BRIAN CHU

Perelman School of Medicine
University of Pennsylvania
Class of 2023

Stanford University
Class of 2018
Major: Biological Chemistry
Minor: Computer Science

Email: brianchu2010 at gmail
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RESEARCH

Broadly, I'm curious about why physicians behave the way they do: how do they make decisions? Is evidence-based medicine as evidenced-based as advertised? How do costs and reimbursements factor into decision-making (and what is the cost for that)? How do different circumstances and environments change physician behavior? I have a particular interest in antibiotic prescribing patterns and its effects on patient outcomes. I've also worked on social media analytics as a way to get an unfiltered perspective on behavioral health. I also enjoy staying up-to-date on recent developments in computational technology in medicine.

Before medical school, my main research interests were in biochemistry and translational research.

RESEARCH ADVISORS BEFORE MED SCHOOL

• Carolyn Bertozzi
• Euan Ashley
• Pilar Ruiz-Lozano
• Pui-Yan Kwok

FEATURED PUBLICATIONS

Effect size reporting among prominent health journals: a case study of odds ratios. BMJ Evid Based Med. 2020. [PDF]

Chu B, Liu M, Leas EC, Althouse BM, Ayers JW.

The accuracy of statistical reporting in research is often hotly debated, yet few meta-research studies gauge the prevalence of errors. We studied the use of odds ratios (ORs) in four leading health journals—JAMA, NEJM, AJPH, and PLOS One—and show that reporting of ORs frequently omit reporting effect sizes, and even when they did, interpretations were usually incorrect. Omitting accurate interpretations of effect size poses challenges for readers (including lawmakers and news media) who synthesize results across articles, especially from leading journals like the ones we studied. Once errors are disseminated into media and policies, they are hard to detect and even harder to change. Future editorial standards should require stricter standards on the use and reporting of ORs.

Patient crowdsourcing of dermatologic consults on a Reddit social media community. J Am Acad Dermatology. 2020. [PDF]

Chu B, Fathy R, Nobles A, Lipoff JB.

For a variety of reasons, perhaps in part due to lack of widespread adoption of telemedicine (before COVID-19), patients are turning to social media to seek medical advice. We looked at a community on Reddit (a rapidly growing social media platform) focused on dermatologic discussion, finding that users are anonymously sharing personal pictures and crowd-sourcing diagnoses. Their motivations included lack of access, long wait times, and discomfort with clinicians. Moreover, nearly all responders did not share credentials, introducing the risk of spreading misinformation. Physicians could partner with such communities to develop guidelines for requests and to improve the quality of advice, though care must be taken to avoid disrupting the original community.

Association of antibiotic exposure with survival and toxicity in patients with melanoma receiving immunotherapy. J Natl Cancer Inst. 2020. [PDF] [ASCO Daily News] [ASCO Post]

Mohiuddin J, Chu B, Facciabene A, Poirier K, Wang X, Doucette A, Zheng C, Xu W, Anstadt EJ, Amaravadi RK, Karakousis GC, Mitchell TC, Huang AC, Shabason JE, Lin A, Swisher-McClure S, Maity A, Schuchter LM, Lukens JN.

Increasing evidence suggests that concurrent use of antibiotics worsens the efficacy of immune checkpoint inhibitors (ICI), a type of cancer therapy. In the largest retrospective study to date on this topic, we found decreased survival in patients with stage III or IV melanoma who received antibiotics just prior to initiation of ICI. Interestingly, we also found increased incidence of colitis with antibiotic treatment, suggesting that antibiotic-induced gut dysbiosis could have mediated the change in ICI efficacy. Given the high usage of antibiotics, physicians should be judicious with their use in patients likely to receive ICI.

OTHER PUBLICATIONS

Moderate Colitis Not Requiring IV Steroids Is Associated with Improved Survival in Stage IV Melanoma after Anti-CTLA4 Monotherapy, But Not Combination Therapy. Oncologist. 2022. [PDF]

Anstadt EJ, Chu B, Yegya-Raman N, Han X, Doucette A, Poirier K, Mohiuddin JJ, Maity A, Facciabene A, Amaravadi RK, Karakousis GC, Cohen JV, Mitchell TC, Schuchter LM, Lukens JN.

Quality of life and physical activity in 629 individuals with sarcoidosis: Prospective, cross-sectional study using smartphones (Sarcoidosis App). JMIR mHealth and uHealth. 2022. [PDF]

Chu B, O'Connor DM, Wan MT, Barnett I, Shou H, Judson MA, Rosenbach M

Medical schools as gatekeepers: A survey and analysis of factors predicting dermatology residency placement. J Am Acad Dermatology. 2022. [PDF]

Ogidi P, Ahmed F, Cahn BA, Chu B, Lipoff JB

Spread of Misinformation About Face Masks and COVID-19 by Automated Software on Facebook. JAMA Intern Med. 2021. [PDF]

Ayers JW, Chu B, Zhu Z, Leas EC, Smith D, Dredze M, Broniatowski DA.

Sociodemographic features of a cohort of people living with albinism in Botswana. JAAD International. 2020. [PDF]

Chu B, Maranga A, Mosojane KI, Ralethaka M, Ngubula JC, Shifa JZ, Jereni BH, Nkomazana O, Williams VL.

In this second project with Dr. Williams's collaborators in Africa, we focused on the sociodemographic features of surveyed people with albinism (PWA) in Botswana. We show that PWA faced unique economic, educational, health-related, and psychosocial challenges compared to non-PWA, despite a universal health care system. For clinicians caring for this patient population, we demonstrate the need to promote additional psychosocial and skin-protective behaviors, as well as the need for public health interventions to support PWA in Botswana.

Distribution of skin type diversity in photographs in American Academy of Dermatology online educational modules. Cutis. 2020. [PDF]

Chu B*, Fathy R*, Onyekaba G, Lipoff JB. (*co-first authors)

At the time of writing, recent studies had shown poor representation of darker skin in derm textbooks. My classmates and I posed that question to a resource frequently assigned to students: the AAD Basic Dermatology Curriculum, a standard curriculum published by the AAD. We found that darker skin were underrepresented for skin cancers and overrepresented for STIs, demonstrating an opportunity for the AAD to better align with their goals to improve diversity in educational materials.

Patterns of Skin Cancer and Treatment Outcomes for Patients With Albinism at Kisangani Clinic, Democratic Republic of Congo. Int J Dermatol. 2020. [PDF]

Inena G, Chu B, Falay D, Limengo B, Matondo I, Bokanga A, Kovarik C, Williams VL.

Albinism is rare, but disproportionately prevalent in certain regions of Africa, where people with albinism (PWA) face a variety of medical and social challenges. In the first study of PWA in the Democratic Republic of the Congo, we found a high prevalence of nonmelanoma skin cancers, low use of sun-protective measures, and frequent societal discrimination, compounded by political and infrastructural instability. However, we also found a high rate of cure for skin cancers, demonstrating the impact that a small, dedicated albinism clinic can make on a local population.

Sociodemographic Differences Associated With Utilization of Weekend Versus Weekday Primary Care Visits. J Gen Intern Med. 2020. [PDF]

Barbieri JS, Chu B, Mostaghimi A.

A national NPR survey found that half of patients who couldn't see their doctor when they needed care cited night or weekend accessibility issues, yet little is known about the sociodemographic characteristics of patients using weekend visits. Using a large national public database, we show that Hispanic patients and those living in wealthier, less rural areas were more likely to utilize weekend visits. However, the absolute differences were small, suggesting that expanded hours would be welcome across the sociodemographic spectrum.

Association of Air Pollution and Chronic Inflammatory Skin Diseases: Challenges of Google Trends Data and Importance of Local Data. J Am Acad Dermatology. 2020. [PDF]

Chu B, Markeson CD, Barbieri JS.

What are the challenges of using Google Trends data as a digital epidemiological approach? In our reply to a study demonstrating that increased air pollution was correlated with increased search interest for “itch”, we show that the same study done with an extended study period and a more geographically discrete analysis found no correlations. Importantly, we argue that analyzing air quality data at the state-level poses interpretability challenges due to the heterogeneity of environments within each state.

Dermatology Without Dermatologists? Analyzing Instagram Influencers With Dermatology-Related Hashtags. J Am Acad Dermatology. 2020. [PDF]

[Response to Letter to the Editor] Instagram influencer definitions and the need for dermatologist engagement on social media. J Am Acad Dermatology. 2020. [PDF]

Ranpariya V, Chu B, Fathy R, Lipoff JB.

Although many patients use social media for information, the credentials of dermatology influencers on Instagram remained unknown. In this review of Instagram content labeled with dermatology-related tags, we found that board-certified dermatologists comprised <5% of dermatology influencers, and that nearly all influencers featured promotional material. Given the potential for misinformation and conflicts of interest, these findings serve as a call for dermatology organizations to push back with their own high quality content.

Variation in topical antibiotics recommendations in wound care instructions by non-dermatologists. J Gen Intern Med. 2020. [PDF]

Fathy R*, Chu B*, Singh P, James WD, Barbieri JS. (*co-first authors)

Many physicians provide instructions to patients for simple wound care on their clinic webpages. Building off our findings that physicians frequently (and unnecessarily) prescribe topical antibiotics after simple skin procedures, we studied whether this trend was reflected in those online instructions. By looking at the webpages of the top non-dermatologist utilizers of biopsies, we demonstrate that many physicians are not only prescribing such antibiotics, but also educating patients that antibiotics are needed for wound healing. Such instructions reinforce persistent myths of simple wound care.

The frequency of topical antibiotic use following biopsy and excision procedures amongst dermatologists and non-dermatologists: 2006-2015. J Am Acad Dermatology. 2020. [PDF]

Fathy R, Chu B, James WD, Barbieri JS.

Simple skin protectants like petroleum jelly are sufficient for wound care after skin biopsies or excision. Yet, patients are routinely sent home with topical antibiotics instead. We use a national public database to quantify this practice, demonstrating that physicians (especially dermatologists) are increasingly sending patients home with topical antibiotics. At best, this is unnecessary; at worst, this increases adverse reactions and antibiotic overuse.

The frequency of off-label prescribing in the treatment of dermatologic diseases during 2006-2015. J Am Acad Dermatology. 2020. [PDF]

Chu B, Fleischer A Jr, Barbieri JS.

Physicians frequently use drugs for indications other than those listed on their labels, often driven by low financial incentives by pharmaceutical companies to investigate every possible use of a drug. We use a national public database to show that off-label prescribing is widespread in dermatology, even for common conditions like acne, which could be problematic considering Medicare often excludes off-label prescribing for coverage determination.

Rapid detection of Mycobacterium tuberculosis in sputum with a solvatochromic trehalose probe. Sci Transl Med. 2018. [PDF]

Kamariza M, Shieh P, Ealand CS, Peters JS, Chu B, Rodriguez-Rivera FP, Babu Sait MR, Treuren WV, Martinson N, Kalscheuer R, Kana BD, Bertozzi CR.

How can we use our understanding of metabolic biochemistry to build a better point-of-care diagnostic for tuberculosis? We designed fluorogenic trehalose analogs that stain live bacteria in minutes upon incorporation into the cell wall, with minimal background noise and no need for sample washing. This chemically stable agent presents a new approach for designing rapid sputum-based TB tests for low-resource environments. The start-up OliLux Biosciences is now developing this technology for commercialization.

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