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Brennan
M. R. Spiegel, M.D., M.S.H.S. Associate Professor of Medicine, Division of Digestive Diseases, David Geffen School of Medicine at UCLA; Section Chief, Center for Outcomes Research and Education; CURE Digestive Diseases Research Center |
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Contact Information Center
for Outcomes Research and Education
Dr. Spiegel is Associate Professor of Medicine in the Division of Digestive Diseases, UCLA School of Medicine, and in the Division of Gastroenterology, VA Greater Los Angeles Health Care System. Dr. Spiegel is the Section Chief for Outcomes Research at the UCLA Divisions of Digestive Diseases, Co-Director of the Health Outcomes Core for the NIH-sponsored Center for Neurobiology of Stress, and a member of the CURE Digestive Diseases Research Center. He is the Program Director for the UCLA Fellowship Program in Digestive Diseases. Dr. Spiegel attended Tufts University where he majored in Philosophy and Community Health, and received his M.D. with Alpha Omega Alpha honors from New York Medical College. He received training in internal medicine at Cedars-Sinai Medical Center in Los Angeles, completed a fellowship in Gastroenterology at UCLA, and completed advanced studies in Health Services Research at the UCLA School of Public Health, where he received a Master’s Degree in Health Services. He received a 5-year Research Career Development Award through the Veteran Administration during which time he was trained in health services methodology. Dr. Spiegel's research interests have focused on functional gastrointestinal disorders such as irritable bowel syndrome (IBS) and dyspepsia, acid-peptic disorders, chronic liver disease, gastrointestinal hemorrhage, and colon cancer screening. His research interests include defining strategies to improve the quality and cost-effectiveness of care for patients with IBS and dyspepsia. Toward that end, he has studied the cost-effectiveness of various tests in IBS including the role of colonoscopy and testing for celiac sprue. In addition, he is focused on endpoint assessments, and is the co-chair of the Rome Foundation Outcomes and Endpoints Committee to define the psychometric properties of common endpoints in IBS. Dr. Spiegel’s publications are focused in the fields of digestive diseases health economics and health related quality of life. He has published cost-effectiveness analyses on topics including the use of cox-2 inhibitors in chronic arthritis, the use of proton pump inhibitors in dyspepsia, the appropriate use of upper endoscopy in gastrointestinal hemorrhage, and the use of antiviral therapies in chronic viral hepatitis. In addition, Dr. Spiegel has performed research across a range of other health services methodologies, including health related quality of life measurement, survey design and administration, systematic review and meta-analysis, expert panel research, development of quality indicators, cost-effectiveness analysis, and use of clinical informatics to support decision making. He is a peer-reviewer for numerous medical journals, and is on the editorial boards for the Alimentary Pharmacology and Therapeutics and Clinical Gastroenterology and Hepatology. He is currently an Associate Editor of the American Journal of Gastroenterology. He receives active funding from the NIH, VA, and industry sources.
Selected References (complete list in Curriculum Vitae) Spiegel BMR, Vakil NB, Ofman JJ. Endoscopy for acute non-variceal upper gastrointestinal tract hemorrhage: is sooner better? A systematic review. Archives of Internal Medicine 2001;161:1393-1404. Spiegel BMR, Vakil NB, Ofman JJ. Dyspepsia management in primary care: a decision analysis of competing strategies. Gastroenterology 2002;122:1270-1285. Spiegel BMR, Ofman JJ, Vakil NB. Minimizing recurrent peptic ulcer hemorrhage after endoscopic hemostasis: the cost-effectiveness of competing strategies. American Journal of Gastroenterology 2003;98:86-97. Spiegel BMR, Targownik LE, Karsan HA, Dulai GS, Gralnek IM. Endoscopic screening for esophageal varices in cirrhosis: is it ever cost-effective? Hepatology 2003:37:366-77. Spiegel BMR, Targownik LE, Dulai GS, Gralnek IM. The cost-effectiveness of cyclooxygenase-2 selective inhibitors in the management of chronic arthritis. Annals of Internal Medicine 2003;138:795-806. Targownik LE, Gralnek IM, Dulai GS, Spiegel BMR, Oei T, Bernstein CN. Management of acute non-variceal upper gastrointestinal tract hemorrhage: comparison of a U.S. and a Canadian medical center. Canadian Journal of Gastroenterology 2003;17:489-95. Spiegel BMR, DeRosa VP, Gralnek IM, Wang V, Dulai GS. Testing for celiac sprue in diarrhea-predominant irritable bowel syndrome: a cost-effectiveness analysis. Gastroenterology 2004;126:1721-32. Targownik LE,
Spiegel BM, Dulai GS, Karsan HA, Gralnek IM. The cost-effectiveness
of hepatic pressure gradient monitoring in the prevention of recurrent
variceal hemorrhage. American Journal of Gastroenterology 2004;99:1306-15. Spiegel BMR,
Targownik LE, DeRosa V, Dulai GS, Gralnek IM, Chiou CF. The quality
of published health economic analyses in digestive diseases: a systematic
review and quantitative appraisal. Gastroenterology 2004;127:403-411. Spiegel BMR,
Gralnek IM, Mayer EB, Bolus R, Dulai GS, Chang L, Naliboff B. Clinical
determinants of health-related quality of life in patients with
irritable bowel syndrome. Archives of Internal Medicine 2004;164:1773-1780. Targownik LE,
Spiegel BMR, Dulai GS, Gralnek IM, Farrell J. Colonic stent
vs. emergency surgery for management of acute left-sided malignant
colonic obstruction: A decision analysis. Gastrointestinal Endoscopy
2004;60:865-74. Kanwal F, Dulai
GS, Spiegel BMR, Yee HF, Gralnek IM. Recipient Characteristics
and Post-Liver Transplantation Outcomes Before and After MELD. Alimentary
Pharmacology and Therapeutics 2005;15;21:169-77. Dulai GS, Shekelle
P, Jensen DM, Spiegel BMR, Chen J, Oh D, Kahn K. Dysplasia
and risk of neoplastic progression in a regional Veteran’s
Administration Barrett’s surveillance cohort. American Journal
of Gastroenterology 2005;100:775-83. Spiegel BMR,
Younossi ZM, Hays RD, Revicki D, Robbins S, Kanwal F. The impact
of hepatitis C on health related quality of life: a systematic review
of the literature. Hepatology 2005;41:790-800. Karsan HA, Morton
SC, Shekelle PG, Suttorp MJ, Spiegel BMR, Edelstein MA, Shanman
R, Gralnek IM. Combination endoscopic band ligation and sclerotherapy
compared with endoscopic band ligation alone for the secondary prophylaxis
of esophageal variceal hemorrhage: a meta-analysis. Digestive Diseases
and Sciences 2005;50:399-406. Spiegel BMR,
Chiou CF, Ofman JJ. Minimizing complications from nonsteroidal anti-inflammatory
drugs: the cost-effectiveness of competing strategies in varying
risk groups. Arthritis Care and Research 2005;15:185-97. Bloom M, Barghout
V, Kahler K, Bentkover J, Kurth H, Gralnek IM, Spiegel BMR.
Budget Impact of Tegaserod on a Managed Care Organization Formulary.
American Journal of Managed Care 2005;11:S27-S34. Kanwal F, Gralnek
IM, Martin P, Dulai GS, Martin P, Spiegel BMR. The cost-effectiveness
of competing therapies in the management of chronic infection with
hepatitis B virus. Annals of Internal Medicine 2005;142:821-31. Tan S, Tillisch
K, Bolus R, Olivas T, Naliboff L, Chang L, Spiegel BMR, Mayer
EA S. Subgrouping of irritable bowel syndrome patients using traditional
Chinese medicine symptom classification – a pilot study. Am
J Chin Med. 2005;33(3):365-79. Kanwal F, Gralnek
IM, Hays RD, Spiegel BMR, Dulai GS, Bozzette S, Asch S. Impact
of chronic viral hepatitis on health related quality of life in
HIV: results from a nationally representative sample. American Journal
of Gastroenterology. 2005;100:1984-94 . Spiegel BMR,
Kanwal F, Naliboff B, Mayer E. The impact of somatization on gastrointestinal
health resource use in irritable bowel syndrome. American Journal
of Gastroenterology 2005;100:2262-73. Spiegel BMR,
Chen K, Broder M, Chiou Chiun-Fang. Erythropoietic Growth Factors
for the management of treatment-related anemia in hepatitis C: clinical
and economic consequences. Clinical Gastroenterology and Hepatology
2005;3:1034-42. Spiegel BMR,
Gralnek IM, Bolus R, Mayer E, Chang L, Dulai GS, Naliboff B. Is
a negative colonoscopy associated with improved health-related quality
of life or reassurance in irritable bowel syndrome? Gastrointestinal
Endoscopy 2005;62:892-899. Spiegel BMR,
Farid M, Gralnek IM, Dulai GS, Kanwal F. Comparing rates of dyspepsia
with coxib versus NSAID+PPI combination therapy: a systematic review
and meta-analysis. American Journal of Medicine 2006; 119(5):448.e27-36. Spiegel BMR,
Lim B, Mann N, Dulai GS, Gralnek IM. The cost-effectiveness of intravenous
versus oral proton pump inhibitor therapy in the management of peptic
ulcer hemorrhage: a cost-effectiveness analysis. Clinical Gastroenterology
and Hepatology 2006;4:988-997. Kanwal F, Farid
M, Gralnek IM, Dulai G, Martin P, Chen G, Spiegel BMR. Treatment
alternatives for hepatitis B cirrhosis: a cost-effectiveness analysis.
American Journal of Gastroenterology 2006;101:2076-89. Gralnek IM,
Fennerty B, Spiegel BMR. The effectiveness of esomeprazole
in erosive esophagitis: a meta-analysis. Clin Gastroenterol Hepatol.
2006;4:1452-8 Spiegel BMR,
Bolus R, Han S, Tong M, Esrailian E, Talley J, Tran T, Smith J,
Karsan H, Durazo F, Bacon B, Martin P, Younossi Z, Hwa-Ong S, Kanwal
F. Development and validation of a disease-targeted health-related
quality of life instrument in chronic hepatitis B infection: the
HBQOL v1.0. Hepatology 2007;46:113-21. Spiegel
BMR, Schoenfeld P, Naliboff B. Prevalence of suicidal behavior
in patients with chronic abdominal pain and irritable bowel syndrome:
a systematic review. Aliment Pharmacol Ther. 2007;26:183-193. Singh H, Latosinsky
S, Spiegel BM, Targownik LE. The cost-effectiveness of colonic
stenting as a bridge to curative surgery in patients with acute
left-sided malignant colonic obstruction: a Canadian perspective.
Can J Gastroenterol. 2006 ;20:779-85. Esrailian E,
Spiegel BMR, Targownik L, Dulai GS, Gralnek IM. Differences
in the management of Crohn's disease among experts and community
providers, based on a national survey of sample case vignettes.
Aliment Pharmacol Ther. 2007;26:1005-18 Spiegel
BMR, Esrailian E, Laine L, Chamberlain M. Clinical relevance
of adjuvant chemotherapy in glioblastoma multiforme: a meta-analysis
of competing agents. CNS Drugs 2007;21:775-87. Spiegel
BMR, Esrailian E, Eisen G. The budget impact of screening for
esophageal varices in cirrhosis Gastrointestinal Endoscopy 2007;66:679-92. Huang E, Esrailian
E, Spiegel BMR. The cost-effectiveness of competing therapies
for hepatic encephalopathy: a decision analysis. Alimentary Pharmacology
and Therapeutics. 2007;26:1147-61. Mayer EA, Bradesi
S, Chang L, Spiegel BMR, Bueller JA, Naliboff BD. Functional
GI disorders: From animal models to drug development. Gut 2007. Kanwal F, Hoang
T, Spiegel BMR, Dominitz J, Goetz M, Gifford A, Asch S. Predictors
of treatment in patients with chronic hepatitis C virus infection—Role
of patient versus non-patient factors. Hepatology;46:1741-9 2007. World Gastroenterology
Organization Advisory Board on Irritable Bowel Syndrome. Systematic
review on the management of irritable bowel syndrome in the European
Union. Eur J Gastro Hep 2007;19:S11-37 [Member of Advisory Board
and co-author of consensus document] Desai A, Bolus
R, Nissenson A, Bolus S, Solomon M, Khawar O, Gitlin M, Talley J,
Spiegel BMR. Identifying “best practices” in dialysis
care: results of a national survey and cognitive interviews of dialysis
stakeholders. Clinical Journal of the American Society of Nephrology
(CJASN) 2008; Apr 16. Spiegel
BMR, Strickland A, Naliboff B, Mayer E, Chang L. Predictors
of patient-assessed illness severity in irritable bowel syndrome.
American Journal of Gastroenterology 2008 [Jun 30 – Epub ahead
of print] Spiegel
BMR, Melmed G, Robbins S, Esrailian E. The relationship between
biomarkers and health related quality of life in end-stage renal
disease: a systematic review. Clinical Journal of the American Society
of Nephrology (CJASN) 2008; Oct 1. Esrailian E,
Gralnek IM, Jensen D, Laine L, Dulai GS, Eisen G, Spiegel BMR.
Evaluating the process of care in non-variceal upper gastrointestinal
hemorrhage: a national vignette survey of experts vs. community
gastroenterologists. Alimentary Pharmacology & Therapeutics
2008;28:1199. Spiegel BMR, Ho W, Esrailian E, Targan S, Higgins P, Siegel C, Dubinsky M, Melmed G. Controversies in Ulcerative Colitis: A National Survey Comparing Decision-Making of Experts versus Community Gastroenterologists. Clinical Gastroenterology and Hepatology. 2008 [Epub ahead of print] Ford AC, Talley
NJ, Spiegel
BMR, Foxx-Orenstein A, Schiller L, Quigley EMM, Moayyedi P.
Efficacy of fibre, antispasmodics, and peppermint oil in irritable
bowel syndrome: systematic review and meta-analysis. British Medical
Journal. 2008 13;337. Greengold B,
Nyamathi A, Kominski G, Hodge F, Singer M, Spiegel BMR. Cost-Effectiveness
Analysis of Behavioral Intervention to Improve Vaccination Compliance
in Homeless Adults. Vaccine. 2008;27:718-25. Kanwal F, Spiegel
BMR, Hays RD, Bolus R, Kim SJ, Gralnek IM. Prospective validation
of the short form liver disease quality of life instrument (SF-LDQOL).
Aliment Pharmacol Ther. 2008;28:1088-101. Spiegel BMR, Farid M, van Oijen MGH, Laine L, Howden CW, Esrailian E. Adherence to best practice guidelines in dyspepsia: a survey comparing dyspepsia experts, community gastroenterologists, and primary care providers. Alimentary Pharmacology and Therapeutics 2009;29:871-81. Desai A, Bolus
R, Nissenson A, Chertow GM, Bolus S, Solomon M, Khawar O, Talley
J, Spiegel BMR. Is there “cherry picking” in the
ESRD program? Perceptions from a dialysis provider survey. Clinical
Journal of the American Society of Nephrology (CJASN) 2009;4:772-7 Kanwal F, Gralnek
IM, Bolus R, Kim SJ, Spiegel BMR. Health Related Quality
of Life Predicts Mortality in Patients awaiting Liver Transplantation.
Clinical Gastroenterology and Hepatology 2009 [Epub ahead of print] Yield of diagnostic
tests for celiac disease in individuals with symptoms suggestive
of irritable bowel syndrome: systematic review and meta-analysis.
Ford AC, Chey WD, Talley NJ, Malhotra A, Spiegel BM, Moayyedi
P. Arch Intern Med. 2009 Apr 13;169:651-8. Spiegel
BMR, Harris L, Lucak S, Mayer E, Naliboff B, Bolus R, Esrailian
E, Chey WD, Lembo A, Karsan H, Tillisch K, Dulai G, Talley J, Chang
L. Developing valid and reliable health utilities in irritable bowel
syndrome: results from the IBS PROOF cohort. American Journal of
Gastroenterology 2009 [Epub ahead of print] Desai A, Farid
M, Singh I, van Oijen MGH, Esrailian E, Solomon MD, Spiegel BMR.
The relationship between laboratory-based outcomes and mortality
in end-stage renal disease: a systematic review. Hemodialysis International
2009[Epub ahead of print] Ford AC, Spiegel
BMR, Talley NJ, Moayyedi P. Small Intestinal Bacterial Overgrowth
in Irritable Bowel Syndrome: Systematic Review and Meta-analysis.
Clinical Gastroenterology and Hepatology July 2009 [Epub ahead of
print] Chan M; Cohen
H; Spiegel BMR. Colonoscopy yields fewer polyps as the day
progresses: Experience in a Veteran Administration teaching hospital.
Clinical Gastroenterology and Hepatology [Epub ahead of print] Spiegel
BMR, Camilleri M, Bolus R, Andresen V, Chey WD, Fehnel S, Mangel
A, Talley NJ, Whiehead WE. Psychometric evaluation of endpoints
in IBS randomized controlled trials: a Rome Foundation Working Group
report. Gastroenterology [Epub ahead of print] Spiegel
BMR, Bolus R, Harris LA, Lucak S, Naliboff B, Esrailian E, Chey
WD, Lembo A, Karsan H, Tillisch K, Talleyl J, Mayer E, Chang L.
Measuring IBS patient reported outcomes with an abdominal pain numeric
rating scale: results from the PROOF cohort. Alimentary Pharmacology
and Therapeutics. [Epub ahead of print] [Spiegel=Corresponding Author] Weinberg B,
Spiegel BMR, Tomlinson J, Farrel J. Asymptomatic Pancreatic
cysts: maximizing survival and quality of life using Markov-based
clinical nomograms. Gastroenterology. [Epub ahead of print] Spiegel
BMR, Farid M, Esrailian E, Talley J, Chang L. Is irritable bowel
syndrome a diagnosis of exclusion? A survey of primary care providers,
gastroenterologists, and IBS experts. Manuscript in press at American
Journal of Gastroenterology. Spiegel
BMR, Bolus R, Desai AA, Zagar P, Parker T, Moran J, Bolus S,
Solomon MD, Khawar O, Gitlin M, Talley J, Nissenson A. Dialysis
practices that distinguish top vs. bottom performing facilities
by hemoglobin outcomes. Manuscript in press at Am J Kidney Dis. Spiegel
BMR. The impact of negative diagnostic tests in the management
of non-ulcer dyspepsia: is no news good news? Evidence-Based Gastroenterology
2002;3:47-48. Spiegel
BMR, Gralnek IM. Early medical therapy reduces intra-gastric
blood in upper gastrointestinal tract hemorrhage: a difference that
makes a difference? Evidence-Based Gastroenterology 2002;3:40-41. Spiegel
BMR, Gralnek IM. Carvedilol or propranolol for variceal prophylaxis:
Unconfidence intervals confound the choice. Evidence-Based Gastroenterology
2003;4:107-109. Spiegel
BMR. How much do coxibs cost? Evidence-Based Gastroenterology
2004;5:10-11 Spiegel
BMR, Dulai, GS. Rethinking the safety of clopidogrel: lessons
learned from ulcers in Asia. Evidence-Based Gastroenterology 2005. Spiegel
BMR, Dulai GS. PPI therapy in nonulcer dyspepsia: still working
after all these years. Evidence-Based Gastroenterology 2005. Spiegel
BMR. Barrett’s esophagus and cancer: overview / overdone?
Audio-Digest Gastroenterology 2006(Sept);20:9. Spiegel
BMR. Do physicians follow evidence-based guidelines in the diagnostic
work-up of IBS? In Press at Nature Clinical Practice Gastroenterology
and Hepatology. Spiegel,
BMR. A letter a day keep the cancer away: improving colon cancer
screening adherence with a mailed brochure. Evidence-Based Gastroenterology
2007. Spiegel
BMR, Chey WD, Chang L. Bacterial overgrowth and irritable bowel
syndrome: unifying hypothesis, or a spurious consequence of proton
pump inhibitors? In press at American Journal of Gastroenterology. Spiegel
BMR. Endoscopy for acute upper gastrointestinal tract hemorrhage:
sooner is better. In press at Gastrointestinal Endoscopy. Ho, W; Spiegel, BMR. Obesity and Functional GI Disorders: Causation, Association or Neither? Gastroenterology & Hepatology 2008;4:527.
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