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Emergency Medicine Research

Research Overview

A specialist in Pediatric Emergency Medicine, Dr. Andrew Fine’s research focuses on bridging public health informatics with medical decision sciences. He has published a series of innovative manuscripts demonstrating the methods and the value of incorporating epidemiological context into medical decision making.

The research examines approaches to building models that incorporate local trends and help guide rational testing and treatment for diseases of great public health importance, including meningitis, pertussis, Lyme disease and group A streptococcal pharyngitis. Dr. Fine is also engaged actively in projects evaluating the usage and impact of evidence-based guidelines in the emergency department, as well as the value of health information exchange. He is leading the effort to digitize evidence-based guidelines. He helps to lead the Predictors of Patient Placement (POPP) project, which is generating a tool and dashboard to shorten waiting times in the emergency department, based on real-time electronic health record information. Dr. Fine has received several awards for teaching, professionalism and citizenship. He served as a group tutorial leader for the required Clinical Epidemiology and Population Health course for 1st year Harvard Medical School students. Dr. Fine has been elected to The Society for Pediatric Research.

Research Background

Andrew Fine majored in History and received his A.B. from Harvard. He received his M.P.H. from the John Hopkins University School of Hygiene and Public Health and his M.D. from the University Of Pennsylvania School Of Medicine. He completed a residency in pediatrics and then served as Chief Resident at the University of California, San Francisco. He moved to Boston Children’s Hospital, where he completed his Pediatric Emergency Medicine Fellowship. He continued as a Research Fellow for the Center for Biopreparedness for two years after and he joined the faculty in 2005.

Education

Medical School

University of Pennsylvania
1997 Philadelphia PA

Internship

University of California, San Francisco
1998 San Francisco CA

Residency

Pediatrics University of California, San Francisco
2001 San Francisco CA

Fellowship

Pediatric Emergency Medicine Boston Children's Hospital
2005 Boston MA

Publications

  1. Development of a reference standard to assign bacterial versus viral infection etiology using an all-inclusive methodology for comparison of novel diagnostic tool performance. Clin Infect Dis. 2025 Jan 03. View Abstract
  2. High speed, high risk: the rise of e-scooter injuries in adolescents. Pediatr Res. 2024 Dec 17. View Abstract
  3. Brief, Resolved, Unexplained Events Explained in a Two-Month Old Infant. J Pediatr. 2024 Oct; 273:114127. View Abstract
  4. Harnessing the Power of Generative AI for Clinical Summaries: Perspectives From Emergency Physicians. Ann Emerg Med. 2024 Aug; 84(2):128-138. View Abstract
  5. Impact of a Bronchiolitis Clinical Pathway on Management Decisions by Preferred Language. Pediatr Qual Saf. 2024 Jan-Feb; 9(1):e714. View Abstract
  6. Impact of COVID-19 and the cancellation of the 2020 PAS Meeting on abstract publications. Pediatr Res. 2024 Jun; 95(7):1668-1669. View Abstract
  7. National Patterns of Outpatient Follow-Up Visits After Emergency Care for Acute Bronchiolitis. JAMA Netw Open. 2023 10 02; 6(10):e2340082. View Abstract
  8. Carolina Blues. JAMA Surg. 2023 10 01; 158(10):1115. View Abstract
  9. Digital Antimicrobial Stewardship Decision Support to Improve Antimicrobial Management. Appl Clin Inform. 2023 05; 14(3):418-427. View Abstract
  10. Association Between Molecular Streptococcal Testing and Antibiotic Use for Pharyngitis in Children. J Pediatric Infect Dis Soc. 2022 06 22; 11(6):303-304. View Abstract
  11. Factors associated with first-time and repeat blood donation: Adverse reactions and effects on donor behavior. Transfusion. 2022 06; 62(6):1269-1279. View Abstract
  12. Physician Risk Perception and Testing Behaviors for Children With Fever. Pediatr Emerg Care. 2022 Feb 01; 38(2):e805-e810. View Abstract
  13. Prediction across healthcare settings: a case study in predicting emergency department disposition. NPJ Digit Med. 2021 Dec 15; 4(1):169. View Abstract
  14. Patient Ethnicity and Pediatric Visits to the Emergency Department for Fever. Pediatr Emerg Care. 2021 Nov 01; 37(11):555-559. View Abstract
  15. Attending-Provider Handoffs and Pediatric Emergency Department Revisits. Pediatr Emerg Care. 2021 Nov 01; 37(11):e679-e685. View Abstract
  16. Prediction of patient disposition: comparison of computer and human approaches and a proposed synthesis. J Am Med Inform Assoc. 2021 07 30; 28(8):1736-1745. View Abstract
  17. Seasonality of Common Pediatric Infectious Diseases. Pediatr Emerg Care. 2021 Feb 01; 37(2):82-85. View Abstract
  18. Long-term Effects of an Evidence-based Guideline for Emergency Management of Pediatric Syncope. Pediatr Qual Saf. 2020 Nov-Dec; 5(6):e361. View Abstract
  19. Kicking it through the uprights: getting it published after presenting at PAS. Pediatr Res. 2021 05; 89(7):1598-1600. View Abstract
  20. Improving the prediction of streptococcal pharyngitis; time to move past exudate alone. Am J Emerg Med. 2021 07; 45:196-201. View Abstract
  21. Identifying Patients at Lowest Risk for Streptococcal Pharyngitis: A National Validation Study. J Pediatr. 2020 05; 220:132-138.e2. View Abstract
  22. A Bayesian Spatiotemporal Analysis of Pediatric Group A Streptococcal Infections. Open Forum Infect Dis. 2019 Dec; 6(12):ofz524. View Abstract
  23. Impact of viral symptoms on the performance of the modified centor score to predict pediatric group A streptococcal pharyngitis. Am J Emerg Med. 2020 07; 38(7):1322-1326. View Abstract
  24. A method to identify pediatric high-risk diagnoses missed in the emergency department. Diagnosis (Berl). 2018 Jun 27; 5(2):63-69. View Abstract
  25. Patients Visiting Multiple Emergency Departments: Patterns, Costs, and Risk Factors. Acad Emerg Med. 2017 11; 24(11):1349-1357. View Abstract
  26. Diagnostic Lumbar Puncture Among Children With Facial Palsy in a Lyme Disease Endemic Area. J Pediatric Infect Dis Soc. 2017 Jun 01; 6(2):205-208. View Abstract
  27. Early Prediction Model of Patient Hospitalization From the Pediatric Emergency Department. Pediatrics. 2017 May; 139(5). View Abstract
  28. Complexity and Severity of Pediatric Patients Treated at United States Emergency Departments. J Pediatr. 2017 07; 186:145-149.e1. View Abstract
  29. Viral Features and Testing for Streptococcal Pharyngitis. Pediatrics. 2017 May; 139(5). View Abstract
  30. Patient and Parent-Reported Signs and Symptoms for Group A Streptococcal Pharyngitis. Pediatrics. 2016 07; 138(1). View Abstract
  31. Effect of Randomized Clinical Trial Findings on Emergency Management. Acad Emerg Med. 2016 Jan; 23(1):36-47. View Abstract
  32. Implementing a guideline to improve management of syncope in the emergency department. Pediatrics. 2014 Nov; 134(5):e1413-21. View Abstract
  33. Participatory medicine: a home score for streptococcal pharyngitis. Ann Intern Med. 2014 Feb 18; 160(4):289. View Abstract
  34. Participatory medicine: A home score for streptococcal pharyngitis enabled by real-time biosurveillance: a cohort study. Ann Intern Med. 2013 Nov 05; 159(9):577-83. View Abstract
  35. Validation of anaphylaxis in the Food and Drug Administration's Mini-Sentinel. Pharmacoepidemiol Drug Saf. 2013 Nov; 22(11):1205-13. View Abstract
  36. Trends in the management of viral meningitis at United States children's hospitals. Pediatrics. 2013 Apr; 131(4):670-6. View Abstract
  37. Risks of radiation versus risks from injury: a clinical decision analysis for the management of penetrating palatal trauma in children. Laryngoscope. 2013 May; 123(5):1279-84. View Abstract
  38. Large-scale validation of the Centor and McIsaac scores to predict group A streptococcal pharyngitis. Arch Intern Med. 2012 Jun 11; 172(11):847-52. View Abstract
  39. Improved diagnostic accuracy of group A streptococcal pharyngitis with use of real-time biosurveillance. Ann Intern Med. 2011 Sep 20; 155(6):345-52. View Abstract
  40. Integrating spatial epidemiology into a decision model for evaluation of facial palsy in children. Arch Pediatr Adolesc Med. 2011 Jan; 165(1):61-7. View Abstract
  41. Use of population health data to refine diagnostic decision-making for pertussis. J Am Med Inform Assoc. 2010 Jan-Feb; 17(1):85-90. View Abstract
  42. Parent-driven technology for decision support in pediatric emergency care. Jt Comm J Qual Patient Saf. 2009 Jun; 35(6):307-15. View Abstract
  43. Clinical predictors of Lyme disease among children with a peripheral facial palsy at an emergency department in a Lyme disease-endemic area. Pediatrics. 2008 Nov; 122(5):e1080-5. View Abstract
  44. Linking surveillance to action: incorporation of real-time regional data into a medical decision rule. J Am Med Inform Assoc. 2007 Mar-Apr; 14(2):206-11. View Abstract
  45. Shock. Comprehensive Pediatric Hospital Medicine (Zaoutis and Chiang). 2007. View Abstract
  46. Incorporating vaccine-preventable disease surveillance into the National Health Information Network: leveraging children's hospitals. Pediatrics. 2006 Oct; 118(4):1431-8. View Abstract
  47. Feasibility of leveraging electronic data from pediatric hospitals for national surveillance: a survey of chief information officers. AMIA Annu Symp Proc. 2005; 954. View Abstract
  48. R/O Appy in a 10-year-old – But How to Pin Down the Diagnosis. Contemporary Pediatrics. 2004; 21(5):24-28. View Abstract
  49. Is it influenza or anthrax? A decision analytic approach to the treatment of patients with influenza-like illnesses. Ann Emerg Med. 2004 Mar; 43(3):318-28. View Abstract
  50. Is it Anthrax or Influenza: How Good Does a Rapid Test Have to be?. Pediatric Research. 2003; 53(4:2):104A. View Abstract
  51. Nutritional Impact of Gastroschisis. J Pediatr Gastroenterol Nutr. 2002; 35:A442. View Abstract
  52. Multiple evanescent white dot syndrome following hepatitis a vaccination. Arch Ophthalmol. 2001 Dec; 119(12):1856-8. View Abstract
  53. Total Parenteral Nutrition Cholestasis in Neonates: Incidence and Risk Factors, 1995-98. J Pediatr Gastroenterol Nutr. 1999; 29:A514. View Abstract
  54. Genetic linkage of autosomal dominant juvenile glaucoma to 1q21-q31 in three affected pedigrees. Genomics. 1994 May 15; 21(2):299-303. View Abstract
  55. Barron vs Baltimore: A Case Study in the Late Career of Chief Justice John Marshall. 1991. View Abstract
  56. Functional vision in patients with neovascular maculopathy and poor visual acuity. Arch Ophthalmol. 1986 Jul; 104(7):1009-12. View Abstract
  57. Earliest symptoms caused by neovascular membranes in the macula. Arch Ophthalmol. 1986 Apr; 104(4):513-4. View Abstract

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