MPEC team, led by Drs. Kenneth Freedberg and Rochelle Walensky, is internationally recognized in the evaluation of clinical outcomes, costs, and cost-effectiveness for preventing, managing, and treatment HIV/AIDS and other infectious diseases.

Many of the research activities at MPEC utilize the Cost-Effectiveness of Preventing AIDS Complications (CEPAC) model. Since 1994, researchers at MGH have used this Monte Carlo simulation model to evaluate the cost-effectiveness of national and multinational strategies for combating HIV/AIDS. The model, first developed in response to the outbreak of the HIV/AIDS epidemic in the United States, has grown over time in both scope and application to provide comprehensive analyses for prospective treatment strategies of HIV/AIDS and AIDS-related complications, including tuberculosis and other infections.

The MPEC team collaborates with research teams in Botswana, Brazil, Côte d’Ivoire, France, India, Mozambique, South Africa, and Zimbabwe, as well as investigators from Brigham and Women’s Hospital, the Harvard School of Public Health, Weill Cornell Medical College, and Yale University. Research from the MPEC team has been published in several leading medical journals, including the Journal of the American Medical Association, New England Journal of Medicine, and AIDS.

The staff of at the Medical Practice Evaluaton Center at Massachusetts General Hospital is comprised of faculty members, fellows, students and support staff, and research assistants.


Faculty Members

 

Kenneth Freedberg, MD, MSC

Kenneth Freedberg, MD, MSc

Dr. Freedberg is is a Professor of Medicine at Harvard Medical School, Professor in the Department of Health Policy and Management at the Harvard School of Public Health, and a physician at the Massachusetts General Hospital. He is Director of the Program in Clinical Epidemiology and Outcomes Research at the Harvard University Center for AIDS Research (CFAR) and Director of the Program in HIV Research in the Division of General Medicine at Massachusetts General Hospital.  His research interests focus on HIV, TB, as well as other chronic disease clinical outcomes and health policy, utilizing the methods of comparative effectiveness, cost-effectiveness analysis, clinical epidemiology, and implementation science. Dr. Freedberg earned an MD from Harvard Medical School and also holds a Master’s in Health Services Administration from the Harvard School of Public Health.

 

Rochelle Walensky, MD, MPH
Rochelle Walensky, MD, MPH

Dr. Walensky is a Professor of Medicine at Harvard Medical School and an infectious disease physician at the Brigham and Women's Hospital and Massachusetts General Hospitals. She is Associate Director of the Program in Clinical Epidemiology and Outcomes Research at the Harvard University Center for AIDS Research. Her research interests include the promotion of routine HIV counseling, testing and referral and the economic evaluation of alternative HIV testing and treatment policies. Dr. Walensky earned an MD from the Johns Hopkins School of Medicine and an MPH from the Harvard School of Public Health.

 

Ingrid Bassett, MD, MPH
Ingrid Bassett, MD, MPH

Dr. Bassett is an Assistant Professor of Medicine at Harvard Medical School and an infectious disease physician at the Massachusetts General Hospital. Her research interests include HIV testing, linkage to HIV care, and TB screening in South Africa. Dr. Bassett earned an MD from Harvard Medical School and an MPH from the Harvard School of Public Health.

 

 

Andrea Ciaranello, MD, MPH
Andrea Ciaranello, MD, MPHDr. Ciaranello is an Assistant Professor of Medicine at Harvard Medical School and an infectious disease physician at the Massachusetts General Hospital. Her research interests involve the use of simulation models to examine the long-term clinical outcomes and cost-effectiveness of strategies to prevent, diagnose, and manage perinatal HIV infection. Dr. Ciaranello earned an MD from the Yale School of Medicine and an MPH from the Harvard School of Public Health.
Elena Losina, PhD
Elena Losina, PhD Dr. Losina is an Associate Professor of Orthopedic Surgery at Harvard Medical School and an Associate Professor of Biostatistics at the Boston University School of Public Health. Her research interests include study design and biostatistical analysis in HIV operational research. Dr. Losina earned a PhD in Biostatistics from Boston University School of Public Health.

 

Robert A. Parker
Robert A. Parker, ScD., CStatDr. Parker is is a Visiting Professor of Medicine at Harvard Medical School, and an Associate Biostatistician at the MGH Biostatistics Center. His research interests include non-standard study design and non-standard data analysis. Dr. Parker earned his ScD from the Harvard School of Public Health, and is a Chartered Statistician in the Royal Statistical Society (UK).
Erica Shenoy, MD, PhD
Erica Shenoy, MD, PhDDr. Shenoy is an Instructor in Medicine and an infectious disease physician at the Massachusetts General Hospital. Dr. Shenoy's research interests lie in optimization of infection control strategies and surveillance, which she investigates through clinical research studies in inpatient and ambulatory patient populations and through modeling techniques. She earned an MD from Harvard Medical School and a PhD in Health Policy/Economics from Harvard University.

 

Virginia Triant, MD, MPH
Virginia Triant, MD, MPH

Dr. Triant is an Instructor in Medicine at Harvard Medical School and an Assistant Physician in Infectious Diseases at Massachusetts General Hospital. Dr. Triant joined the MPEC in 2012. Her research focuses on the intersection of HIV and chronic disease complications, with a focus on cardiovascular disease. She has developed a Partners HealthCare System-based HIV longitudinal clinical care cohort to investigate cardiovascular and metabolic outcomes, risk factors, prevention, risk prediction, and management, as well as other HIV epidemiology questions. Dr. Triant earned her MD from Yale School of Medicine.


 

Fellows

Aima Ahonkhai, MD, MPH

Aima Ahonkhai, MD, MPH

Dr. Ahonkhai is an Instructor in Medicine at Harvard Medical School and an infectious disease physician at the Massachusetts General Hospital. Dr. Ahonkhai joined the MPEC in 2009 as a research fellow. Her primary research interests lie in improving the quality of HIV care in resource limited settings. Dr. Ahonkhai earned her MD and MPH from the John Hopkins University School of Medicine.

Kimberly Blumenthal, MD
Kimberly Blumenthal, MD

Dr. Blumenthal is a research fellow in the Division of Rheumatology, Allergy and Immunology and the Medical Practice Evaluation Center and a practicing allergist at the Massachusetts General Hospital. She is interested in quality improvement and cost-effectiveness research related to drug allergy, currently studying how patients’ reported antibiotic allergies affect care. Dr. Blumenthal earned an MD from the Yale University School of Medicine. 

Paul Drain, MD, MPH
Paul Drain, MD, MPH

Dr. Drain is a Clinical and Research Fellow at the Massachusetts General Hospital and joined the MPEC in 2012. His research interests include diagnostic point-of-care testing for HIV and HIV-related opportunistic infections in resource-limited settings. Dr. Drain is a former public health Peace Corps volunteer in Morocco, and has also worked in Kenya, Tanzania, Madagascar, and South Africa. Dr. Drain earned his MD and MPH from the University of Washington. 

 
Emily Hyle, MDDr. Hyle is an Instructor in Medicine at Harvard Medical School and an infectious disease physician at the Massachusetts General Hospital. Dr. Hyle joined the MPEC in 2011 as a research fellow. Her research interests include non-communicable diseases in HIV-infected patients in resource-limited settings. Dr. Hyle earned an MD from the Perelman School of Medicine at the University of Pennsylvania.
Julie Levison, MD, MPhil, MPH
Julie Levison, MD, MPhil, MPHDr. Levinson is an Instructor in Medicine at Harvard Medical School and an infectious disease physician at the Brigham and Women’s Hospital and Massachusetts General Hospital. Dr. Levison joined the MPEC in 2008. Her research interests include the management of antiretroviral treatment failure and access to equitable clinical care in resource-limited settings. Dr. Levison earned an MPhil  from Oxford University as a Rhodes Scholar, an MD from Harvard Medical School, and an MPH from the Harvard School of Public Health.
Anne Neilan, MD, MPH
Anne Neilan, MD, MPHDr. Neilan is an adult infectious disease fellow at the Massachusetts General Hospital. Dr. Neilan joined the MPEC in 2014. Her research interested included HIV-infected children and adolescents. Dr. Neilan earned her MD and MPH from The Mount Sinai School of Medicine in New York.
Leim Binh Luong Nguyen, MD, Ms
Leim Binh Luong Nguyen, MD, MsDr. Nguyen is an infectious disease resident in Paris, France. He joined the MPEC in 2014 as a research fellow. He works with Médecins sans Frontières, a French NGO on modelling the impact of HIV prevention Strategies in Kenya. He has worked in Central African Republic as Project Manager for the Institut Pasteur. He earned his MD from Pierre et Marie Curie University and his Msc from Ecole Normale Superieure in Paris.
Virginia Triant, MD, MPH
Kelli O'Laughlin, MD, MPH

Dr. O'Laughlin is an attending emergency medicine physician at Brigham & Women’s Hospital and is faculty at the Harvard Humanitarian Initiative. She joined MPEC in 2012 as a research fellow.  She conducts operational research in low-resource settings to expand access to HIV testing and related care for refugees in living in Uganda. Dr. O’Laughlin earned her MD from Oregon Health & Science University and her MPH from the Harvard School of Public Health.

Krishna Reddy, MD
Krishna Reddy, MD

Dr. Reddy is a fellow in Pulmonary and Critical Care Medicine at Massachusetts General Hospital, Brigham and Women's Hospital, and Beth Israel Deaconess Medical Center. His research interests include tuberculosis diagnostics and lung diseases in people with HIV. Previously he conducted research on tuberculosis diagnostics as a Fogarty Scholar in Peru. Dr. Reddy earned an MD from Harvard Medical School.


 

Students and Staff

Aima Ahonkhai, MD, MPH

Nadia Abuelezam, PhD

Dr. Abuelezam recieved her doctorate in infectious disease epidemiology from the Harvard School of Public Health. Her work focuses on agent-based mathematical models for HIV disease prediction and prevention. She is currently working with the CEPAC Dynamic Model in a South African setting and is interested in simulating the results of the large community randomized HIV prevention trials in sub-Saharan Africa. She graduated from Harvey Mudd College in 2009 with a BS in mathematical biology. 

Elizabeth Banks, MBA
Elizabeth Barks, MBA
Elizabeth joined the MPEC in 2011 following a successful tenure in management consulting and private industry.  She holds a Bachelor’s in Economics from The University of Notre Dame, and earned an MBA from the Kellogg School of Management at Northwestern University, with focused studies in Marketing and Nonprofit Management.
Nicole Holt, MD, MPH
Nicole Holt, MPH

Nicole joined the MPEC in January 2014 after working for four and a half years at Spaulding Rehabilitation Hospital. She has a background in the coordination and implementation of research studies. She holds a Bachelor’s in Psychology and History from Brown University and earned a Masters of Public Health from Oregon State University with a focus in Health Promotion. 

N. Kaye Horstman, PhD, MPH
N. Kaye Horstman, PhD, MPHDr. Horstman joined the MPEC in the fall of 2013 after doing laboratory research in bacterial pathogenesis. Her current research interests include using simulation models to estimate the burden and transmission of opportunistic infections in populations with high HIV prevalence. She has an MPH in Quantitative Methods from the Harvard School of Public Health, a PhD in Basic Medical Sciences from New York University, and a BS in Biology from Randolph-Macon Woman’s College.
Julie Levison, MD, MPhil, MPH
Taige HouTaige joined the MPEC in 2011. He is the programmer and server administrator for the group and works on software development for MPEC. He has BS in Physics and Mathematics from the Massachusetts Institute of Technology.
Anne Neilan, MD, MPH
Jodi Kurtz, MSM, MAJodi joined the MPEC in 2012, and has a wide array of experience with both pre and post award management of sponsored research programs, as well as clinical trial management and regulatory compliance.  She has a BS from Carnegie Mellon University, an MA from the University of Washington, and an MSM with a specialization in Research Administration from Emmanuel College. 
Leim Binh Luong Nguyen, MD, Ms
Aaron Lucas, PhD, MPHDr. Lucas joined the MPEC in July of 2013 after completing his PhD/MPH in Industrial Engineering and Management Sciences from Northwestern University. Aaron has worked previously on simulation modeling in the context of health insurance reform in the United States. His interests include cost-effectiveness analysis, simulation and network modeling/analysis in healthcare.
 
Alethea McCormick, ScD 
Krishna Reddy, MD
Jamie Nangle

Jamie joined the MPEC as the Office Manager in early 2013 after working for two and a half years at Partners Healthcare. She held a position for several years as an Executive Assistant prior to her time at Partners. She holds a Bachelor’s degree in Psychology from Wheaton College, MA.

Pamela Pei, PhD
Pamela Pei, PhD 

Dr. Pei joined the MPEC in 2011. Prior to joining the MPEC, she worked as a health economist at the United BioSource Corporation. Her research interests include the use of simulation models to examine HIV transmission, the cost-effectiveness, and budget impact of interventions to treat and prevent HIV infections. Dr. Pei earned a PhD in Operations Research from the Massachusetts Institute of Technology.

Karen Silva
Karen Silva

Karen has been working at Mass General has been working at the Massachusetts General Hospital in various capacities since 1987, and joined the MPEC in 2009. She holds a bachelor’s degree from Salem State University.


 

Research Assistants

 

Kenneth Freedberg, MD, MSC

Jordan Francke

Jordan joined the MPEC in June 2013. He graduated from Bowdoin College in 2013 with an AB in Neuroscience. Jordan works closely with Dr. Ciaranello on projects using the CEPAC Pediatric Model.

 

Rochelle Walensky, MD, MPH
Melanie Gaynes

Melanie joined the MPEC in August 2013. She graduated from Bowdoin College in 2013 with an AB in Sociology. Melanie works closely with Dr. Bassett on projects related to retention and linkage to care in South Africa.

 

Ingrid Bassett, MD, MPH
Michael Girouard

Michael joined MPEC in July 2013. He graduated from Williams College in 2013 with a BA in Chemistry and French. Michael works on projects related to HIV/TB coinfection. He is also working on a project with collaborators in Brazil. 

 

Andrea Ciaranello, MD, MPH
Margo JacobsenMargo joined MPEC in July 2014. She graduated from Cornell University in 2013 with a BA in Anthropology. Margo is currently working with Dr. Hyle on a US-based cost of elimination study.
Elena Losina, PhD
Iman Khan Iman joined MPEC in June 2013 after graduating from Wellesley College in 2013 with a BA in Spanish. Iman works with Dr. Levison studying barriers to retention of Latino immigrants in HIV care.

 

Robert A. Parker
Rachel MacLeanRachel is joined MPEC in July 2014. She graduated from Williams College in 2014 with a BA in Political Economy. Rachel is working on a project evaluating the benefits of ART policies in Brazil.
Erica Shenoy, MD, PhD
Sarah Park, MPHSarah joined the MPEC in July 2013. She graduated from Yale School of Public Health in 2013 with a MPH in Health Policy and from University of California, Berkeley in 2011 with a BA in Public Health and minor in Public Policy. She is currently working on projects related to pharmacogenomics, cardiovascular diseases, and CD4 and HVL monitoring.

 

Marion Robine
Marion Robine 

Marion joined the MPEC in June 2012. She graduated from Cornell University in 2012 with a BS in Biology and Society. Marion works closely with Dr. Bassett on projects related to retention and linkage to care in South Africa. She is also working on a project with collaborators in Côte d’Ivoire.

 

Virginia Triant, MD, MPH
Katherine Rosettie 

Katherine joined MPEC in June 2013. She graduated from Cornell University in 2013 with a BS in Biology and Global Health.

 

Virginia Triant, MD, MPH
Erin Ryan, MPH

Erin joined the MPEC in March 2014. She graduated from the Boston University School of Public Health in January 2014 with a MPH in International Health and a certificate in Pharmaceuticals, and from Boston College in May 2012 with a BA in Sociology and double minor in Chemistry and Hispanic Studies. Erin works closely with Dr. Erica Shenoy on projects involving hospital acquired infections (HAIs) and optimization of infection control strategies using simulation modeling.

 

Virginia Triant, MD, MPH
Cynthia Shi

Cynthia joined the MPEC in September 2013. She graduated from Columbia University in 2011 with a BA in Neuroscience & Behavior and Sociology. Cynthia is currently a graduate student in the SM Epidemiology program at the Harvard School of Public Health. She works with Dr. Drain on projects related to point-of-care testing for HIV, tuberculosis, and cryptococcal meningitis in South Africa.

Research Projects

The multidisciplinary MPEC team is internationally recognized in the evaluation of clinical outcomes, costs, and cost-effectiveness for preventing, managing, and treatment HIV/AIDS and other infectious diseases.

Many MPEC research projects utilize the CEPAC (Cost-Effectiveness in Preventing AIDS Complications) model, which simulates a large cohort of patients and follows each patient on a monthly basis until death. CEPAC uses published data on the natural history of HIV and opportunistic infections, as well as the efficacy and cost of prophylaxis and treatment along with other epidemiological parameters to simulate the overall impact of HIV on a specific population.  CEPAC researchers simulate prospective treatment strategies onto the cohort under varying epidemiological conditions and use the outputs to project a strategy’s efficacy and cost-effectiveness. For more information on the model, please visit the CEPAC web site.

Our faculty and fellows also conduct observational and interventional research studies in patient populations in the United States and in international settings.

Selected Recent Publications:

Hyle EP, Naidoo K, Su AE, El-Sadr WM, Freedberg KA. HIV, tuberculosis, and noncommunicable diseases: what is known about the costs, effects, and cost-effectiveness of integrated care? J Acquir Immune Defic Syndr. 2014 Sep 1;67 Suppl 1:S87-95.

Ciaranello AL, Leroy V, Rusibamayila A, Freedberg KA, Shapiro R, Engelsmann B, Lockman S, Kelly KA, Dabis F, Walensky RP. Individualizing the WHO HIV and infant feeding guidelines: optimal breastfeeding duration to maximize infant HIV-free survival. A IDS.2014 Jul;28 Suppl 3:S287-99.

Bassett IV, Regan S, Luthuli P, Mbonambi H, Bearnot B, Pendleton A, Robine M, Mukuvisi D, Thulare H, Walensky RP, Freedberg KA, Losina E, Mhlongo B. Linkage to care following community-based mobile HIV testing compared with clinic-based testing in Umlazi Township, Durban, South Africa. HIV Med. 2014 Jul;15(6):367-72.

Ouattara EN, Ross EL, Yazdanpanah Y, Wong AY, Robine M, Losina E, Moh R, Walensky RP, Danel C, Paltiel AD, Eholié SP, Freedberg KA, Anglaret X. Clinical impact and cost-effectiveness of making third-line antiretroviral therapy available in sub-Saharan Africa: A model-based analysis in Côte d'Ivoire. J Acquir Immune Defic Syndr. 2014 Jul 1;66(3):294-302.

Levison J, Triant V, Losina E, Keefe K, Freedberg K, Regan S. Development and validation of a computer-based algorithm to identify foreign-born patients with HIV infection from the electronic medical record. Appl Clin Inform. 2014 Jun 18;5(2):557-70.

McCormick AW, Abuelezam NN, Rhode ER, Hou T, Walensky RP, Pei PP, Becker JE, DiLorenzo MA, Losina E, Freedberg KA, Lipsitch M, Seage GR 3rd. Development, calibration and performance of an HIV transmission model incorporating natural history and behavioral patterns: application in South Africa. PLoS One. 2014 May 27;9(5):e98272.

Shenoy ES, Noubary F, Kim J, Rosenberg ES, Cotter JA, Lee H, Walensky RP, Hooper DC. Concordance of PCR and culture from nasal swabs for detection of methicillin-resistant Staphylococcus aureus in a setting of concurrent antistaphylococcal antibiotics. J Clin Microbiol. 2014 Apr;52(4):1235-7.

Linas BP, Barter DM, Leff JA, DiLorenzo M, Schackman BR, Horsburgh CR, Assoumou SA, Salomon JA, Weinstein MC, Kim AY, Freedberg KA. The cost-effectiveness of improved hepatitis C virus therapies in HIV/hepatitis C virus coinfected patients. AIDS. 2014 Jan 28;28(3):365-76.

Drain PK, Losina E, Coleman SM, Giddy J, Ross D, Katz JN, Walensky RP, Freedberg KA, Bassett IV. Diagnostic accuracy of a point-of-care urine test for tuberculosis screening among newly-diagnosed HIV-infected adults: a prospective, clinic-based study. BMC Infect Dis. 2014 Feb 26;14:110.

Bassett IV, Govindasamy D, Erlwanger AS, Hyle EP, Kranzer K, van Schaik N, Noubary F, Paltiel AD, Wood R, Walensky RP, Losina E, Bekker LG, Freedberg KA. Mobile HIV screening in Cape Town, South Africa: clinical impact, cost and cost-effectiveness. PLoS One. 2014 Jan 22;9(1):e85197.

Longenecker CT, Triant VA. Initiation of antiretroviral therapy at high CD4 cell counts: does it reduce the risk of cardiovascular disease? Curr Opin HIV AIDS. 2014 Jan;9(1):54-62.

Ciaranello AL, Morris BL, Walensky RP, Weinstein MC, Ayaya S, Doherty K, Leroy V, Hou T, Desmonde S, Lu Z, Noubary F, Patel K, Ramirez-Avila L, Losina E, Seage GR 3rd, Freedberg KA. Validation and calibration of a computer simulation model of pediatric HIV infection. PLoS One. 2013 Dec 13;8(12):e83389.

Walensky RP, Ross EL, Kumarasamy N, Wood R, Noubary F, Paltiel AD, Nakamura YM, Godbole SV, Panchia R, Sanne I, Weinstein MC, Losina E, Mayer KH, Chen YQ, Wang L, McCauley M, Gamble T, Seage GR 3rd, Cohen MS, Freedberg KA. Cost-effectiveness of HIV treatment as prevention in serodiscordant couples. N Engl J Med. 2013 Oct 31;369(18):1715-25.

Hyle EP, Sax PE, Walensky RP. Potential savings by reduced CD4 monitoring in stable patients with HIV receiving antiretroviral therapy. JAMA Intern Med. 2013 Oct 14;173(18):1746-8.

Shenoy ES, Kim J, Rosenberg ES, Cotter JA, Lee H, Walensky RP, Hooper DC. Discontinuation of contact precautions for methicillin-resistant staphylococcus aureus: a randomized controlled trial comparing passive and active screening with culture and polymerase chain reaction. Clin Infect Dis. 2013 Jul;57(2):176-84.

Schackman BR, Haas DW, Becker JE, Berkowitz BK, Sax PE, Daar ES, Ribaudo HJ, Freedberg KA. Cost-effectiveness analysis of UGT1A1 genetic testing to inform antiretroviral prescribing in HIV disease. Antivir Ther. 2013;18(3):399-408.

Levison JH, Wood R, Scott CA, Ciaranello AL, Martinson NA, Rusu C, Losina E, Freedberg KA, Walensky RP. The clinical and economic impact of genotype testing at first-line antiretroviral therapy failure for HIV-infected patients in South Africa. Clin Infect Dis. 2013 Feb;56(4):587-97.

Anglaret X, Scott CA, Walensky RP, Ouattara E, Losina E, Moh R, Becker JE, Uhler L, Danel C, Messou E, Eholié S, Freedberg KA. Could early antiretroviral therapy entail more risks than benefits in sub-Saharan African HIV-infected adults? A model-based analysis. Antivir Ther. 2013;18(1):45-55

Walensky RP, Sax PE, Nakamura YM, Weinstein MC, Pei PP, Freedberg KA, Paltiel AD, Schackman BR. Economic savings versus health losses: the cost-effectiveness of generic antiretroviral therapy in the United States. Ann Intern Med. 2013 Jan 15;158(2):84-92.

 

A full list of our publications can be found on PubMed.

A list of CEPAC publication can be found on the CEPAC Publications Page.

MPEC Medical Practice Evaluation Center

50 Staniford Street
9th floor
Boston, MA 02114

Phone: 617-724-8445
Email: MPEC@mgh.harvard.edu

Public Transportation Access: yes
Disabled Access: yes