By Saphia Suarez
For Kamil Faridi, MD, MSc, cardiology is the perfect blend of clinical medicine and research.
“Applying novel, evidence-based research directly to patient care has always been a prominent and very exciting aspect of cardiology,” said Faridi, assistant professor of medicine (cardiovascular medicine).
Faridi focuses on cardiovascular outcomes research, particularly related to new therapies as they transition from clinical trials to real-world patient care. “There's a lot of variation in how different medications and devices are used, and generally patients who are treated outside of clinical trials have higher risks of adverse outcomes, but may also derive the most benefit from new treatments,” said Faridi. “We don't always know how commonly certain therapies will be used or how they may impact individual patient risks, so I'm really interested in post-marketing surveillance of new cardiovascular therapies to help find answers to these questions.”
Faridi plans to gain additional experience in advanced statistical methodologies and implementation science to help determine how best to implement evidence-based clinical care into real-world clinical practice.
He is already learning in practice—Faridi is using medical claims data to help improve monitoring of outcomes for patients with atrial fibrillation. He is currently studying real-world use of the WATCHMAN device, which is placed via a transcatheter procedure and prevents strokes in atrial fibrillation patients as an alternative to anticoagulation. “A lot of patients have trouble with anticoagulation because they can cause bleeding problems, and many may therefore benefit from the WATCHMAN device as an alternative,” said Faridi. He is comparing outcomes from medical claims data to data reported in a national registry of patients who receive the WATCHMAN device. “We’re seeing how these data sources compare in order to determine if we can find better ways to use medical claims data to accurately monitor outcomes in the community,” said Faridi. He received the Yale Center for Clinical Investigation Junior Faculty Scholar Award for this research.
In related work, Faridi has also been looking at medical claims data as a cheaper and more efficient alternative to adjudication by Clinical Events Committees in clinical trials.
“The way we have historically assessed trial outcomes is, if there's an adverse clinical event pertinent to the trial outcome, such as a heart attack, local sites report that to the study investigators, who then evaluate available health records and make a determination on whether the event meets the prespecified definition of the outcome,” said Faridi. “That process is inefficient in a lot of ways, and it's very costly to do. There may be other ways to more efficiently determine outcomes for patients. One of those may be to simply use medical billing data, also known as claims data, which tracks patient encounters in the health system and labels them with specific diagnoses used for billing.”
Faridi added that claims data is not as accurate as data adjudicated within clinical trials.
“But there may be ways to improve the performance of claims data, such as using more advanced algorithms to improve their accuracy,” said Faridi. If successful, claims data could be used to supplement adjudication in clinical trials, potentially making them more efficient and less expensive. They could also be used to more accurately assess outcomes in real world clinical practice, after therapies are approved and implemented into patient care.”
“Looking forward, I’m hoping to lead large studies using advanced statistical methodologies and implementation science to positively impact how we deliver healthcare for patients with cardiovascular disease,” said Faridi.
The Section of Cardiovascular Medicine shares in the academic mission of one of the world’s leading centers in biomedical research. To learn more about Faridi’s work and the Section of Cardiovascular Medicine, visit Cardiovascular Medicine.