Haider Warraich
@haiderwarraich
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Program Manager @ARPA_H | Building the Future of Healthcare | Cardiologist, Researcher, Writer | Personal account | https://t.co/33m8INXKHm
Boston, MA
Joined October 2010
As my @US_FDA term concludes, delighted to join @ARPA_H to harness generative #AI to transform chronic disease care. 🙏 to all who have supported me and excited for this generational opportunity to revolutionize medicine. Will take a village and looking forward to collaborating!.
We are excited to welcome our new Program Manager, Dr. Haider Warraich! Welcome to the team! #ARPAHGetsToWork
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Out now in @nejm is our analysis w/ a *historic finding*: for the first time in a century, more Americans now die at home than any other location. A monumental reversal with huge implications for how we support patients & caregivers. Minor thread below
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Truly the greatest honor of my life to be joining the @US_FDA working closely w/ Commissioner @DrCaliff_FDA, FDA Leadership and its Centers, and all stakeholders to help generate better evidence and achieve better outcomes for our greatest challenge - chronic disease.
Congratulations to BWH cardiologist Dr. @haiderwarraich on joining the @US_FDA as a Senior Clinical Advisor for Chronic Disease to the FDA Commissioner. In this role, he will help further policy across drugs, devices, nutrition, tobacco, & health AI concerning chronic conditions.
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Ten years ago, I left 🇵🇰 for the *very first time* and came to the @harvardcoop bookstore. I took this picture and to me it looked like Hogwarts! 😮. Ten years later I am launching my book here today! Can't make this up. #AmericanDream
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If there was one ❤️ breaking story that showed how damaged peer review is, and how a new model of publication is needed, I would nominate this 🔥🔥one from @statnews. Cant believe I missed it. @EricTopol @VPrasadMDMPH @hmkyale @biorxivpreprint @drjohnm
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Out Now: My Op Ed in @nytimes: #FakeNews threatens democracy but **fake medical news** threatens our lives. Are physicians and researchers ready to fight back? Is Silicon Valley liable? Featuring research from @cpgYALE @VPplenarysesh & others
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Delighted to lead world class heart failure care for the veterans of New England in collaboration with @BrighamWomens! Grateful for the wonderful support from leadership, colleagues, mentors and mentees! No greater honor than serving our #Veterans
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*Personal News*. I have officially joined the faculty at @BrighamWomens @harvardmed @DeptVetAffairs! Wonderful to be back in Boston, truly the 🕋 of Medicine! Lucky to work with some of the best people in our vocation! Would love to meet old friends and make new ones!😀
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One of the best sentences I have read in a paper in @JAMA_current by John Ioannidis: "Meta-analyses become weighted averages of expert opinions."
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In @JAMA_current today, we reveal a startling finding:. From 1999-2019, the gap in mortality rates between rural and urban areas in the 🇺🇸 tripled! Driving this is a historic 📈 in mortality rates amongst middle-aged White rural Americans. More details below: 1/4
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Despite advances in heart failure, most patients dont receive life saving meds. A big reason is financial burden. In new review in @JACCJournals led by 🌠 @mghmedres @SmrithiSukumar we outline the burden patients face and what we as clinicians can do. 🧵 1/3
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As the 🇺🇸 faces a massive physician shortage, @statnews reports visas of 4,222 foriegn medical graduates who matched into residencies are being blocked!! This should NEVER happen! @ECFMG_IMG @AmerMedicalAssn @cnnhealth @NPRHealth @KHNews.
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UNBELIEVABLE: Diabetes costs exceed cancer costs in the United States. Will we finally start taking it more seriously? (Data from @AHRQNews MEPS)
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One of the most important tales I have ever told is out in @nytimes today. Evolution was meant to help us survive a brutal world. How did it create our greatest killer?
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JUST OUT! Our paper in @JAMANetworkOpen w/ the most comprehensive look at #heartdisease patients referred to #PalliativeCare. Sobering: 1/3rd of ❤️patients are *bedbound* at time of referral and over time FEWER % referred by cardiology. 1/n
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NEED YOUR INPUT! Creating a podcast with @ACCinTouch on palliative care & heart disease. What should I address for patients and clinicians? What questions do YOU have? I never say this but pls RT - want to include diverse inputs! Tnx @NMHheartdoc for the opp! @AAHPM #hpm.
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My Op Ed in today's @nytimes on how I came "to see my lack of experience as a strength." Featuring research by @AnupamBJena Is medicine ready to hand the keys to young docs? @dukemedicine @DukeU @DCRINews @CompAndChoices Love the artwork too! @nytopinion.
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Not something I would have ever imagined growing up in Pakistan, but how wonderful being profiled by @harvardmed to represent my field and talk about what drives me forward. 🙏 .Link:
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In @statnews today, my conversation with an icon of medicine, science, and the truth #AnthonyFauci, a role model for all those who seek to advocate for public health and social justice, which I argue are an extension of our work in healthcare.
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As 2019 closes, I am most grateful for these two girls! Don't know what I did to deserve their love! Wishing everyone a wonderful 2020! #HappyNewYear
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Palliative care continues to be greatly underused for patients with heart disease, and the field of cardiology needs to reckon with how best to help our patients to the very end. Thanks to @HarvardHeartLtr and @DLBHATTMD for putting the spotlight on this critical space.
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I have been skeptical of telemedicine but in @latimes I make the case that telemedicine is the future, and I hope the #coronavirus #COVID19 pandemic will force us to transform healthcare. What we learn in this crisis should become the norm in the future.
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Out today in @JAMACardio, an *essential* review on palliative inotropes led by @ChuziSarah w/ Larry Allen @ShannonMDunlay and me. We provide a review of the data and provide guidance for this difficult area. Brief thread follows: 1/4
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If ever we physicians needed another reminder about the value of humility - here it is: the "most certain" physicians are wrong 40% of the time.
Often wrong but never in doubt. On medical misdiagnosis,.Danny Kahneman called attention to this remarkable stat. Reviewed in #DeepMedicine, thanks @dawallach for citing
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Its been difficult to integrate palliative care in heart failure. Even more so in one of its most dangerous manifestations: cardiogenic shock. Now in @JCardFail led by super⭐️ @BrighamMedRes Joe Kim w/ @Ajar_Kochar we write about how to make PC a critical part of shock care. 1/
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Telemedicine could improve healthcare access for vulnerable patients but our new analysis in @JAMANetworkOpen suggests it could actually widen disparities. Brief thread on this important analysis led by @BrighamMedRes @emefahloccoh & @GoodRx below 1/4
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What is #hospice care for #heartfailure patients like? Here's our research from #gwtg #Medicare patients at @AHAMeetings #qcor18 - only 5% use hospice, 23% die WITHIN 48 hrs! Median survival is 11 days! Lots 2 do. Tnx to @gcfmd @texhern @NMHheartdoc @DLBHATTMD @_adevore
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1/ Perhaps the most powerful image of a patient's heart I have every witnessed, out in @JAMACardio. As dramatic as this image is, the back story was even more gut wrenching. What broke him was not his disease, but our health system. I still get angry thinking about this.
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Talking about serious illness and death is very hard but even harder when the patient has limited English proficiency and different culture/values. In new 📜 in @PalliativeMed_j we highlight experiences of medical interpreters during these encounters. 1/3
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Out in @JAMA_current, how #COVID19 impacted prescriptions for #HydroxyChloroquine and 10 most common drugs in 🇺🇸: .**~0.5 million more Rx for #HCQ given over 10 weeks compared to 2019! Led to 64% 📉 in long-term HCQ fills** Other major findings 👇
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Excited to host the exceptional @Ajar_Kochar of @BrighamWomens (and lifelong @OslerResidency marine) at @VABostonHC to give grand rounds on all things cardiogenic shock! . If this title doesnt get folks excited, I dont know what will! ⚡️⚡️⚡️
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As the father of a beautiful brown 6 year old 🇺🇸🇵🇰girl, I feel like this most beautiful @nytopinion essay was written just for me. The world would be less arresting. without @WajahatAli's words. #browngirldads @rohan_khera @Ajar_Kochar @mvaduganathan
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Why Impossible is Nothing:. Mom grew up in a village in 🇵🇰. Trained in orthodontics in 🇺🇸&🇩🇪. Promoted to Brigadier General. Awarded highest honor in 🇵🇰 (Sitara-e-Imtiaz). The most morally-upright and loving person I know. She is why Impossible is Nothing. #HappyMotherDay2019
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Nothing beats being back at home @AKUGlobal and knowing it is in such capable and mission-driven hands as @AdilHaiderMD & @ZainabASamad! A visit I will never forget fueled by lots of 🫖 and 💘!.
So great to welcome @haiderwarraich back to @AKUGlobal from @BrighamWomens @VABostonHC - thrilled to get an advance copy of his upcoming book: Song of Our Scars: The Untold Story of Pain. Thank you for spending day with us from Grand Rounds to @srf_aku students - lots of ❤️
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Palliative care has a Class 1 Recommendation by @AHAScience/@ACCinTouch for #heartfailure patients and in our new 📜 in @JCardFail led by super star @ChuziSarah, we surveyed 🏥 around the 🇺🇸 to see how well palliative and heart failure care are integrated. Brief thread 1/4
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This made my day! . A reader who had a mechanical heart pump (LVAD) and later had a ❤️ transplant sent me her book of poems. Really loved this poem on her "tin heart". We need more accounts of patients so that we get a window into their worlds! #FeelingGrateful
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My 2 cents on #ORBITA to @jameshamblin @TheAtlantic: "People can nitpick the study as much as they want, but burden of proof should be on the procedure to show an advantage." @Ajar_Kochar @DCRINews @dukemedicine @texhern @khurramn1 @hmkyale @VinayPrasad82.
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Heart failure is not just the leading cause of hospital admissions or a debilitating illness, it is a disease of great economic consequences which we cover in this @hfsa scientific statement in @JCardFail #openaccess Essential reading for everyone in this space!.
New Scientific Statement from the @HFSA Advocacy Committee. "Economic Issues in HF in the United States". @paheidenreich @gcfmd @DrNancySweitzer @haiderwarraich . @robmentz @dranulala @AndrewJSauer @vbluml @ShashankSinhaMD @DrMarthaGulati . 👉
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In new 📜 we show palliative care is as effective if not more in improving quality of life in Black heart failure patients, challenging assumptions. Yet Black patients have poor access to PC & hospice. 🙏 to excellent co-authors led by @DukeMedSchool IM resident Rachel Tobin.
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Despite advances in treatment, mortality from heart failure has 📈📈 since 2011, and its urban areas usually w/ best access to 👩⚕️🏥 who are doing the worst. In our new paper, led by @ShahzebKhanMD in @CircOutcomes we highlight the u turn in the heart health of Americans.
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LVADs are changing what it means to be human but are we ready? My OpEd in @nytimes @nytopinion w/comments by @MRMehraMD @BrighamWomens @harvardmed explores the merger of man and machine.
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Out now for #GoRedforWomen day in @nytimes: how 2 women, @katherinekleon and @SharonneHayes changed everything we know about ❤️ disease. All of us can have lasting impact. All docs have to do is listen esp to women. CC @MinnowWalsh @choo_ek @DrMarthaGulati
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My conversation w/ @EricTopol for @Medscape is one of the best I have ever had! Amongst other things, we go wayway back to when I started writing, and the things I am excited about in the future!
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If you will be seeing a seriously ill #COVID19 patient, you HAVE to read this one-page communication guide out now in @AnnalsofIM by the world experts in communication. As essential as anything we will need in the #CoronavirusPandemic.
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Mom, I made it! :).
Excellent author’s setup. One copy of The Song Of Our Scars well presented. Beautifully painted Pakistani truck for the win. 10/10 @haiderwarraich
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Facing an extraordinary pandemic, @US_FDA needs an extraordinary leader. In @statnews I make the case that @califf001 is exactly that. 🙏 to @vivianleemd & @dramyabernethy for speaking and @texhern for providing key details of his immense career.
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Evidence for palliative care in heart failure continues to accumulate. In a new meta-analysis in @JPSMjournal we found palliative care is very effective at reducing admissions HF patients compared to other non-cancer illnesses. Key findings below 1/
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Q: What is diff between patients with cancer or heart disease referred for palliative care nationally? . A: In our new paper in @AmericanHeartJ: ♥️ disease patients are 10 years older(!), have worse prognosis and functional status. 😶 . But there are other differences 1/
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Racism is one of 🇺🇸's leading killers and our 📜 today led by @ShahzebKhanMD in @CircOutcomes shows the death toll of injustice. Heart disease & stroke are our leading killers and we show that 1/3 of those deaths, 100K a year, are preventable. But not all suffer the same. 1/3
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I know I am biased, but cardiology really is the best! ❤️🔥🫶🫀 To those applying for cardiology fellowship, I cannot wait for you all to join our amazing field!.
🐍 Did you know ACEi came from snake venom? 🤯 . The history of cardiology is so cool! Having such a great time reading this book by @haiderwarraich!! Thank you @CardioNerds 🫀
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Just out: our paper in @JACCJournals showing where patients with ♥️ disease die in the US. **Most people now die at home** A major finding that has implications for care delivery at end of life. Important findings follow.
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Would @BillGates or Steve Jobs be allowed to change the world if they were doctors? #Medicine needs to change and young doctors are ready. But we need a seat at the table. The big table (not the kids table) Who will give us one?
Young doctors are are ready to reboot medicine, but will their senior counterparts let them?, asks @haiderwarraich @nytopinion
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Eye-opening study: Physicians are terrible at prognosis, 99% (!!) over-estimate it. And the kicker, as our prior research has shown, experience has NO effect. #humblepie #hpm #endoflifecare
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10/10! #LifeGoals #IMadeIt.
Nice setup by the author of the important book, The Song of Our Scars, by @haiderwarraich Pakistani truck for the win. 10/10
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Answers to all #COVID19 Qs in 👌review by @SaadOmer3 @CarlosdelRio7 @JAMA_current . How many die?.Can we get reinfected?.How long does immunity last?.Should all wear masks?.How does it spread?.When can restrictions be lifted?.When will we get vaccines?
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One of my most cherished memories is from when the great Eugene Braunwald spoke to us residents at @BIDMChealth about the history of coronary disease. His mentee, the great @CMichaelGibson introduced him. The story of heart disease cannot be told without his voice.
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Symptom burden in hospitalized #heartfailure is unbelievable. So proud to have our paper in @CircHF from @NIH-funded REHAB-HF trial out today. See below for some key highlights.
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In @JAMA_current today, we published grim findings: .-Not only do #Rural areas have much 📈 rates of ☠️ from♥️disease, gap w/ urban areas has doubled .-Middle-aged people saw unprecedented 📈 in ☠️ from♥️disease cc: @EricTopol @HeartBobH @ashishkjha
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@NEJM @harvardmed @BrighamWomens @BrighamResearch @AAHPM @HMSPallCare @DeptVetAffairs @DukeU @DukeMedSchool @Medscape Patients w/ cancer far more likely to die at home, showing home care may not be adequate for other conditions. Racial/ethnic minorities far more likely to die in the hospital. As are women, who are less likely to have caregivers. We need new models to support patients at home.
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In @JCardFail today, we analyze a critical understudied aspect of health: isolation & loneliness. From the @NIH REHAB-HF paper, we show that 1/3 of heart failure patients live alone and they are overwhelmingly women and really sick. Link: 1/3
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Heart failure is increasingly a geriatric condition and this new 📜 in @CircHF led by @MannanMinhas @safinmc & @sardarhassan91 shows hospitalizations for people >80 years are 📈 in the US, but they are shorter and less costly and deadly. This is good news!
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Our paper in @AHAMeetings @CircOutcomes is important for anyone interested in #research and clinical trials. Simple Q: do patients in trials change over time? Yes - and also there outcomes can change too. Thread below:
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Look who I got parenting advice from today! #CoachK! He said too many parents ask kids "How much did you score?" but should ask "How do you feel about your game?" or "Did you help a teammate out?" #starstruck #letsgoduke #BeatUNC #livinglegend
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#ACC22 Simultaneous Pub: The Cardiac ICU has evolved and so should the care patients get. In @ESC_Journals led by @BrighamMedRes Joe Kim w/ cardiac critical care leaders, we review how #palliativecare can be integrated in the CICU. Link: Thread 1/5
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Q: Is Outpatient Palliative Care Cost-Effective in Heart Failure? . A: Yes! And heres the data out in @JCardFail from the @NINR PAL-HF trial led by @Brystana & @robmentz. One more reason to ensure our patients w/ heart failure get access to PC!
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My paper in @JAMAInternalMed at #acc18 w/ @khurramn1 @rohan_khera out now showing US wasted >$2 biilion on brand name atorvastatin even after a generic was available. Also, shockingly, Brand name out of pocket < generic OOP in 2014 due 2 collusion w/ #pbm .
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Here is my interview with @NPR @nprfreshair w/ Terry Gross. We talk about the entire story of the ❤️ and about how its treatments are changing what it means to be human. And finally, we talk about what it means to be an immigrant from 🇵🇰 in 🇺🇸
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Sort of headline I dread. Seeking palliative care does not mean "decided against seeking additional medical help" - it means that type of medical help sought is changing. Opportunity for @CNN to educate the public about "comfort care" - let me know if you need help explaining.
Former first lady Barbara Bush, 92, is in failing health and has decided against seeking additional medical help, a spokesman says
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Incredible honor w/ @RabailBaig to host @AKUGlobal leadership including President Sulaiman Shahabuddin, Zeenat Sulaiman, @virani_md, Robert Sweet and others! Ecstatic to see our beloved university be led by such committed leadership! Thank you for all you do!🙏
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My first time in @ClevelandClinic was as an elective student who couldn't afford a subway sandwich. My second time was today giving a keynote at this amazing conference! Thank you @LCalabreseDO for the invite and all those who have helped me along the way! 🙏🇵🇰🇺🇲.
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Out in @bmj_latest is a paper that tells the entire depressing story of American health and politics over the last 20 years. While Democratic areas have thrived, Republican areas are lagging, and the mortality gap has grown 6 fold. Read on for more. 1/6 .
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Delighted that @JeongHwanKimMD has joined @VABostonHC & @BrighamWomens as advanced heart failure faculty. By way of @UChiPritzker @emoryhealthcare @TuftsMedicalCtr/@bethisraellahey, he is an amazing human, clinician and researcher, and we are thrilled to welcome him to our fam!
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In the age of #BigData the need for qualitative research is critical. So pleased that @JACCJournals @coconnormd published our 📜 led by @BIDMChealth resident @ZaraLatif5 assessing the challenges interpreters face in heart failure care. Link: Thread 👇 1/4
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When people hear Rural they assume White. But that's not true. 8% of rural folk are Black, and in our new paper in @CircOutcomes we show they have the greatest mortality from heart failure of *any group any where* in the US. Systemic racism knows no boundaries. CC @NMHheartdoc
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Can't wait to nerd out on all things cardiology with the @CardioNerds soon! . The story of the human heart is one of the most fascinating tales of all time and hope this upcoming book club and conversation will inspire others to tell it in newer and better ways!.
Excited to start reading it!! Gift from @CardioNerds, many many thanks to @ThomasMDas @AmitGoyalMD @Dr_DanMD. @haiderwarraich
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Thrilled to be on @nprfreshair w/ the best interviewer in the world 👉 Terry Gross to talk about #StateoftheHeart on July 22nd!! My last w/ her was one of the most meaningful conversations of my life (there were 😢). @StMartinsPress @Trident_Media @NPR
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WOW! @rogers_sim_ made this 👌 visual abstract from my @guardian/@observer interview about my new book, State of the Heart, showing how literally *every single* aspect of modern living seems purposefully designed for batter the heart! Go use this!
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Wonderful feature in @escardio @ESC_Journals on one of the very best people in medicine and cardiology - @DLBHATTMD! While dearly missed at @BrighamWomens, @MountSinaiNYC & @MountSinaiHeart are so lucky to benefit from his leadership!
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When my patient came to the hospital unable to breathe weeks after #COVID19, it was his heart not his lungs that was failing. Now he might need a ♥️transplant. In @nytopinion I explain how COVID19 could create a wave of heart disease. Here's how 1/n
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Heart disease is less about the heart and more about the wallet: It is an economic condition. The "moonshot" is already here - can we make sure everyone can afford it? Important work in @JAMACardio by @rohan_khera @khurramn1 @hmkyale @jvaleromd
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Cardiologists talking about serious illness, supportive and palliative care??? What has the world come to??? Is there a stent for that?! 😂😂😂 Honored that you chose to highlight this! #hpm.
A slide for talk to Kaiser Permanente Cardiology Chiefs Group next week @JDodsonMD @KAlexanderMD @MichaelGNanna @SPBell_gericard @MathewMaurer @robmentz @kfmarie Congratulations @haiderwarraich #starttheconversation
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@rbloise24 @CAPCpalliative @AAHPM @HMSPallCare @CambiaHealthFdn @DianeEMeier @TrinityHealthMI @MSHSGeriPalCare @GeriPalBlog @UKPallCare @DukePallCare @IraByock @Pallimed @StacieTSinclair @ctsinclair ~6.5 million in US with heart failure. ~3000/yr transplanted ~2000/yr get LVAD. 50% have HFpEF and few life prolonging tx. Median survival of any hospitalized Medicare HF pt is 2 yrs. ALL of these patients need #palliative and #supportive care. #knowledgebomb.
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New @JACCJournals 📜 led by @jvaleromd @khurramn1 on #financialtoxicity shows surprisingly that compared to cancer, pts with ♥️ disease have:. ⬆️difficulty paying bills.⬆️cost-related 💊 non-adherence.⬆️foregone-delayed care.⬆️food-insecurity. Wow. Link:
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1 of the most inspiring voices in #cardiology @rwyeh of @BIDMChealth has been selected by @DukeCardiology fellows as our annual visiting professor! All of us are so excited to meet him! @Ajar_Kochar @ACFanaroff @MichaelGNanna @SJGreene_md @FudimMarat @ZakLoringMD @SVRaoMD.
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So proud to call this guy a dear friend and colleague. Cardiology is lucky to have someone like him!.
The winner of the #NCYIF21 Jeremiah Stamler Award for Excellence in Clinical Science Cardiovascular Research is Dr @rohan_khera from @YaleCardiology ❤️🔥🏆
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LVADs have fundamentally changed how heart failure patients live - and die. Led by @sdslavin of @MassGeneralNews in @PalliativeMed_j, we describe critical considerations when an LVAD is stopped. Key points follow.
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This #NursesDay #NursesWeek2019 as physicians face increasing distrust, leading to misinformation, I write in @statnews that we should learn from the most trusted people in the US *16 straight years* - Nurses. @ANANursingWorld
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Best (secret) part of being an attending so far?. The "trainees" have no idea how much I am learning from them!!! 🤓🧐.
“For the first time since the early part of the 20th century, more Americans are dying at home than in the hospital or a nursing home.”. Look forward to learning from @haiderwarraich on the wards this week @BrighamWomens.
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Phenomenal talk at @BrighamWomens by @BrighamFellows @ArashNargesi blowing the lid on what modern analytics can do for cardiovascular health and care. Superb mentorship by @rohan_khera @cards_lab!.
"What questions will they ask me after a talk on applications of AI in cardiovascular medicine?". Fantastic chatGPT ending to a such a stimulating talk by @ArashNargesi. Exciting times for CV medicine and research.
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Insurance increasing out of pocket costs has been disastrous. Our new @JACCJournals paper shows this is causing 27% (!) of non-elderly heart failure patients to forego medical care, leading to 📈 ER visits 📈 hospital admissions & 📈 total costs. Link:
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Out now in @nytopinion I discuss the dangers of #Hydroxychloroquine #Hype and propose how we can protect patients from dangerous drugs. Pandemonium often follows a pandemic. Yet it has never been more important to be guided by evidence rather than fear.
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This paper shows how heart failure is fundamentally different from cancer because many OVERESTIMATE mortality in HF while in cancer we tend to underestimate risk. Why do we then still use same #hpm #palliativecare models for everyone?.
Can the Surprise Question identify an adv HF cohort who benefit from palliative care? . Our perspective on improving referral to pall care in adv HF: @ESC_Journals #EJHF .@haiderwarraich @mvaduganathan @JavedButler1 @NMCardioVasc
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Honored to be giving @harvardmed-wide Medical Grand Rounds along with amazing colleagues @rkwadhera @jasonwasfy @ZaraLatif5 touching on factors influencing CV health from policy, to health systems to patients. Free and open to everyone 👇.
This week will be a @harvardmed Combined Rounds discussion on the topic, "Advancing Cardiovascular Care and Health in the United States - From Policies to Patients." Speakers include Drs. Rishi Wadhera and Zara Latif. Join us!. 📅 November 2.🕖 8am.💻
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