About

Alan Garber is a professor of Public Policy at Harvard Kennedy School, where he also serves as the President of Harvard University. He holds the title of Mallinckrodt Professor of Health Care Policy at Harvard Medical School, and is a Professor of Economics at Harvard Faculty of Arts and Sciences, as well as a Professor of Health Policy and Management at Harvard T.H. Chan School of Public Health. His work encompasses public policy, health care policy, and economics, contributing to the fields through his research and leadership roles. His profile indicates a focus on health care policy and public leadership, reflecting his extensive involvement in shaping policy and academic discourse at Harvard.

Research topics

• Medicine
• Computer Science
• Medical education
• Internal medicine
• Pedagogy
• Psychology
• Mathematics education
• Virology
• Medical emergency

Selected publications

• Learning From Excess Pandemic Deaths

  JAMA · 2021 · 19 citations

  1st authorCorresponding
  • Medicine
  • Virology
  • Medical emergency

  A comprehensive ability to anticipate and plan for future events distinguishes Homo sapiens from lower animals. But humans are flawed planners. Focusing on the near term has undoubtedly served humans well throughout evolutionary history, yet often leads to unintended consequences. Individuals eat the extra slice of pie with pleasure, but regret the indulgence when they stand on the scale. As small indiscretions accumulate over the years, they threaten health and well-being. Individual present-centeredness is mirrored in the larger society, which struggles with preparations for future needs and long-delayed risks. The maintenance of public infrastructure is a societal responsibility that is often deferred until it can no longer be ignored, as when a bridge collapses. Many are loath to bear the immediate costs of limiting carbon release into the atmosphere despite the growing awareness that eventually the failure to act will lead to environmental catastrophe. There are few rewards to legislators and government leaders who ask constituents to make sacrifices now to avert a future problem that seems as abstract and distant as it is potentially devastating.

  PublisherOA PDFDOI

• Teaching Learners How to Approach Family Decisions as a Process

  Springer eBooks · 2020

  1st authorCorresponding
  • Computer Science
  • Psychology
  • Medical education
  PublisherDOI

• Data Science: What the Educated Citizen Needs to Know

  Harvard Data Science Review · 2019-06-23 · 11 citations

  articleOpen access1st authorCorresponding

  Data Science: What the Educated Citizen Needs to Know 2 At a recent dinner, the conversation turned to the impressive gains in the power and ubiquity of artificial intelligence. Reflecting both the wonder and anxiety of the times, one of our guests speculated that machines would soon surpass humans at determining guilt and innocence. None claimed to know when that would happen, but nobody doubted that sometime soon -if it has not happened already -algorithms would be able to sift through and interpret the totality of evidence better than a human could. One of the guests, a law professor, questioned whether machines would ever replace human juries, and wondered how influential they would be. Suppose that a machine made a determination of guilt. How would an AI tell the story, explaining its reasoning and persuading the jury? The machine, or rather the argument based upon the machine's conclusions, would not escape harsh scrutiny by the attorney representing the accused. She would probe every weakness, exposing flaws in the data and algorithm, exploiting the opacity of underlying machine learning techniques, and appealing to emotions in ways that remain difficult for machines to match. Would juries nevertheless believe the AI? Should they? How would they weigh the arguments presented by the defense attorney against the vast knowledge but less than transparent reasoning of the machine? How could anyone be sure that the underlying algorithms were not subject to bias? It seemed unlikely that AI would succeed in court until it could explain better, appeal to emotions, and persuade jurors to shed their skepticism.

  PublisherOA PDFDOI

• Medicare savings from conservative management of low back pain.

  PubMed · 2018-10-01 · 4 citations

  articleOpen access1st authorCorresponding

  OBJECTIVES: Low back pain (LBP) is a common and expensive clinical problem, resulting in tens of billions of dollars of direct medical expenditures in the United States each year. Although expensive imaging tests are commonly used, they do not improve outcomes when used in the initial management of idiopathic LBP. We estimated 1-year medical costs associated with early imaging of Medicare beneficiaries with idiopathic LBP. STUDY DESIGN: We used a 5% random sample of Medicare fee-for-service enrollees between 2006 and 2010 to determine 12-month costs following a diagnosis of idiopathic LBP. We analyzed costs of care and patient outcomes according to whether or not the patients had been referred for early imaging following their initial diagnosis. METHODS: We employed an instrumental variables analysis using risk-adjusted physician-level propensity to order imaging for patients without LBP as an instrument for imaging use among patients with LBP. We selected this approach to adjust for confounding by indication when estimating the relative costs of early imaging of LBP compared with conservative management. RESULTS: Early imaging is strongly associated with increased costs of care in the first year following LBP diagnosis. Patients receiving an early magnetic resonance imaging scan accrued $2500 more in Medicare expenditures than conservatively managed patients, and patients who received computed tomography accrued $19,900 more. CONCLUSIONS: Medicare beneficiaries with low-risk LBP frequently receive early imaging studies. Early imaging was associated with greater long-term costs than a conservative diagnostic strategy; Medicare expenditures could be reduced by $362 million annually by managing newly diagnosed LBP in accordance with clinical guidelines.

  PublisherOA PDF

• From Misfortune to Mortality

  JAMA · 2018-04-03 · 3 citations

  letter1st authorCorresponding
  PublisherDOI

• Nudges in Exercise Commitment Contracts: A Randomized Trial

  SSRN Electronic Journal · 2017-01-01 · 7 citations

  articleOpen access
  PublisherDOI

• Cost-Effectiveness of Percutaneous Closure of the Left Atrial Appendage in Atrial Fibrillation Based on Results From PROTECT AF Versus PREVAIL

  Circulation Arrhythmia and Electrophysiology · 2016-06-01 · 23 citations

  articleOpen access

  BACKGROUND: Randomized trials of left atrial appendage (LAA) closure with the Watchman device have shown varying results, and its cost effectiveness compared with anticoagulation has not been evaluated using all available contemporary trial data. METHODS AND RESULTS: We used a Markov decision model to estimate lifetime quality-adjusted survival, costs, and cost effectiveness of LAA closure with Watchman, compared directly with warfarin and indirectly with dabigatran, using data from the long-term (mean 3.8 year) follow-up of Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation (PROTECT AF) and Prospective Randomized Evaluation of the Watchman LAA Closure Device in Patients With Atrial Fibrillation (PREVAIL) randomized trials. Using data from PROTECT AF, the incremental cost-effectiveness ratios compared with warfarin and dabigatran were $20 486 and $23 422 per quality-adjusted life year, respectively. Using data from PREVAIL, LAA closure was dominated by warfarin and dabigatran, meaning that it was less effective (8.44, 8.54, and 8.59 quality-adjusted life years, respectively) and more costly. At a willingness-to-pay threshold of $50 000 per quality-adjusted life year, LAA closure was cost effective 90% and 9% of the time under PROTECT AF and PREVAIL assumptions, respectively. These results were sensitive to the rates of ischemic stroke and intracranial hemorrhage for LAA closure and medical anticoagulation. CONCLUSIONS: Using data from the PROTECT AF trial, LAA closure with the Watchman device was cost effective; using PREVAIL trial data, Watchman was more costly and less effective than warfarin and dabigatran. PROTECT AF enrolled more patients and has substantially longer follow-up time, allowing greater statistical certainty with the cost-effectiveness results. However, longer-term trial results and postmarketing surveillance of major adverse events will be vital to determining the value of the Watchman in clinical practice.

  PublisherOA PDFDOI

• Uber’s Message for Health Care

  New England Journal of Medicine · 2016-03-03 · 17 citations

  articleSenior author

  Uber upended the taxi industry by offering an appealing alternative. Its incursion into a highly regulated market suggests that if consumers gain enough from a new solution, it can overcome entrenched interests. Is U.S. health care ripe for disruption by a medical Uber?

  PublisherDOI

• Nudges in Exercise Commitment Contracts: A Randomized Trial

  RePEc: Research Papers in Economics · 2015-01-01

  articleOpen access

  We consider the welfare consequences of nudges and other behavioral economic devices to encourage exercise habit formation. We analyze a randomized trial of nudged exercise commitment contracts in the context of a time-inconsistent intertemporal utility maximization model of the demand for exercise. The trial follows more than 4, 000 people seeking to make exercise commitments. Each person was randomly nudged towards making longer (20 weeks) or shorter (8 weeks) exercise commitment contracts. Our empirical analysis shows that people who are interested in exercise commitment contracts choose longer contracts when nudged to do so, and are then more likely to meet their pre-stated exercise goals. People are also more likely to enroll in a subsequent commitment contract after the original expires if they receive a nudge for a longer duration initial contract. Our theoretical analysis of the welfare implications of these effects shows conditions under which nudges can reduce utility even when they succeed in the goal of promoting habitual exercise.

  OA PDF

• Case 9: Not Your Usual Diabetic Ketoacidosis

  American Diabetes Association eBooks · 2015-01-01

  book-chapterSenior author

  A 51-year-old Hispanic woman with no history of diabetes presented to the emergency department with several days of nausea, vomiting, abdominal pain, and shortness of breath. She also reported blurry vision, polyuria, polydipsia, and a 30 lb weight loss over the past 3 months. She had a past medical history of hypertension. Her mother and maternal grandmother had type 2 diabetes (T2D). She did not smoke or drink alcohol and did not exercise regularly. Her weight was 73.93 kg (BMI 32.5 kg/m2). Physical examination revealed signs of volume depletion. She had acanthosis nigricans at the neck. She had no clinical evidence of retinopathy, neuropathy, or nephropathy.

  PublisherDOI

Recent grants

• NIH Grant R01HS007818

  NIH · $344k · 1996

• NIH Grant RC4AG039036

  NIH · $5.5M · 2013

• NIH Grant R01HL046297

  NIH · $275k · 1994

• Core C - Measurement and Methods in ADRD and Racial Disparities Research

  NIH · $78.7M · 1997–2029

• NIH Grant R37AG036791

  NIH · $2.4M · 2017

Frequent coauthors

• Douglas K Owens

  Stanford University

  210 shared

• Mark A. Hlatky

  Stanford University

  142 shared

• David W. Hutton

  University of Michigan–Ann Arbor

  85 shared

• Paul A. Heidenreich

  VA Palo Alto Health Care System

  81 shared

• Jay Bhattacharya

  Stanford University

  69 shared

• Paul J. Wang

  Stanford University

  66 shared

• Ruo P. Zhu

  University of California, San Francisco

  66 shared

• Mintu P. Turakhia

  Stanford University

  66 shared