Information

Related Research Units

Research Overview

Marvin is pragmatic and with a strong desire to evaluate practice or systems and their implementations and how they impact patient care. This has long led him to the use of data mining methods including natural language processing, machine learning and valued collaborations with local trainees and faculty as well as clinical informatics colleagues around the country. Lately, Marvin has developed an increasing focus on how we can improve and benchmark the quality of care across institutions and populations.

 

Research Background

Marvin Harper received his medical degree from the University of California at San Francisco before his clinical training in pediatrics and pediatric emergency medicine and pediatric infectious diseases (Boston Children’s Hospital). He joined the ED faculty in 1992. Marvin has long had an interest in clinical informatics and how to improve the end user experience and has worked with the Information Services Department since 1995 and has served as the Chief Medical Information Officer since 2008.

 

Education

Medical School

University of California, San Francisco
1986 San Francisco CA

Internship

Pediatrics Boston Children's Hospital
1987 Boston MA

Residency

Pediatrics Boston Children's Hospital
1989 Boston MA

Fellowship

Boston Children's Hospital
1992 Boston MA

Publications

  1. The substance-exposed birthing person-infant/child dyad and health information exchange in the United States. J Am Med Inform Assoc. 2025 Jan 02. View Abstract
  2. Bacteremia in Patients With Fever and Acute Lower Extremity Pain in a Non-Lyme Endemic Region. Pediatrics. 2024 Jan 01; 153(1). View Abstract
  3. Bacteremia in Children With Fever and Acute Lower Extremity Pain. Pediatrics. 2023 05 01; 151(5). View Abstract
  4. Boston Febrile Infant Algorithm 2.0: Improving Care of the Febrile Infant 1-2 Months of Age. Pediatr Qual Saf. 2022 Nov-Dec; 7(6):e616. View Abstract
  5. Pediatric Emergency Department Sepsis Screening Tool Accuracy During the COVID-19 Pandemic. Pediatrics. 2022 07 01; 150(1). View Abstract
  6. Tackling Ambulatory Safety Risks Through Patient Engagement: What 10,000 Patients and Families Say About Safety-Related Knowledge, Behaviors, and Attitudes After Reading Visit Notes. J Patient Saf. 2021 12 01; 17(8):e791-e799. View Abstract
  7. Utility of Blood Cultures and Empiric Antibiotics in Febrile Pediatric Hemophilia Patients With Central Venous Access Devices. Pediatr Emerg Care. 2021 Dec 01; 37(12):e1531-e1534. View Abstract
  8. Outcomes of Patients with Sepsis in a Pediatric Emergency Department after Automated Sepsis Screening. J Pediatr. 2021 08; 235:239-245.e4. View Abstract
  9. Is lymphangitic streaking associated with different pathogens? Am J Emerg Med. 2021 08; 46:34-37. View Abstract
  10. Comparison of Manual and Automated Sepsis Screening Tools in a Pediatric Emergency Department. Pediatrics. 2021 02; 147(2). View Abstract
  11. Effect of a Sepsis Screening Algorithm on Care of Children with False-Positive Sepsis Alerts. J Pediatr. 2021 04; 231:193-199.e1. View Abstract
  12. Presentation, Diagnostic Evaluation, Management, and Rates of Serious Bacterial Infection in Infants With Acute Dacryocystitis Presenting to the Emergency Department. Pediatr Infect Dis J. 2020 12; 39(12):1065-1068. View Abstract
  13. Bacteriology of pediatric breast abscesses beyond the neonatal period. Am J Emerg Med. 2021 03; 41:193-196. View Abstract
  14. Clinician Perceptions of Timing and Presentation of Drug-Drug Interaction Alerts. Appl Clin Inform. 2020 05; 11(3):487-496. View Abstract
  15. Rapid Implementation of an Inpatient Telehealth Program during the COVID-19 Pandemic. Appl Clin Inform. 2020 May; 11(3):452-459. View Abstract
  16. Identifying Patients at Lowest Risk for Streptococcal Pharyngitis: A National Validation Study. J Pediatr. 2020 05; 220:132-138.e2. View Abstract
  17. Performance of an Automated Screening Algorithm for Early Detection of Pediatric Severe Sepsis. Pediatr Crit Care Med. 2019 12; 20(12):e516-e523. View Abstract
  18. Variability in antimicrobial use in pediatric ventilator-associated events. Infect Control Hosp Epidemiol. 2019 01; 40(1):32-39. View Abstract
  19. Predictors of Primary Intracranial Hypertension in Children Using a Newly Suggested Opening Pressure Cutoff of 280 mm H2O. Pediatr Neurol. 2019 02; 91:27-33. View Abstract
  20. Predictors of a drainable suppurative adenitis among children presenting with cervical adenopathy. Am J Emerg Med. 2019 01; 37(1):109-113. View Abstract
  21. An Investigation of Drug-Drug Interaction Alert Overrides at a Pediatric Hospital. Hosp Pediatr. 2018 05; 8(5):293-299. View Abstract
  22. Should patients with complex febrile seizure be admitted for further management? Am J Emerg Med. 2018 08; 36(8):1386-1390. View Abstract
  23. Association between Search Behaviors and Disease Prevalence Rates at 18 U.S. Children's Hospitals. Appl Clin Inform. 2017 10; 8(4):1144-1152. View Abstract
  24. Doing More About Health Care Disparities: Moving Past Description to Action. Pediatrics. 2017 10; 140(4). View Abstract
  25. Utility of Lumbar Puncture in Children Presenting With Status Epilepticus. Pediatr Emerg Care. 2017 Aug; 33(8):544-547. View Abstract
  26. A Pediatric Approach to Ventilator-Associated Events Surveillance. Infect Control Hosp Epidemiol. 2017 03; 38(3):327-333. View Abstract
  27. Use of cidofovir in pediatric patients with adenovirus infection. F1000Res. 2016; 5:758. View Abstract
  28. Ventilator-Associated Events in Neonates and Children--A New Paradigm. Crit Care Med. 2016 Jan; 44(1):14-22. View Abstract
  29. Drug-Drug Interactions Among Hospitalized Children Receiving Chronic Antiepileptic Drug Therapy. Hosp Pediatr. 2016 May; 6(5):282-9. View Abstract
  30. An Introduction to Natural Language Processing: How You Can Get More From Those Electronic Notes You Are Generating. Pediatr Emerg Care. 2015 Jul; 31(7):536-41. View Abstract
  31. Electronic medication reconciliation and medication errors. Int J Qual Health Care. 2015 Aug; 27(4):314-9. View Abstract
  32. Febrile seizures: emergency medicine perspective. Curr Opin Pediatr. 2015 Jun; 27(3):292-7. View Abstract
  33. Factors associated with meaningful use incentives in children's hospitals. Pediatrics. 2015 Jun; 135(6):e1409-16. View Abstract
  34. Preserving patient privacy and confidentiality in the era of personal health records. Pediatrics. 2015 May; 135(5):e1125-7. View Abstract
  35. Group A streptococcal bacteremia without a source is associated with less severe disease in children. Pediatr Infect Dis J. 2015 Apr; 34(4):447-9. View Abstract
  36. Impact of the meaningful use incentive program on electronic health record adoption by US children's hospitals. J Am Med Inform Assoc. 2015 Mar; 22(2):390-8. View Abstract
  37. The Yield of Neuroimaging in Children Presenting to the Emergency Department With Acute Ataxia in the Post-Varicella Vaccine Era. J Child Neurol. 2015 Sep; 30(10):1333-9. View Abstract
  38. Pediatric first time non-febrile seizure with focal manifestations: is emergent imaging indicated? Seizure. 2014 Oct; 23(9):740-5. View Abstract
  39. Core drug-drug interaction alerts for inclusion in pediatric electronic health records with computerized prescriber order entry. J Patient Saf. 2014 Mar; 10(1):59-63. View Abstract
  40. Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle. JAMA. 2013 Dec 04; 310(21):2262-70. View Abstract
  41. A randomized controlled trial of a vancomycin loading dose in children. Pediatr Infect Dis J. 2013 Nov; 32(11):1217-23. View Abstract
  42. Bacteremia risk and outpatient management of febrile patients with sickle cell disease. Pediatrics. 2013 Jun; 131(6):1035-41. View Abstract
  43. Change in adoption of electronic health records by US children's hospitals. Pediatrics. 2013 May; 131(5):e1563-75. View Abstract
  44. IT in the ED: past, present, and future. Pediatr Emerg Care. 2013 Mar; 29(3):402-5. View Abstract
  45. Emergency department management of pediatric patients with cyanotic heart disease and fever. J Emerg Med. 2013 Mar; 44(3):599-604. View Abstract
  46. IT in the ED: a new section of Pediatric Emergency Care. Pediatr Emerg Care. 2012 Dec; 28(12):1399-401. View Abstract
  47. Yield of emergent neuroimaging among children presenting with a first complex febrile seizure. Pediatr Emerg Care. 2012 Apr; 28(4):316-21. View Abstract
  48. Detecting unapproved abbreviations in the electronic medical record. Jt Comm J Qual Patient Saf. 2012 Apr; 38(4):178-83. View Abstract
  49. Occurrence of metabolic acidosis in pediatric emergency department patients as a data source for disease surveillance systems. Pediatr Emerg Care. 2010 Oct; 26(10):733-8. View Abstract
  50. Yield of lumbar puncture among children who present with their first complex febrile seizure. Pediatrics. 2010 Jul; 126(1):62-9. View Abstract
  51. Acute periorbital infections: who needs emergent imaging? Pediatrics. 2010 Apr; 125(4):e719-26. View Abstract
  52. Risk of serious bacterial infection in isolated and unsuspected neutropenia. Acad Emerg Med. 2010 Feb; 17(2):163-7. View Abstract
  53. Risk of Serious Bacterial Infection in Isolated and Unsuspected Neutropenia. Acad Emerg Med 'In press'. 2010; 17:1-5. View Abstract
  54. Acute Periorbital Infections: Who Needs Emergent Imaging?. Pediatrics. Accepted for publication. 2010. View Abstract
  55. Effect of trainees on length of stay in the pediatric emergency department. Acad Emerg Med. 2009 Sep; 16(9):859-65. View Abstract
  56. Assessing quality indicators for pediatric community-acquired pneumonia. Am J Med Qual. 2009 Sep-Oct; 24(5):419-27. View Abstract
  57. Radiographic pneumonia in young, highly febrile children with leukocytosis before and after universal conjugate pneumococcal vaccination. Pediatr Emerg Care. 2009 Jan; 25(1):1-7. View Abstract
  58. Utility of lumbar puncture for first simple febrile seizure among children 6 to 18 months of age. Pediatrics. 2009 Jan; 123(1):6-12. View Abstract
  59. A decision rule for predicting bacterial meningitis in children with cerebrospinal fluid pleocytosis when gram stain is negative or unavailable. Acad Emerg Med. 2008 May; 15(5):437-44. View Abstract
  60. Test characteristics and interpretation of cerebrospinal fluid gram stain in children. Pediatr Infect Dis J. 2008 Apr; 27(4):309-13. View Abstract
  61. Pneumonia. Pediatric Infectious Diseases. The Requisites in Pediatrics. Editors Bergelson JM, Shah SS, Zaoutis TE. 2008; 117-124. View Abstract
  62. Infection following bites. Principles and Practice of Pediatric Infectious Diseases. Editors Long SS, Pickering LK, Prober CG. 2008; 525-30. View Abstract
  63. The toddler with fever. Pediatric Infectious Diseases. The Requisites in Pediatrics. Editors Bergelson JM, Shah SS, Zaoutis TE. 2008; 245-250. View Abstract
  64. Antimicrobials and Infectious Diseases. Manual of Pediatric Therapeutics. Editors Graef JW, Wolfsdorf JI, Greenes DS. 2008; 80-174. View Abstract
  65. Pneumonia in the immunocompromised host. Principles and Practice of Pediatric Infectious Diseases. Editors Long SS, Pickering LK, Prober CG. 2008; 265-9. View Abstract
  66. Leukocyte counts in urine reflect the risk of concomitant sepsis in bacteriuric infants: a retrospective cohort study. BMC Pediatr. 2007 Jun 13; 7:24. View Abstract
  67. Factors associated with antimicrobial resistance and mortality in pneumococcal bacteremia. J Emerg Med. 2007 May; 32(4):349-57. View Abstract
  68. Clinical predictors of occult pneumonia in the febrile child. Acad Emerg Med. 2007 Mar; 14(3):243-9. View Abstract
  69. Use of human immunodeficiency virus postexposure prophylaxis in adolescent sexual assault victims. Arch Pediatr Adolesc Med. 2006 Jul; 160(7):674-80. View Abstract
  70. Extreme thrombocytosis predicts Kawasaki disease in infants. Clin Pediatr (Phila). 2006 Jun; 45(5):446-52. View Abstract
  71. An automated electronic case log: using electronic information systems to assess training in emergency medicine. Acad Emerg Med. 2006 Jul; 13(7):733-9. View Abstract
  72. Identifying hospitalized infants who have bronchiolitis and are at high risk for apnea. Ann Emerg Med. 2006 Oct; 48(4):441-7. View Abstract
  73. Corrections for leukocytes and percent of neutrophils do not match observations in blood-contaminated cerebrospinal fluid and have no value over uncorrected cells for diagnosis. Pediatr Infect Dis J. 2006 Jan; 25(1):8-11. View Abstract
  74. Sexually Transmitted Diseases. Textbook of Pediatric Emergency Medicine. Editors: Fleisher and Ludwig. 2006; 853-871. View Abstract
  75. Pneumonia in hospitalized children. Pediatr Clin North Am. 2005 Aug; 52(4):1059-81, viii. View Abstract
  76. Accuracy and test characteristics of ancillary tests of cerebrospinal fluid for predicting acute bacterial meningitis in children with low white blood cell counts in cerebrospinal fluid. Acad Emerg Med. 2005 Apr; 12(4):303-9. View Abstract
  77. Fever. Signs and Symptoms In Pediatrics. Edited by Davis MA, Gruskin KD, Chiang VW, Manzi S, Davis MA. 2005; 183-198. View Abstract
  78. A low peripheral blood white blood cell count in infants younger than 90 days increases the odds of acute bacterial meningitis relative to bacteremia. Acad Emerg Med. 2004 Dec; 11(12):1297-301. View Abstract
  79. Explanation of mathematical model. Pediatr Infect Dis J. 2004 Sep; 23(9):893. View Abstract
  80. Disseminated histoplasmosis in a nonendemic area. Pediatr Infect Dis J. 2004 Aug; 23(8):781-2. View Abstract
  81. Intracerebral abscess in children: historical trends at Children's Hospital Boston. Pediatrics. 2004 Jun; 113(6):1765-70. View Abstract
  82. Differentiating acute bacterial meningitis from acute viral meningitis among children with cerebrospinal fluid pleocytosis: a multivariable regression model. Pediatr Infect Dis J. 2004 Jun; 23(6):511-7. View Abstract
  83. Update on the Management of the Febrile Infant. Clinical Pediatric Emergency Medicine. 2004; 5(1):5-12. View Abstract
  84. Evaluation of a rapid urine antigen assay for the detection of invasive pneumococcal disease in children. Pediatrics. 2003 Dec; 112(6 Pt 1):1279-82. View Abstract
  85. Utility of sepsis evaluation in infants 90 days of age or younger with fever and clinical bronchiolitis. Pediatr Infect Dis J. 2003 Dec; 22(12):1053-6. View Abstract
  86. Identifying febrile young infants with bacteremia: is the peripheral white blood cell count an accurate screen? Ann Emerg Med. 2003 Aug; 42(2):216-25. View Abstract
  87. Prolonged partial thromboplastin times in children with fever and petechiae without bacteremia or sepsis. Pediatr Emerg Care. 2003 Aug; 19(4):244-7. View Abstract
  88. Antibiotic Therapy for Otitis Media In Children (ATOMIC)—Patient Risk Stratification and Evidence-Based Selection of Antimicrobial Therapy. Emergency Medicine Consensus Reports. 2003; 1-18. View Abstract
  89. A clinical practice guideline for treatment of septic arthritis in children: efficacy in improving process of care and effect on outcome of septic arthritis of the hip. J Bone Joint Surg Am. 2003 Jun; 85(6):994-9. View Abstract
  90. Utility of the peripheral blood white blood cell count for identifying sick young infants who need lumbar puncture. Ann Emerg Med. 2003 Feb; 41(2):206-14. View Abstract
  91. The role of emergent neuroimaging in children with new-onset afebrile seizures. Pediatrics. 2003 Jan; 111(1):1-5. View Abstract
  92. Pneumonia in the immunocompromised host. Principles and Practice of Pediatric Infectious Diseases. Editors Long SS, Pickering LK, Prober CG. 2003; 237-241. View Abstract
  93. Complications of acute pneumonia. Principles and Practice of Pediatric Infectious Diseases. Editors Long SS, Pickering LK, Prober CG. 2003; 225-231. View Abstract
  94. Persistent and recurrent pneumonia. Principles and Practice of Pediatric Infectious Diseases. Editors Long SS, Pickering LK, Prober CG. 2003; 231-237. View Abstract
  95. Rapid antigen assay for the diagnosis of pneumococcal bacteremia in children: a preliminary study. Ann Emerg Med. 2002 Oct; 40(4):399-404. View Abstract
  96. Infectious diseases. Pediatr Emerg Care. 2002 Apr; 18(2):125-9. View Abstract
  97. Human Immunodeficiency Virus Infection. In Synopsis of Pediatric Emergency Medicine; Editors: Fleisher and Ludwig. 2002; 326-331. View Abstract
  98. Management of febrile children in the age of the conjugate pneumococcal vaccine: a cost-effectiveness analysis. Pediatrics. 2001 Oct; 108(4):835-44. View Abstract
  99. Time to positivity of blood cultures for children with Streptococcus pneumoniae bacteremia. Clin Infect Dis. 2001 Oct 15; 33(8):1324-8. View Abstract
  100. Predictive model for serious bacterial infections among infants younger than 3 months of age. Pediatrics. 2001 Aug; 108(2):311-6. View Abstract
  101. Financial and clinical impact of false-positive blood culture results. Clin Infect Dis. 2001 Aug 01; 33(3):296-9. View Abstract
  102. Fever. Audio-Digest: Emergency Medicine. 2001; 18(9). View Abstract
  103. Lack of reduction in hospitalizations and emergency department visits for varicella in the first 2 years post-vaccine licensure. Pediatr Emerg Care. 2001 Apr; 17(2):101-3. View Abstract
  104. Fever interval before diagnosis, prior antibiotic treatment, and clinical outcome for young children with bacterial meningitis. Clin Infect Dis. 2001 Feb 15; 32(4):566-72. View Abstract
  105. Reliability of the urinalysis for predicting urinary tract infections in young febrile children. Arch Pediatr Adolesc Med. 2001 Jan; 155(1):60-5. View Abstract
  106. Pneumococcal bacteremia. eMedicine. 2001. View Abstract
  107. Lyme disease. eMedicine. 2001. View Abstract
  108. Information System applications in the Emergency Department. Clinical Pediatric Emergency Medicine. 2001. View Abstract
  109. Time to detection of positive cultures in 28- to 90-day-old febrile infants. Pediatrics. 2000 Dec; 106(6):E74. View Abstract
  110. Predictors of bacteremia in febrile children 3 to 36 months of age. Pediatrics. 2000 Nov; 106(5):977-82. View Abstract
  111. The pediatric forum: white blood cell count likelihood ratios for bacteremia in febrile young children Arch Pediatr Adolesc Med. 2000 Sep; 154(9):963-4. View Abstract
  112. Reevaluation of outpatients with Streptococcus pneumoniae bacteremia. Pediatrics. 2000 Mar; 105(3 Pt 1):502-9. View Abstract
  113. Human Immunodeficiency Virus Infection. Textbook of Pediatric Emergency Medicine; Editors: Fleisher and Ludwig. 2000; 795-809. View Abstract
  114. Non-typhi Salmonella bacteremia in children. Pediatr Infect Dis J. 1999 Dec; 18(12):1073-7. View Abstract
  115. Bacteremia-associated pneumococcal pneumonia and the benefit of initial parenteral antimicrobial therapy. Pediatr Infect Dis J. 1999 Dec; 18(12):1081-5. View Abstract
  116. Nasopharyngeal colonization with pathogens causing otitis media: how does this information help us? Pediatr Infect Dis J. 1999 Dec; 18(12):1120-4. View Abstract
  117. Bacteraemia in young children with high fever: still no easy answers. Med J Aust. 1999 May 17; 170(10):462-3. View Abstract
  118. Low risk of bacteremia in febrile children with recognizable viral syndromes. Pediatr Infect Dis J. 1999 Mar; 18(3):258-61. View Abstract
  119. Occult pneumonias: empiric chest radiographs in febrile children with leukocytosis. Ann Emerg Med. 1999 Feb; 33(2):166-73. View Abstract
  120. Clinical implications of penicillin and ceftriaxone resistance among children with pneumococcal bacteremia. Pediatr Infect Dis J. 1999 Jan; 18(1):35-41. View Abstract
  121. Occult bacteremia with group B streptococci in an outpatient setting. Pediatrics. 1998 Jul; 102(1 Pt 1):67-72. View Abstract
  122. Risk of bacteremia for febrile young children in the post-Haemophilus influenzae type b era. Arch Pediatr Adolesc Med. 1998 Jul; 152(7):624-8. View Abstract
  123. Parenteral vs oral antibiotics in the prevention of serious bacterial infections in children with Streptococcus pneumoniae occult bacteremia: a meta-analysis. Acad Emerg Med. 1998 Jun; 5(6):599-606. View Abstract
  124. Do oral antibiotics prevent meningitis and serious bacterial infections in children with Streptococcus pneumoniae occult bacteremia? A meta-analysis. Pediatrics. 1997 Mar; 99(3):438-44. View Abstract
  125. Antibiotics and Infectious Disorders. Manual of Pediatric Therapeutics. 1997; 76-164. View Abstract
  126. Invasive pneumococcal infections in human immunodeficiency virus-infected children. J Infect Dis. 1996 Apr; 173(4):870-6. View Abstract
  127. Effect of antibiotic therapy on the outcome of outpatients with unsuspected bacteremia. Pediatr Infect Dis J. 1995 Sep; 14(9):760-7. View Abstract
  128. Group A beta-hemolytic streptococcal bacteremia: historical overview, changing incidence, and recent association with varicella. Pediatrics. 1995 Sep; 96(3 Pt 1):428-33. View Abstract
  129. Osteomyelitis and septic arthritis in children: appropriate use of imaging to guide treatment. AJR Am J Roentgenol. 1995 Aug; 165(2):399-403. View Abstract
  130. Pediatric infectious disease emergencies. Curr Opin Pediatr. 1995 Jun; 7(3):302-8. View Abstract
  131. Care of bereaved parents. A study of patient satisfaction. J Reprod Med. 1994 Feb; 39(2):80-6. View Abstract
  132. Case report: streptococcal toxic shock syndrome presenting as septic thrombophlebitis in a child with varicella. Pediatr Infect Dis J. 1993 Dec; 12(12):1033-4. View Abstract
  133. HIV-infected children in the pediatric emergency department. Pediatr Emerg Care. 1993 Oct; 9(5):265-9. View Abstract
  134. Occult bacteremia in the 3-month-old to 3-year-old age group. Pediatr Ann. 1993 Aug; 22(8):484, 487-93. View Abstract

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