Behind the scenes with David Kim: Assistant Professor and Program Director of the Tufts Cost-Effectiveness Analysis (CEA) Registry

Rachel Breslau (RB): How did you get involved in health economics and outcomes research?

David Kim (DK): When I was about to graduate from college, I had a series of plans that didn't go as I had hoped. So I took a year off after graduation and I thought carefully about what I’d actually like to do for my career and what I might be good at. Somehow, I found the field of health decision sciences, which promotes systematic decision making about the use of health technologies and public health interventions. I was particularly fascinated by cost-effectiveness analysis (CEA) because it is similar to the way I think in my life in general – it doesn’t just compare the benefits of doing A vs. B, but it also compares the costs. CEA helps us assess whether something is really a good use of our limited resources or if there is a better use for them. For example, my wife often teases me that I’m too focused on efficiency. When she bought things from Amazon or the grocery store, I used to ask, “Even if it only costs $5, do the benefits of using whatever you buy justify the cost?” And yes, I no longer ask this question for a long, happy marriage.

RB: How did you get involved with the Cost-Effectiveness Analysis (CEA) Registry?

DK: When I first joined CEVR, I used the CEA Registry data to explore the use of cost-effectiveness thresholds in the literature and the influence of analytic time horizon on cost-effectiveness results. Then in 2019, Peter asked me if I would be interested in leading the Registry program. He had a vision that someone could take the CEA Registry to the next level—to get more visibility and to make a bigger impact. Still, the Registry has a lot of room to improve, but getting to work on it has been an amazing opportunity.

RB: Do you have goals or a vision for what the Registry might look like in the future?

DK: The primary aims of the CEA Registry are to: 1) identify the best opportunities to improve health; 2) assist health care stakeholders in resource allocation decisions; and 3) move the field towards the use of standardized methodology. Although we have been working hard to achieve all three aims, one challenge is that the Registry was not optimally designed for a non-academic audience to use and understand the value-for-money evidence. For a lay person interested in the value of a new Alzheimer’s drug, for example, there is probably too much technical jargon, along with other barriers, in the Registry right now to use it to answer that question. Our team is currently undergoing a major redesign of the Registry focusing on enhancing usability with better data visualizations and summary statistics and on improving the quality and efficiency of the data collection process. I hope that the Registry becomes a go-to source to identify the value-for-money evidence for anyone who thinks about how to best use our limited resources.  

RB: What else are you working on right now?

DK: One major project in collaboration with researchers at the Tufts University Friedman School of Nutrition Science and Policy is to develop the Tufts Obesity, Diabetes, and Cardiovascular Disease Microsimulation (ODC-M) model. This model aims to project the US population’s health trajectory and to evaluate the health and economic impact of interventions to improve diet quality, particularly among people with comorbidities. Another project is to develop the Criteria for Health Economic Quality Evaluation (CHEQUE) Tool to improve methodology and reporting quality assessment for CEA. I’m also working on a project to understand variation in, and downstream consequences of, low-value health services, which provide no substantial benefits to patients and potentially lead to waste in our health care system.

RB: What are you most proud of in your career?

DK: This is a tough question. It’s probably the people that I have worked with. I’m proud of the junior researchers that I am privileged to mentor and to see them grow and the amazing colleagues and researchers that I have learned from. My mentors have helped me tremendously to navigate the academic jungle and to be a better researcher and human being. Among many people who have influenced me, I would specifically acknowledge three: Anirban Basu, who was my PhD advisor at University of Washington, Peter Neumann, who recruited me here at Tufts, and John Wong, with whom I have had countless unplanned conversations since the first day I arrived. I’m extremely grateful for their generous support, and I cherish all of the relationships I have built.

RB: What advice do you have for students or others who are new to health economics and outcomes research?

DK: I get similar questions from the CEA Registry Summer Fellows. Each summer, six Fellows spend eight weeks with us reading for the Registry, participating in trainings, and conducting their own research [Learn more about the Summer Fellows program and apply here]. My mantra is expect the best, prepare for the worst, and take whatever comes. And to borrow from Dr. Tony Fauci, it would also be to find a good mentor who cares about you, not just your work, and also to be a good mentor.

RB: I'm wondering if there's a memory from your time at CEVR that stands out to you.

DK:  CEVR has a big annual meeting every April, and at the end of the event one year I proposed that all of the CEVR faculty and staff take a selfie together. Throughout the year we all work on many different projects, but we come together for a common goal when we’re preparing for the annual meeting. Even though it's a simple group selfie, it kind of speaks to the process and what we're trying to accomplish.

RB: Where did you grow up?

DK: I grew up in South Korea. I was born in Buffalo, New York because my dad did his graduate study in the states, but when I was two years old, my dad got a job back in Korea so our family moved back there. When I was about to turn 18, my dad “voluntold” me (to borrow Josh Cohen’s term), “Why don't you go to the United States for your college education?” So, I came to the US in 2004 to start college at University of Michigan. I spent 8 years in Ann Arbor and met my wife there. After we got married, we moved to Seattle for my PhD training, and then we moved all the way across the US to Boston in 2016. My now 5-year-old twin girls were born two months after I started at Tufts.

RB: When you were a kid, what did you want to be when you grew up?

DK: When I was a kid, I loved a Korean drama called KAIST.  It was a story of love, agony, and research from the top minds in science. One of the characters was a young, creative professor who challenged conventional approaches to education. Because of the drama, I wanted to be a professor, but that dream got lost during busy school years. When I came to the US, some people suggested that I should be a doctor, so I tried, but it didn't go as planned. When I was offered this faculty position at CEVR, I realized that I would be fulfilling my childhood dream of being a professor. It's kind of amazing that there were lots of years in the middle when I didn't think about this as my dream, but here I am.

RB: What do you do when you're not doing health economics and outcomes research?

DK: In the past five years, my free time has been occupied with my family (a wife and five-year-old twin girls). The girls keep me and my wife very busy, but it’s so much fun and such a blessing to spend time with my family. Besides that, I like to hang out with my friends and have barbecues whenever Boston weather permits. I'm also a big fan of college football and a die-hard Michigan Wolverines supporter. And yes, we just defeated our archrival, that school down south, in the Game and won the Big Ten Championship (first time since I graduated). Peter sometimes texts me about the Michigan games.

Rachel Breslau is a research assistant at CEVR. She graduated from Tufts University in 2021 with a BA in Economics and Political Science.


Behind the scenes with David Kim: Assistant Professor and Program Director of the Tufts Cost-Effectiveness Analysis (CEA) Registry

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