David Y. Hwang MD

Assistant Professor of Neurology; Staff Neurointensivist, Neuroscience Intensive Care Unit

Research Interests

Neurocritical care; Intensive care unit; Outcome prognostication; Family satisfaction; Consistency of communication by ICU staff; Family anxiety and depression in the ICU; Palliative care

Current Projects

I am currently the Yale PI for the following studies:

Family Satisfaction in the Neuroscience Intensive Care Unit - survey study of Neuro ICU patients' families regarding their impressions of care

Shared Decision Making for Families of Patients with Intracerebral Hemorrhage (ICH) - survey study of general population's priorities in making goals-of-care decisions for patients with ICH

GAMES - study of IV glyburide for cerebral edema following acute ischemic stroke

I am a sub-investigator for the following clinical trials:

i-DEF - study of deferoxamine mesylate for intracerebral hemorrhage

ATACH II - study of aggressive blood pressure lowering for intracerebral hemorrhage

CLEAR III - study of intraventricular tPA for intraventricular hemorrhage

POINT - study of aspirin and clopidogrel for transient ischemic attack

ICTuS 2/3 - study of induced hypothermia in acute ischemic stroke


Research Summary

Our group is actively studying the experience of family members acting as surrogate decision makers for patients admitted to the Yale Neuroscience Intensive Care Unit. We welcome trainees of all levels--including undergraduates, medical students, residents, mid-levels, and nurses--to contact us and become involved. We would be happy to work with any medical students interested in a thesis that encompasses quality improvement, end-of-life care, and/or patient/family satisfaction in ICUs to tailor a project that fits their interests.

Currently, our multidisciplinary team surveys a family member of every patient who is admitted to the Neuro ICU for greater than 3 days regarding their satisfaction with care. We use the FS-ICU 24 survey as our instrument and enroll surviving patients at time of ICU discharge. We also contact family members of patients who pass away about one month after death and ask them to fill out the FS-ICU as well. This infrastructure can serve as the basis for pre- and post-intervention data collection, and the staff of our unit is open to ideas regarding novel interventions to improve the family experience.

Through prior projects, members of our group have previously highlighted the fact that as high as 25% of families of ICU patients perceived "mixed" messages from multiple care providers regarding the clinical course of their admitted relatives. Our group remains interested in studying reasons for why families may receive inconsistent information from different members of the care team.

In addition, our group is either planning on collecting data or analyzing data regarding (1) the effects that role-playing interview exercises among residents may have on patient satisfaction, (2) the relationship between family satisfaction with ICU care and long term incidence of depression/anxiety/PTSD, and (3) the abilities of care providers to predict the functional outcome of patients with diseases such as hemorrhagic stroke.


Selected Publications

  • *Hwang, D.Y., *D. Yagoda, H.M. Perrey, T.M. Tehan, M. Guanci, L. Ananian, P.F., Currier, J.P. Cobb, and J. Rosand. Assessment of satisfaction with care among family members of survivors in a neuroscience intensive care unit. J Neurosci Nurs 2014;46(2):106-116. *Co-first authorship
  • *Hwang, D.Y., *D. Yagoda, H.M. Perrey, T.M. Tehan, M. Guanci, L. Ananian, P.F., Currier, J.P. Cobb, and J. Rosand. Consistency of communication among intensive care unit staff as perceived by family members of patients surviving to discharge. J Crit Care 2014;29(1):134-138. *Co-first authorship
  • *Hwang, D.Y., *D. Yagoda, H.M. Perrey, P.F. Currier, T.M. Tehan, M. Guanci, L. Ananian, J.P. Cobb, and J. Rosand. Anxiety and depression symptoms among families of adult intensive care unit survivors immediately following brief length of stay. J Crit Care 2014;29(2):278-282. *Co-first authorship
  • Hwang, D.Y., G.S. Silva, K.L. Furie, and D.M. Greer. Comparative sensitivity of computed tomography vs. magnetic resonance imaging for detecting acute posterior fossa infarct. J Emerg Med 2012;42:559-565.
  • Hwang, D.Y., D.A. Gallo, B.A. Ally, P.M. Black, D.L. Schacter, and A.E. Budson. Diagnostic retrieval monitoring in patients with frontal lobe lesions: further exploration of the distinctiveness heuristic. Neuropsychologia 2007;45:2543-2552.
  • Hwang, D.Y. and J.L. Bernat. Neurologists and end-of-life decision-making: the role of “protective paternalism.” Invited editorial in press for Neurology: Clinical Practice.

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