About

Michael Farrell Hoffman, PhD, is an Assistant Professor of Clinical Psychiatry and a Pediatric Psychologist at the Children's Hospital of Philadelphia, affiliated with the University of Pennsylvania Department of Psychiatry. He specializes in working with children with hearing differences, providing integrated psychological services through the CHOP Center for Childhood Communication. His clinical work emphasizes patient-centered, collaborative care aimed at improving quality of life in children and adolescents. Common referral questions include issues related to deaf identity, adjustment to hearing loss or limited device usage, family stress, academic and peer difficulties, as well as traditional psychiatric diagnoses such as anxiety, depression, autism, and ADHD. Dr. Hoffman’s research focuses on health-related quality of life in Deaf and hard of hearing children and their families. He also investigates clinical pathways for supporting mental health among deaf patients in pediatric medical settings. His scholarly contributions include studies on diagnostic processes, integration of psychology into pediatric audiology and otolaryngology clinics, development of quality of life instruments for children with cochlear implants, and longitudinal assessments of social and cognitive outcomes in children with hearing differences.

Research topics

• Medicine
• Internal medicine
• Computer science
• Surgery
• Family medicine

Selected publications

• Epidemiology of Aspergillosis Diagnoses in the U.S. using a National EHR Database, 2013-2023

  medRxiv · 2025-06-23

  preprintOpen access

  Abstract Importance Aspergillosis is an under-recognized fungal infection associated with rising hospitalizations, concerns about antifungal resistance, and substantial morbidity and mortality in the U.S. Yet, national data on aspergillosis remain fragmented due to absence of centralized surveillance. Objective To examine demographic and geographic variation and temporal trends in aspergillosis prevalence in the U.S. from 2013 to 2023; to assess how the COVID-19 pandemic influenced prevalence across population subgroups. Design Retrospective cohort study using a large, national electronic health record (EHR) database. Setting 142 healthcare systems in the U.S. using Oracle Health EHR systems, encompassing disparate care settings. Participants Adults aged 18 years and older who received care between January 1, 2013, and December 31, 2023. The cohort included over 76 million patients, and over 127 million person-years, with 20,764 aspergillosis diagnoses. Exposures Calendar year, patient characteristics (age, sex, race, ethnicity, residence type), and state of residence. COVID-19 was treated as a time-varying exposure. Main Outcomes and Measures Annual and overall prevalence of aspergillosis per 100,000 person-years; adjusted prevalence ratios (aPRs) by demographic group and state, estimated using quasi-Poisson and Bayesian spatiotemporal regression. COVID-19-related shifts in prevalence were assessed using estimated marginal means. Results Between 2013 and 2023, aspergillosis prevalence increased 5% annually, peaking in 2022. Rhode Island had the highest aPR across all years; Utah the lowest. Prevalence was higher in males (aPR: 1.37), older adults (aPR for ≥65 vs. 18 to 34: 4.95), and urban residents (rural aPR: 0.86). Post-COVID-19, prevalence increased disproportionately among Hispanic or Latino patients and several racial minority groups. Suggestive trends of increasing prevalence were also observed among rural residents. Conclusions and Relevance This study provides the most comprehensive national assessment to date of aspergillosis patterns in the U.S., revealing evidence of rising prevalence and emerging disparities shaped by the COVID-19 pandemic. Clinicians should consider regional and demographic risk patterns to support earlier diagnosis, guide antifungal treatment, and improve outcomes—especially among older adults and populations disproportionately affected by COVID-19. Clinicians practicing in rural or underserved areas should be particularly mindful of shifting risk profiles and advocate for improved diagnostic resources to reduce delays in care. Key Points Question How has aspergillosis prevalence changed in the U.S. over time, and how did the COVID-19 pandemic influence prevalence among demographic and geographic subgroups? Findings In a nationally representative EHR cohort of over 76 million adults, aspergillosis prevalence increased by 5% annually from 2013 to 2023. After the emergence of COVID-19, prevalence increased disproportionately among Hispanic or Latino patients and racial minority groups. Meaning Findings suggest increasing aspergillosis prevalence in the U.S., with indications of widening disparities. While subject to data limitations, these trends underscore the importance of considering regional and demographic factors in clinical decision-making, particularly for populations disproportionately affected by COVID-19.

  PublisherOA PDFDOI

• Updating the Epidemiology of Blastomycosis and Histoplasmosis in the United States, Using National Electronic Health Record Data, 2013–2023

  The Journal of Infectious Diseases · 2025-09-09 · 3 citations

  articleOpen access

  BACKGROUND: Where surveillance data are limited, nationally representative electronic health records allow for geographic, temporal, and demographic characterization of the fungal diseases blastomycosis and histoplasmosis. METHODS: We identified incident blastomycosis and histoplasmosis cases from 2013 to 2023 within Oracle EHR Real-World Data, which comprises 1.6 billion healthcare encounters nationally. To characterize spatiotemporal incidence trends, we used generalized estimating equations weighted for nonrepresentativeness of electronic health record-reporting facilities. We computed standardized incidence rate ratios (sIRRs), which relay relative differences in standardized incidence rates between regions, race/ethnicity, gender, and age subgroups and the national population. RESULTS: National incidence rates in 2023 were 2.4 (95% confidence interval [CI]: 1.6-3.5) and 1.9 times (95% CI: 1.6-2.2) rates in 2013, for blastomycosis and histoplasmosis, respectively. Blastomycosis incidence rates among Hispanic or Latino and non-Hispanic Black individuals were 60% (sIRR: 1.6 [95% CI: 1.0-2.4]) and 30% (sIRR: 1.3 [95% CI: 1.0-1.6]) higher than the standardized national incidence rate. Histoplasmosis incidence rates were elevated among non-Hispanic White patients (sIRR: 1.05 [95% CI: 1.02-1.08]). Standardized incidence rates of both diseases were higher among older and male patients, were consistently elevated in the Upper Midwest and Ohio Valley regions, and increased greatly in the Northern Rockies and Plains from 2013 to 2023. We estimated high incidence in states (blastomycosis: Illinois, Kentucky, and West Virginia; histoplasmosis: Missouri, Iowa, and Oklahoma) that do not report to surveillance. CONCLUSIONS: This analysis revealed increasing incidence rates of blastomycosis and histoplasmosis, with increasing diagnoses outside of historically endemic regions, and notable differences in incidence by race/ethnicity, gender, and age.

  PublisherOA PDFDOI

• Updating the epidemiology of blastomycosis and histoplasmosis in the United States, using national electronic health record data, 2013 - 2023

  medRxiv · 2025-06-06

  preprintOpen access

  Introduction: Where surveillance data are limited, nationally-representative electronic health records allow for geographic, temporal, and demographic characterization of the fungal diseases blastomycosis and histoplasmosis. Methods: We identified incident blastomycosis and histoplasmosis cases from 2013 to 2023 within Oracle EHR Real-World Data, which comprises 1.6 billion healthcare encounters nationally. To characterize geographic and temporal incidence rates, we used weighted generalized estimating equations adjusting for non-representativeness of EHR-reporting facilities. We computed standardized incidence rate ratios (sIRRs), which relay relative differences in standardized incidence rates among region, race/ethnicity, gender, and age subgroups and the national population. Results: National incidence rates in 2023 were 2.4 (95% CI: 1.6-3.5) and 1.9 times (95% CI: 1.6-2.2) rates in 2013, for blastomycosis and histoplasmosis, respectively. Blastomycosis incidence rates among Hispanic/Latino and non-Hispanic Black individuals were 60% (sIRR: 1.6 [95% CI: 1.0-2.4]) and 30% (sIRR: 1.3 [95% CI: 1.0-1.6]) higher than the standardized national incidence rate. Histoplasmosis incidence rates were elevated among non-Hispanic White patients (sIRR: 1.05 [95% CI: 1.02-1.08]). Standardized incidence rates of both diseases were higher among older and male patients and were elevated in the Upper Midwest (sIRR: blastomycosis: 5.1 [95% CI: 3.7-6.8]; histoplasmosis: 1.7 [95% CI: 1.5-1.9]) and Ohio Valley regions (sIRR: blastomycosis: 2.0 [95% CI: 1.7-2.3]; histoplasmosis: 2.3 [95% CI: 2.2-2.5], and increased in the Northern Rockies and Plains from 2013 to 2023. Discussion: This analysis revealed increasing incidence rates of blastomycosis and histoplasmosis and expansion outside of historically endemic regions, with notable differences in incidence by race/ethnicity, gender, and age.

  PublisherOA PDFDOI

• YouTube User Traffic to Paired Epilepsy Education Videos in English and Spanish: Comparative Study

  JMIR Formative Research · 2024-11-10 · 2 citations

  articleOpen accessSenior author

  Background: Effectively managing epilepsy in children necessitates the active engagement of parents, a factor that is reliant on their understanding of this neurological disorder. Widely available, high-quality, patient-focused, bilingual videos describing topics important for managing epilepsy are limited. YouTube Analytics is a helpful resource for gaining insights into how users of differing backgrounds consume video content. Objective: This study analyzes traffic to paired educational videos of English and Spanish versions of the same content. By examining the use patterns and preferences of individuals seeking information in different languages, we gained valuable insights into how language influences the use of clinical content. Methods: Physician experts created epilepsy management videos for the REACT (Reaching Out for Epilepsy in Adolescents and Children Through Telemedicine) YouTube channel about 17 subjects, with an English and Spanish version of each. The Children's Mercy Kansas City neurology clinic incorporated these into the department's educational process. YouTube Analytics enabled analysis of traffic patterns and video characteristics between September 2, 2021, and August 31, 2023. Results: The Spanish group had higher engagement and click-through rates. The English versions of all videos had 141,605 total impressions, while impressions for the Spanish versions totaled 156,027. The Spanish videos had 11,339 total views, while the English videos had 3366. The views per month were higher for the Spanish videos (mean 472, SD 292) compared to the English set (mean 140, SD 91; P<.001). The two groups also differed in search behavior and external traffic sources, with WhatsApp driving more traffic to the Spanish videos than the English versions (94 views compared to 1). The frequency of search terms used varied by language. For example, "tonic clonic" was the most frequent term (n=372) resulting in views for English videos, while "tipos de convulsiones" (types of convulsions) was the most common expression (n=798) resulting in views for Spanish videos. We noted increased monthly views for all videos after adding tags on YouTube. Before tagging, the mean number of views per month for the English-language group was 61 (SD 28), which increased to 220 (SD 53) post tagging. A similar trend can be observed in the Spanish-language group as well. Before tagging, the mean number of monthly views was 201 (SD 71), which increased to 743 (SD 144) after tagging. Conclusions: This study showed high traffic for Spanish video content related to epilepsy in a set of paired English/Spanish videos. This highlights the importance of bilingual health content and optimizing video content based on viewer preferences and search behavior. Understanding audience engagement patterns through YouTube Analytics can further enhance the dissemination of clinical video content to users seeking content in their primary language, and tagging videos can have a substantial impact on views.

  PublisherDOI

• Utilization of geospatial distribution in the measurement of study cohort representativeness

  Journal of Biomedical Informatics · 2024-07-08 · 1 citations

  articleOpen access

  OBJECTIVE: The ability to apply results from a study to a broader population remains a primary objective in translational science. Distinct from intrinsic elements of scientific rigor, the extrinsic concept of generalization requires there be alignment between a study cohort and population in which results are expected to be applied. Widespread efforts have been made to quantify representativeness of study cohorts. These techniques, however, often consider the study and target cohorts as monolithic collections that can be directly compared. Overlooking known impacts to health from socio-demographic and environmental factors tied to individual's geographical location, and potentially obfuscating misalignment in underrepresented population subgroups. This manuscript introduces several measures to account for geographic information in the assessment of cohort representation. METHODS: Metrics were defined across two themes: First, measures of recruitment, to assess if a study cohort is drawn at an expected rate and in an expected geographical pattern with respect to individuals in a reference cohort. Second, measures of individual characteristics, to assess if the individuals in the study cohort accurately reflect the sociodemographic, clinical, and geographic diversity observed across a reference cohort while accounting for the geospatial proximity of individuals. RESULTS: As an empirical demonstration, methods are applied to an active clinical study examining asthma in Black/African American patients at a US Midwestern pediatric hospital. Results illustrate how areas of over- and under-recruitment can be identified and contextualized in light of study recruitment patterns at an individual-level, highlighting the ability to identify a subset of features for which the study cohort closely resembled the broader population. In addition they provide an opportunity to dive deeper into misalignments, to identify study cohort members that are in some way distinct from the communities for which they are expected to represent. CONCLUSION: Together, these metrics provide a comprehensive spatial assessment of a study cohort with respect to a broader target population. Such an approach offers researchers a toolset by which to target expected generalization of results derived from a given study.

  PublisherDOI

• Enhancing Accessibility and Engagement: A Comparative Analysis of User Traffic to Paired Clinical Videos in English and Spanish (Preprint)

  2024-01-24

  preprintOpen accessSenior author

  <sec> <title>BACKGROUND</title> Effectively managing epilepsy in children necessitates the active engagement of parents, a factor that is reliant on their understanding of this neurological disorder. </sec> <sec> <title>OBJECTIVE</title> This study analyzes traffic to paired educational videos of English and Spanish versions of the same content. By examining the usage patterns and preferences of individuals seeking information in different languages, we gained valuable insights into how language influences the utilization of clinical content. </sec> <sec> <title>METHODS</title> Physician experts created epilepsy management videos for the REACT YouTube channel about 17 subjects, with an English and Spanish version of each. The CMKC (Children's Mercy Kansas City) Neurology Clinic incorporated these into the department's educational process. YouTube Analytics enabled analysis of traffic patterns and video characteristics. </sec> <sec> <title>RESULTS</title> Our analysis revealed significant differences in engagement between English and Spanish language videos on the REACT YouTube Channel. On average, the Spanish group received significantly more views than the English group (p &lt; 0.0001). External (to YouTube) traffic sources accounted for approximately 13% of the total impressions but contributed significantly to the overall viewership. They resulted in approximately 77% of the total views. Further analysis showed that English-speaking users brought fewer views internally than externally, while the Spanish language groups demonstrated a higher level of engagement. Geographic location data revealed that countries with predominantly non-English speaking populations had higher view counts. Videos discussing atonic seizures, tonic-clonic seizures, and the differences between seizures and epilepsy received the highest number of views within the English group, while the Spanish videos addressing convulsions and absence seizures garnered the most attention. The top searches that resulted in views for English videos were “tonic,” “clonic,” or “tonic-clonic," with a total of 372 views. </sec> <sec> <title>CONCLUSIONS</title> The study highlighted the importance of bilingual content and optimizing video content based on viewer preferences and search behavior. Understanding audience engagement patterns can further enhance the dissemination of clinical video content. This work shows that developing clinical content in both English and Spanish can meet the community's needs. Using YouTube for video content has global access and data analysis benefits. Healthcare professionals and patients can use this platform to access reliable information and improve their clinical knowledge. </sec> <sec> <title>CLINICALTRIAL</title> NA </sec>

  PublisherDOI

• Committing to genomic answers for all kids: Evaluating inequity in genomic research enrollment

  Genetics in Medicine · 2023-05-15 · 18 citations

  articleOpen accessSenior authorCorresponding

  PurposePersistent inequities in genomic medicine and research contribute to health disparities. This analysis uses a context-specific and equity-focused strategy to evaluate enrollment patterns for Genomic Answers for Kids (GA4K), a large, metropolitan-wide genomic study on children.MethodsElectronic health records for 2247 GA4K study participants were used to evaluate the distribution of individuals by demographics (race, ethnicity, and payor type) and location (residential address). Addresses were geocoded to produce point density and 3-digit zip code maps showing local and regional enrollment patterns. Health system reports and census data were used to compare participant characteristics with reference populations at different spatial scales.ResultsRacial and ethnic minoritized and populations with low-income were underrepresented in the GA4K study cohort. Geographic variation demonstrates inequity in enrollment and participation among children from historically segregated and socially disadvantaged communities.ConclusionOur findings illustrate inequity in enrollment related to both GA4K study design and structural inequalities, which we suspect may exist for similar US-based studies. Our methods provide a scalable framework for continually evaluating and improving study design to ensure equitable participation in and benefits from genomic research and medicine. The use of high-resolution, place-based data represents a novel and practical means of identifying and characterizing inequities and targeting community engagement.

  PublisherOA PDFDOI

• Characterization of Pediatric Chronic Cough Via Electronic Medical Record Database

  2023-05-01

  article
  PublisherDOI

• Chronic Cough: Characterizing and Quantifying Burden in Adults Using a Nationwide Electronic Health Records Database

  Journal of Healthcare Informatics Research · 2023-09-27 · 2 citations

  articleOpen access
  PublisherOA PDFDOI

• The use of virtual tools in narrowing the impact of health disparities in neurology

  Frontiers in Pediatrics · 2022-10-14 · 4 citations

  articleOpen access

  The concept of Epilepsy Treatment Gap (ETG) refers to the proportion of people with epilepsy who are not being appropriately treated. The ETG in the USA approaches 10%, with historically underserved populations and rural populations disproportionately affected. The ETG in Low-and Middle-Income Countries (LMIC) is reported to be 5-10 times higher than in high-income countries. The growing availability of reliable internet access offers a unique opportunity to provide better care to children and adults with epilepsy. In this paper we explore various telehealth (TH) initiatives that have leveraged the availability of easy and free access to an internet connection in reducing the ETG in underserved regions of the world. We describe several interventions targeted to reach patients and providers in rural areas of the United States and in LMIC. First, we examine initiatives that were developed to improve patient access to coordinated care and education regarding epilepsy and seizures. Next, we describe an intervention designed to improve knowledge of epilepsy diagnosis and treatment for providers in LMIC. We conclude with a brief overview of the use of virtual tools in diminishing the ETG.

  PublisherOA PDFDOI

Frequent coauthors

• Earl F. Glynn

  25 shared

• Richard H. Pearl

  Illinois College

  25 shared

• Emil Chuang

  18 shared

• Eric S. Maller

  Pfizer (United States)

  18 shared

• Richard L. Hodinka

  University of South Carolina

  18 shared

• Steven M. Altschuler

  18 shared

• Jonathan E. Kolitz

  Feinstein Institute for Medical Research

  17 shared

• Daniel R. Budman

  Northwell Health

  17 shared

Education

• Ph.D., Bacteriology

  University of Wisconsin Madison

  1996

• BA, Oxbridge Molecular Biology

  William Jewell College

  1991