About

David Do, MD, is an Adjunct Associate Professor of Neurology at the University of Pennsylvania's Perelman School of Medicine. He serves as the Innovation Manager at the Center for Health Care Innovation and is the Director of Clinical Informatics in the Department of Neurology. Additionally, he holds the position of Assistant Chief Medical Information Officer for Data and Analytics within the University of Pennsylvania Health System. His clinical expertise is in neurology, and his research focuses on software development, applications, electronic health record (EHR) data, and EHR integration.

Research topics

• Internal medicine
• Medicine
• Virology
• Cardiology
• Surgery
• Intensive care medicine
• Emergency medicine

Selected publications

• The Effect of Ocrelizumab on Anti‐JC Virus Antibody Index

  Brain and Behavior · 2026-05-01

  articleOpen access

  PURPOSE/INTRODUCTION: The anti-JC virus (JCV) antibody index is used to stratify the risk of progressive multifocal leukoencephalopathy (PML) in multiple sclerosis (MS), particularly with natalizumab therapy. B-cell-depleting therapies may alter antibody levels and potentially confound the estimation of PML risk. This study evaluated the effect of ocrelizumab on anti-JCV antibody indices during the first 2 years of treatment. METHODS: We conducted a retrospective cohort study of 553 MS patients who initiated ocrelizumab between 2017 and 2019. Anti-JCV antibody indices were measured using the STRATIFY JCV assay at baseline and approximately every 6 months prior to subsequent infusions. Linear mixed-effects models were used to assess longitudinal changes in log-transformed JCV indices, adjusting for age, sex, and ethnicity. Secondary analyses evaluated serum B-cell counts and immunoglobulin levels. Sensitivity analyses addressed missing data. RESULTS/FINDING: There was no significant change in anti-JCV antibody index over time following ocrelizumab initiation (mean percent change per infusion cycle -0.049%, 95% CI: -0.449 to 0.351; p = 0.81). Results were consistent across sensitivity analyses and did not differ by age or sex. In contrast, peripheral B-cell counts declined significantly after treatment initiation and remained suppressed. Serum IgG, IgM, and IgA levels decreased modestly but significantly over time. JCV seroconversion occurred in 4.1% of initially seronegative patients, while seroreversion occurred in 6.6% of initially seropositive patients. CONCLUSION: Anti-JCV antibody indices remain stable during the first 2 years of ocrelizumab treatment despite marked B-cell depletion and modest reductions in serum immunoglobulins. These findings suggest that existing PML risk stratification tools based on anti-JCV antibody indices remain applicable during early ocrelizumab therapy.

  PublisherDOI

• Development of high-content screening assay for gene silencing in adult sensory neurons

  Journal of Neuroscience Methods · 2025-06-06

  articleOpen access

  High-content screening in post-mitotic neurons faces challenges due to low transfection efficiency and expensive viral or electroporation methods. To accelerate discovery specifically in adult sensory neurons, we sought a scalable, low-cost platform that preserves neuronal health. We developed a 384-well lipid-based siRNA screening assay using adult EGFP-expressing Fischer 344 DRG neurons. Key optimizations included a systematic comparison of plate plastics and lipid/siRNA ratios and reagents, yielding maximal knock-down with minimal toxicity. Optimal conditions (0.12 μL reagent, 2.5 pmol siRNA/well) reduced EGFP fluorescence by ≥50% in 45% of neurons, with mean knockdown efficiencies up to 60% and minimal impact on neurite length. PTEN-targeting siRNAs increased neurite outgrowth by 40% (p<0.001), while death siRNA reduced length by 30% (p<0.001), demonstrating sensitivity to both stimulatory and inhibitory gene perturbations. Our approach offers substantially lower cost and higher throughput than alternatives. Relative to electroporation protocols for adult DRG neurons, reagent cost is reduced ~12-fold and hands-on time drops from ~2 days to ~3 hours, while eliminating specialized equipment. Notably, the assay was optimized for cost-efficiency and scalability; for instance, our 384-well format protocol can screen hundreds of genes in triplicate for under $10,000, making high-content screening feasible in smaller laboratories. This platform enables rapid, cost-effective evaluation of hundreds to thousands of candidate genes in adult sensory neurons, facilitating identification of neurite growth regulators. • Developed a 384-well lipid-based siRNA screening assay in adult EGFP-expressing DRG neurons, achieving ≥50% EGFP knockdown in 45% of neurons with minimal toxicity. • Implemented a dual-reporter system combining EGFP fluorescence and β III-tubulin immunostaining to simultaneously assess transfection efficiency and neurite outgrowth. • Optimized conditions (0.12 μL transfection reagent, 2.5 pmol siRNA/well) yield mean knockdown efficiencies up to 60% without significantly impacting neurite length. • Validated assay sensitivity by showing PTEN silencing increases neurite outgrowth by 40% while a death-targeting siRNA reduces neurite length by 30%. • Reduced reagent cost ~12-fold compared to electroporation, enabling screening of hundreds of genes in triplicate under $10 000 with standard laboratory equipment

  PublisherDOI

• Peer and Patient Feedback to Increase Adherence to Postoperative Opioid Prescribing Guidelines

  JAMA Surgery · 2025-06-11 · 3 citations

  article

  Importance: Prescribing more opioids than patients need following surgery is associated with long-term use, misuse, and diversion. Interventions are needed to increase adherence to procedure-specific guidelines while preserving the ability to manage pain. Objective: To test whether providing clinicians monthly feedback with peer comparisons and patient-reported outcomes would increase adherence to postoperative opioid prescribing guidelines. Design, Setting, and Participants: This stepped-wedge cluster randomized clinical trial was conducted at 6 surgical departments or divisions caring for patients undergoing 30 high-volume surgical procedures in a 5-hospital academic health system in Pennsylvania and New Jersey. Surgical clinicians (attending surgeons, advanced practice professionals, and resident physicians) with 5 or more opioid prescriptions per month for eligible procedures during a 3-month period at baseline were eligible for inclusion. Six clinician clusters were randomly assigned to the intervention in 3 steps offset by 2 months. Each step included a 9-month baseline, a 6-month intervention, and a 6-month follow-up. The first step of the intervention began on June 8, 2022. Follow-up concluded in October 2023, and data analysis was performed from November 2023 to April 2024. Intervention: Clinicians were emailed a report on their most frequently performed procedures, which contained a figure of the following mean numbers: pills prescribed relative to guidelines, pills peer clinicians prescribed, and pills patients reported using after a procedure; an additional figure displayed patients' self-reported ability to manage pain. Monthly reports included prescribing trends, peer comparison feedback, and reminders about how many pills patients take and how well patients reported pain management with guideline-adherent prescriptions. Main Outcomes and Measures: The primary outcome was the proportion of guideline-adherent opioid prescriptions; secondary outcomes included patient-reported ability to manage pain (measured on a 0 to 10 scale, with 0 being not at all able), pain score, pills prescribed, pills leftover, and refill rate. Results: A total of 143 surgical clinicians treating 20 557 patients were included (10 069 at baseline, 5382 during the intervention, and 5106 at follow-up). Mean (SD) patient age was 57.0 (15.7) years, and 10 996 patients (53.5%) were female. The baseline guideline adherence rate was 57.2%. During the intervention, adherence increased to 71.8%, with an adjusted intervention effect of 5.3% (95% CI, 2.0%-8.7%). The impact of the intervention increased over time, and adherence remained above baseline at follow-up (74.4%). The largest change was noted for orthopedic procedures of knee, hip, and shoulder arthroplasty. Patient-reported pain and ability to manage pain were unchanged. Conclusions and Relevance: In this stepped-wedge cluster randomized clinical trial, a feedback intervention using peer comparisons and patient-reported data increased opioid guideline adherence without compromising patients' ability to manage pain. Trial Registration: ClinicalTrials.gov Identifier: NCT05358522.

  PublisherDOI

• Handcrafting Joy to Support Both the Patient and Clinician Experience

  Journal of Patient Experience · 2024-01-01

  articleOpen access

  A patient's hospital stay is too often wrapped in fear and worry. Healthcare leaders have emphasized the immense need to improve patient experience and address patients' individual needs. In addition to helping with the medical aspect of healing, we believe health systems can encourage and empower providers to perform acts of kindness to help elevate the otherwise stressful experience of being hospitalized. We describe an initiative focused on tailoring joyful surprises, like unexpected gifts, to help support both patients and clinicians, aiming to improve patient experience and satisfaction while reducing provider burnout. In sharing the stories of the interactions between the providers and patients, it is clear that not only has this program brought joy to our patients, but that it has also helped reconnect our providers with their sense of meaning and purpose in caring for people and meeting their needs. Thus, we herein describe a patient-centered initiative that enables healthcare providers to provide unique and joyful surprises for their patients in a manner that is readily scalable, cost-effective, accessible, and deeply impactful.

  PublisherDOI

• Testing the Effectiveness of a Text-Message-Based Home Monitoring Program and Oxygen Monitoring for Patients with COVID-19 -- The COVID Watch Study

  2024-02-06

  report
  PublisherDOI

• Nonopioid medications for managing opioid withdrawal in acute care settings: A scoping review

  American Journal of Health-System Pharmacy · 2024-12-03 · 1 citations

  review

  PURPOSE: There are hospitalized patients with chronic opioid use who will experience signs and symptoms of opioid withdrawal who were not on medications for opioid use disorder (OUD) prior to admission, do not want to start or are unable to start medications for OUD during admission, and want to limit or avoid the use of opioids. The purpose of this scoping review was to assess the potential effectiveness and safety of using non-opioid agents for managing acute opioid withdrawal in acute care settings. METHODS: PubMed (inception to 2024), Embase (inception to 2024), and Cochrane Library (inception to 2024) were the databases evaluated for the literature search. Bibliographies of full-text articles were reviewed for additional relevant papers. RESULTS: Twenty-eight studies evaluating nonopioid agents for managing acute opioid withdrawal were identified in the literature search. The agents could be divided into 4 broad mechanistic categories: α-adrenergic receptor agonists, N-methyl-d-aspartate (NMDA) antagonists, gamma-aminobutyric acid (GABA) modulators, and serotonergic agents. Of these drug classes, the available literature suggests the α-adrenergic receptor agonists clonidine and lofexidine have the best evidence of efficacy as alternative agents for acute opioid withdrawal, although the majority of studies comparing such agents to opioids for opioid withdrawal were conducted well before the rise in synthetic opioid overdose deaths and have other methodologic issues that limit firm conclusions concerning efficacy and, particularly, safety. CONCLUSION: For the nonopioid alternative agents that have been studied for acute opioid withdrawal, there is more evidence supporting the efficacy of α-adrenergic receptor agonists as opposed to NMDA antagonists, GABA modulators, or sertonergic agents; however, more research is needed regarding the efficacy and safety of nonopioid alternatives for acute opioid withdrawal in order to better guide clinical decision-making.

  PublisherDOI

• 1192. Validation of an Electronic Dashboard in Identifying Excess Duration of Antibiotics for Pneumonia

  Open Forum Infectious Diseases · 2023-11-27

  articleOpen access

  Abstract Background Many inpatients receive inappropriately prolonged courses of antibiotics for community acquired pneumonia (CAP) and hospital acquired pneumonia (HAP). Identifying these patients is important for use in interventions to reduce unnecessary antibiotic exposure. In this study, we evaluate how well an electronic dashboard identifies inpatients receiving excess treatment for pneumonia and characterize reasons for excess antibiotic duration. Methods Within an academic health system, a dashboard was created to generate an alert when inpatients received antibiotics longer than 120 hours (5 days) or azithromycin longer than 72 hours (3 days) for CAP and 168 hours for HAP (7 days). We reviewed a random sample of encounters with an alert between November 2018 and January 2023. Through chart review, we collected medical history, provider documentation of antibiotic indication, duration of treatment, and reasons for excess duration. Descriptive statistics were used to report 1) the proportion of patients with true positive alerts (alerts generated for patients who truly received an excess duration of antibiotics for pneumonia) and false positive alerts (alerts generated but the patients had not received an excess duration of antibiotics for pneumonia) and 2) reasons for true positive and false positive alerts. Results Out of 200 patients, 156 (78.0%) were found to have a true positive alert, while 44 (22.0%) had a false positive alert. Of the patients who received a longer duration than needed for pneumonia (i.e. true positives), 24.5% had no documented reason for prolonged duration and 21.5% had documented inadequate clinical improvement as defined in Table 2. Excess days of azithromycin for CAP was also a common reason for true excess duration (13.5%). Incorrect antibiotic indication selection was the most common reason for a false positive alert (31.8%). Conclusion The electronic dashboard is a useful tool that can correctly identify inpatients receiving excess duration of treatment for pneumonia in a majority of cases. Future stewardship endeavors should focus on interventions to reduce such excess duration especially for the most common reasons found. Disclosures Kathleen Degnan, MD, Gilead: Grant/Research Support

  PublisherOA PDFDOI

• A Characterization of Neurology Consults for Inpatients with SARS-CoV-2 Infection Compared to Other Respiratory Viruses

  Neurology International · 2023-11-23

  articleOpen access

  Introduction: Neurological consultation for patients infected with SARS-CoV-2 is common; it is currently unknown whether the neurologist’s approach to inpatient consultation of patients with SARS-CoV-2 should differ from the paradigm used to evaluate hospitalized patients with similar respiratory viruses. The goal of the present study is to determine if the preponderance of new neurologic diagnoses differs between inpatients with SARS-CoV-2 and similar non-SARS-CoV-2 respiratory viruses for whom neurology is consulted. Methods: We performed a retrospective chart analysis of inpatient neurologic consultations at three major Philadelphia-based hospitals. We compared the final neurologic diagnosis of 152 patients infected with SARS-CoV-2 to 54 patients with a similar ubiquitous non-SARS-CoV-2 respiratory virus (influenza A, influenza B, respiratory syncytial virus, rhinovirus, or adenovirus, the most commonly tested respiratory viruses at our institution). Secondary metrics included age, sex, level of care, prior neurologic diagnoses, and mortality. A multinomial logistic regression model was utilized to evaluate the relative difference between diagnostic category groups on all metrics. Results: The proportion of patients with seizure who were infected with SARS-CoV-2 admitted to an intensive care unit (ICU) was significantly higher than those who were admitted to a medical–surgical floor. SARS-CoV-2 was also associated with increased risk for ICU admission compared to other common respiratory viruses. SARS-CoV-2 inpatients requiring neurologic consultation were also more likely to be older and female as compared to the non-SARS-CoV-2 cohort. In other domains, the proportion of neurologic diagnoses between SAR-CoV-2 and non-SARS-CoV-2 respiratory viruses showed no significant difference. Conclusion: Patients requiring inpatient neurologic consultation with a diagnosis of SARS-CoV-2 infection or another respiratory virus were found to be remarkably similar in terms of their ultimate neurologic diagnosis, with the exception of a larger preponderance of seizure in critical-care-level patients with SARS-CoV-2 infection. Our study suggests that the neurological approach to patients hospitalized with SARS-CoV-2 should be similar to that for patients with similar common respiratory infections, noting that seizure was seen more frequently in critically ill patients infected with SARS-CoV-2.

  PublisherOA PDFDOI

• Predictors of Recurrent Venous Thrombosis After Cerebral Venous Thrombosis

  Neurology · 2022-09-19 · 25 citations

  articleOpen access

  <h3>Background and Objective</h3> Cerebral venous thrombosis (CVT) is a rare cause of stroke carrying a nearly 4% risk of recurrence after 1 year. There are limited data on predictors of recurrent venous thrombosis in patients with CVT. In this study, we aim to identify those predictors. <h3>Methods</h3> This is a secondary analysis of the ACTION-CVT study which is a multicenter international study of consecutive patients hospitalized with a diagnosis of CVT over a 6-year period. Patients with cancer-associated CVT, CVT during pregnancy, or CVT in the setting of known antiphospholipid antibody syndrome were excluded per the ACTION-CVT protocol. The study outcome was recurrent venous thrombosis defined as recurrent venous thromboembolism (VTE) or de novo CVT. We compared characteristics between patients with vs without recurrent venous thrombosis during follow-up and performed adjusted Cox regression analyses to determine important predictors of recurrent venous thrombosis. <h3>Results</h3> Nine hundred forty-seven patients were included with a mean age of 45.2 years, 63.9% were women, and 83.6% had at least 3 months of follow-up. During a median follow-up of 308 (interquartile range 120–700) days, there were 5.05 recurrent venous thromboses (37 VTE and 24 de novo CVT) per 100 patient-years. Predictors of recurrent venous thrombosis were Black race (adjusted hazard ratio [aHR] 2.13, 95% CI 1.14–3.98, <i>p</i> = 0.018), history of VTE (aHR 3.40, 95% CI 1.80–6.42, <i>p</i> &lt; 0.001), and the presence of one or more positive antiphospholipid antibodies (aHR 3.85, 95% CI 1.97–7.50, <i>p</i> &lt; 0.001). Sensitivity analyses including events only occurring on oral anticoagulation yielded similar findings. <h3>Discussion</h3> Black race, history of VTE, and the presence of one or more antiphospholipid antibodies are associated with recurrent venous thrombosis among patients with CVT. Future studies are needed to validate our findings to better understand mechanisms and treatment strategies in patients with CVT.

  PublisherOA PDFDOI

• A Single Center, Retrospective Analysis of Inpatient Neurologic Consultations of Patients Infected with SARS-CoV-2 (P7-9.002)

  Neurology · 2022-05-03

  article

  To determine if inpatient neurological consultations differ between COVID-19 and non-COVID-19 respiratory infections.

  PublisherDOI

Frequent coauthors

• Marios Psychogios

  Universität Hamburg

  8 shared

• Alex Brehm

  8 shared

• Nils Henninger

  University of British Columbia

  7 shared

• Maria Cristina Vedovati

  University of Perugia

  7 shared

• Sami Al Kasab

  Medical University of South Carolina

  7 shared

• Roy Rosin

  University of Pennsylvania Health System

  7 shared

• Muhib Khan

  Mercy Health Saint Mary's

  6 shared

• Piers Klein

  Boston Medical Center

  6 shared