Bio

Clinical Focus


  • Critical Care
  • Pulmonary Disease

Academic Appointments


Administrative Appointments


  • Co-Director - Pulmonary and Critical Care Grand Rounds, Stanford University (2013 - Present)
  • Associate - Center for Health Policy and Center for Primary Care Outcomes Research, Stanford University (2008 - Present)
  • Co-Director - Pulmonary and Critical Care Journal Club, Stanford University (2008 - Present)

Honors & Awards


  • Mentored Clinical Scientist National Research Award (K08), Agency for Healthcare Research and Quality (AHRQ) (2012 - 2017)
  • Ruth L. Kirschstein National Research Service Award (F32), Agency for Healthcare Research and Quality (AHRQ) (2008 - 2010)
  • Helena Anna Henzl Gabor Young Women in Science Award, Stanford University (2007)
  • Resident Award for Excellence in Teaching, Northwestern University (2001, 2002, 2003)
  • Phi Beta Kappa, University of California, San Diego (1995)
  • Magna Cum Laude, University of California, San Diego (1996)
  • Regents Scholar, University of California, San Diego (1994-1996)
  • Highest Departmental Honors, University of California, San Diego (1996)

Professional Education


  • Fellowship:Stanford University School of Medicine (2008) CA
  • Medical Education:Georgetown University (2001) DC
  • Residency:Feinberg School of Medicine - Northwestern University (2004) IL
  • Board Certification: Critical Care Medicine, American Board of Internal Medicine (2008)
  • Board Certification: Pulmonary Disease, American Board of Internal Medicine (2007)
  • Board Certification: Internal Medicine, American Board of Internal Medicine (2004)
  • Fellowship:Yale School of Medicine (2006) CT
  • Internship:Feinberg School of Medicine - Northwestern University (2002) IL

Research & Scholarship

Current Research and Scholarly Interests


I have a fantastic research team and we love working together :) My lab uses mathematical modeling, decision analysis, prognostic modeling, multivariate logistic regression, cost-effectiveness analysis, and meta-analysis to examine pandemic Influenza. We collaborate with colleagues in the Center for Health Policy / Center for Primary Care and Outcomes Research (CHP-PCOR) and Department of Management Science and Engineering at Stanford, the School of Public Health at the University of Michigan, and the U.S. Centers for Disease Control and Prevention (CDC) to examine and design pandemic influenza mitigation strategies.

Teaching

2013-14 Courses


Graduate and Fellowship Programs


Publications

Journal Articles


  • Long-term Marijuana Use and Pulmonary Function JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Patel, R. B., Khazeni, N. 2012; 307 (17): 1796-1796

    View details for Web of Science ID 000303386800010

    View details for PubMedID 22550189

  • Rifaximin for Irritable Bowel Syndrome without Constipation NEW ENGLAND JOURNAL OF MEDICINE Khazeni, N., Perlroth, D. 2011; 364 (15): 1467-1468

    View details for Web of Science ID 000289467200016

    View details for PubMedID 21488770

  • Diagnostic Strategy for Hematology and Oncology Patients with Acute Respiratory Failure AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE Gohil, A., Khazeni, N. 2011; 183 (2): 279-279

    View details for Web of Science ID 000286644000023

    View details for PubMedID 21242597

  • Effectiveness and Cost-Effectiveness of Expanded Antiviral Prophylaxis and Adjuvanted Vaccination Strategies for an Influenza A (H5N1) Pandemic ANNALS OF INTERNAL MEDICINE Khazeni, N., Hutton, D. W., Garber, A. M., Owens, D. K. 2009; 151 (12): 840-U3

    Abstract

    The pandemic potential of influenza A (H5N1) virus is a prominent public health concern of the 21st century.To estimate the effectiveness and cost-effectiveness of alternative pandemic (H5N1) mitigation and response strategies.Compartmental epidemic model in conjunction with a Markov model of disease progression.Literature and expert opinion.Residents of a U.S. metropolitan city with a population of 8.3 million.Lifetime.Societal.3 scenarios: 1) vaccination and antiviral pharmacotherapy in quantities similar to those currently available in the U.S. stockpile (stockpiled strategy), 2) stockpiled strategy but with expanded distribution of antiviral agents (expanded prophylaxis strategy), and 3) stockpiled strategy but with adjuvanted vaccine (expanded vaccination strategy). All scenarios assumed standard nonpharmaceutical interventions.Infections and deaths averted, costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness.Expanded vaccination was the most effective and cost-effective of the 3 strategies, averting 68% of infections and deaths and gaining 404 030 QALYs at $10 844 per QALY gained relative to the stockpiled strategy.Expanded vaccination remained incrementally cost-effective over a wide range of assumptions.The model assumed homogenous mixing of cases and contacts; heterogeneous mixing would result in faster initial spread, followed by slower spread. We did not model interventions for children or older adults; the model is not designed to target interventions to specific groups.Expanded adjuvanted vaccination is an effective and cost-effective mitigation strategy for an influenza A (H5N1) pandemic. Expanded antiviral prophylaxis can help delay the pandemic while additional strategies are implemented.National Institutes of Health and Agency for Healthcare Research and Quality.

    View details for Web of Science ID 000272728900002

    View details for PubMedID 20008760

  • Effectiveness and Cost-Effectiveness of Vaccination Against Pandemic Influenza (H1N1) 2009 ANNALS OF INTERNAL MEDICINE Khazeni, N., Hutton, D. W., Garber, A. M., Hupert, N., Owens, D. K. 2009; 151 (12): 829-U2

    Abstract

    Decisions on the timing and extent of vaccination against pandemic (H1N1) 2009 virus are complex.To estimate the effectiveness and cost-effectiveness of pandemic influenza (H1N1) vaccination under different scenarios in October or November 2009.Compartmental epidemic model in conjunction with a Markov model of disease progression.Literature and expert opinion.Residents of a major U.S. metropolitan city with a population of 8.3 million.Lifetime.Societal.Vaccination in mid-October or mid-November 2009.Infections and deaths averted, costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness.Assuming each primary infection causes 1.5 secondary infections, vaccinating 40% of the population in October or November would be cost-saving. Vaccination in October would avert 2051 deaths, gain 69 679 QALYs, and save $469 million compared with no vaccination; vaccination in November would avert 1468 deaths, gain 49 422 QALYs, and save $302 million.Vaccination is even more cost-saving if longer incubation periods, lower rates of infectiousness, or increased implementation of nonpharmaceutical interventions delay time to the peak of the pandemic. Vaccination saves fewer lives and is less cost-effective if the epidemic peaks earlier than mid-October.The model assumed homogenous mixing of case-patients and contacts; heterogeneous mixing would result in faster initial spread, followed by slower spread. Additional costs and savings not included in the model would make vaccination more cost-saving.Earlier vaccination against pandemic (H1N1) 2009 prevents more deaths and is more cost-saving. Complete population coverage is not necessary to reduce the viral reproductive rate sufficiently to help shorten the pandemic.Agency for Healthcare Research and Quality and National Institute on Drug Abuse.

    View details for Web of Science ID 000272728900001

    View details for PubMedID 20008759

  • Systematic Review: Safety and Efficacy of Extended-Duration Antiviral Chemoprophylaxis Against Pandemic and Seasonal Influenza ANNALS OF INTERNAL MEDICINE Khazeni, N., Bravata, D. M., Holty, J. C., Uyeki, T. M., Stave, C. D., Gould, M. K. 2009; 151 (7): 464-W159

    Abstract

    Neuraminidase inhibitors (NAIs) are stockpiled internationally for extended use in an influenza pandemic.To evaluate the safety and efficacy of extended-duration (>4 weeks) NAI chemoprophylaxis against influenza.Studies published in any language through 11 June 2009 identified by searching 10 electronic databases and 3 trial registries.Randomized, placebo-controlled, double-blind human trials of extended-duration NAI chemoprophylaxis that reported outcomes of laboratory-confirmed influenza or adverse events.2 reviewers independently assessed study quality and abstracted information from eligible studies.Of 1876 potentially relevant citations, 7 trials involving 7021 unique participants met inclusion criteria. Data were pooled by using random-effects models. Chemoprophylaxis with NAIs decreased the frequency of symptomatic influenza (relative risk [RR], 0.26 [95% CI, 0.18 to 0.37]; risk difference [RD], -3.9 percentage points [CI, -5.8 to -1.9 percentage points]) but not asymptomatic influenza (RR, 1.03 [CI, 0.81 to 1.30]; RD, -0.4 percentage point [CI, -1.6 to 0.9 percentage point]). Adverse effects were not increased overall among NAI recipients (RR, 1.01 [CI, 0.94 to 1.08]; RD, 0.1 percentage point [CI, -0.2 to 0.4 percentage point]), but nausea and vomiting were more common among those who took oseltamivir (RR, 1.48 [CI, 1.86 to 2.33]; RD, 1.7 percentage points [CI, 0.6 to 2.9 percentage points]). Prevention of influenza did not statistically significantly differ between zanamivir and oseltamivir.All trials were industry-sponsored. No study was powered to detect rare adverse events, and none included diverse racial groups, children, immunocompromised patients, or individuals who received live attenuated influenza virus vaccine.Extended-duration zanamivir and oseltamivir chemoprophylaxis seems to be highly efficacious for preventing symptomatic influenza among immunocompetent white and Japanese adults. Extended-duration oseltamivir is associated with increased nausea and vomiting. Safety and efficacy in several subpopulations that might receive extended-duration influenza chemoprophylaxis are unknown.

    View details for Web of Science ID 000270470500004

    View details for PubMedID 19652173

  • Does Itraconazole Improve Quality of Life in Severe Asthma with Fungal Sensitization? AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE Khazeni, N., Levitt, J. E. 2009; 180 (2): 191-192

    View details for Web of Science ID 000268112500021

    View details for PubMedID 19578143

  • Quality Improvement Strategies for Children With Asthma A Systematic Review ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Bravata, D. M., Gienger, A. L., Holty, J. C., Sundaram, V., Khazeni, N., Wise, P. H., McDonald, K. M., Owens, D. K. 2009; 163 (6): E1-E5
  • Quality Improvement Strategies for Children With Asthma A Systematic Review ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE Bravata, D. M., Gienger, A. L., Holty, J. C., Sundaram, V., Khazeni, N., Wise, P. H., McDonald, K. M., Owens, D. K. 2009; 163 (6): 572-581

    Abstract

    To evaluate the evidence that quality improvement (QI) strategies can improve the processes and outcomes of outpatient pediatric asthma care.Cochrane Effective Practice and Organisation of Care Group database (January 1966 to April 2006), MEDLINE (January 1966 to April 2006), Cochrane Consumers and Communication Group database (January 1966 to May 2006), and bibliographies of retrieved articles.Randomized controlled trials, controlled before-after trials, or interrupted time series trials of English-language QI evaluations.Must have included 1 or more QI strategies for the outpatient management of children with asthma.Clinical status (eg, spirometric measures); functional status (eg, days lost from school); and health services use (eg, hospital admissions).Seventy-nine studies met inclusion criteria: 69 included at least some component of patient education, self-monitoring, or self-management; 13 included some component of organizational change; and 7 included provider education. Self-management interventions increased symptom-free days by approximately 10 days/y (P = .02) and reduced school absenteeism by about 0.1 day/mo (P = .03). Interventions of provider education and those that incorporated organizational changes were likely to report improvements in medication use. Quality improvement interventions that provided multiple educational sessions, had longer durations, and used combinations of instructional modalities were more likely to result in improvements for patients than interventions lacking these characteristics.A variety of QI interventions improve the outcomes and processes of care for children with asthma. Use of similar outcome measures and thorough descriptions of interventions would advance the study of QI for pediatric asthma care.

    View details for Web of Science ID 000266566700011

    View details for PubMedID 19487615

  • Does statin use attenuate lung function decline? AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE Khazeni, N., Kuschner, W. G., Gould, M. K. 2008; 177 (6): 671-671

    View details for Web of Science ID 000253852000021

    View details for PubMedID 18316773

  • Vaccine for an Insidious Virus San Francisco Chronicle Sunday Magazine Khazeni N 2008; June 22
  • Vaccine News You Need San Francisco Chronicle Sunday Magazine Khazeni N 2008; Feb. 3
  • Before You Pop That Viagra, Read This San Francisco Chronicle Sunday Magazine Khazeni N 2008; April 20
  • Cultivating the Follicle San Francisco Chronicle Sunday Magazine Khazeni N 2008; Jan. 13
  • HPV Vaccine Has Multiple Benefits Stanford Medicine News Khazeni N 2008: 7
  • Popping the Placebo Effect San Francisco Chronicle Sunday Magazine Khazeni N 2008; March 23
  • The Mammography Maze San Francisco Chronicle Sunday Magazine Khazeni N 2008; May 25
  • The Risks of Scanning San Francisco Chronicle Sunday Magazine Khazeni N 2008; Feb. 17
  • Dangerous Combinations San Francisco Chronicle Sunday Magazine Khazeni N 2008; March 2
  • Chasing the Elusive Cold San Francisco Chronicle Sunday Magazine Khazeni N 2007; July 29
  • Jetting Without the Lag San Francisco Chronicle Sunday Magazine Khazeni N 2007; July 7
  • Keeping Lungs Young San Francisco Chronicle Sunday Magazine Khazeni N 2007; Sept. 23
  • Smells Fishy--But That's Good! San Francisco Chronicle Sunday Magazine Khazeni N 2007; Aug. 19
  • Seeing Into the Future San Francisco Chronicle Sunday Magazine Khazeni N 2007; Nov. 4
  • A Crisis of Great Magnitude San Francisco Chronicle Sunday Magazine Khazeni N 2007; Aug. 26
  • A Lousy Infection San Francisco Chronicle Sunday Magazine Khazeni N 2007; Oct. 7
  • When Traveling, Get Out of Your Seat! San Francisco Chronicle Sunday Magazine Khazeni N 2007; Aug. 12
  • Shooting Back the Flu San Francisco Chronicle Sunday Magazine Khazeni N 2007; Oct. 14
  • Outrunning the Blues San Francisco Chronicle Sunday Magazine Khazeni N 2007; June 24
  • A Nap a Day San Francisco Chronicle Sunday Magazine Khazeni N 2007; June 17
  • In the End, the Choice is Yours San Francisco Chronicle Sunday Magazine Khazeni N 2007; Dec. 9
  • Massive cavitary pulmonary rheumatoid nodules in a patient with HIV EUROPEAN RESPIRATORY JOURNAL Khazeni, N., Homer, R. J., Rubinowitz, A. N., Chupp, G. L. 2006; 28 (4): 872-874

    Abstract

    The case of a 52-yr-old female with rheumatoid arthritis and HIV who developed massive, progressive, cavitary pulmonary nodules is described. Multiple diagnostic bronchoscopies and lung biopsies failed to demonstrate the presence of any microorganisms. Pathological analysis showed palisading histiocytes with necrobiosis consistent with rheumatoid nodules. The effect of co-existing HIV infection on the course and prognosis of rheumatoid arthritis is discussed, and it is concluded that the complex relationship between these two disease processes warrants further investigation.

    View details for DOI 10.1183/09031936.06.00144105

    View details for Web of Science ID 000241345000029

    View details for PubMedID 17012633

  • Morbidity, mortality and sleep-disordered breathing in community dwelling elderly SLEEP ANCOLIISRAEL, S., Kripke, D. F., Klauber, M. R., Fell, R., Stepnowsky, C., ESTLINE, E., Khazeni, N., Chinn, A. 1996; 19 (4): 277-282

    Abstract

    A population-based probability sample of elderly individuals (n = 426), who were originally studied between 1981 and 1986 (mean age at initial study was 72.5 years), were followed for mortality. Those with > or = 30 respiratory disturbances per hour of sleep had significantly shorter survival (p = 0.0034), but the respiratory disturbance index (RDI) was not an independent predictor of death. When Cox proportional hazards analysis was done, only age (the strongest predictor), cardiovascular disease and pulmonary disease were independent predictors of death. It may be that factors that are secondary to or associated with sleep-disordered breathing (SDB), such as cardiovascular or pulmonary disease, predispose these elderly to death.

    View details for Web of Science ID A1996UP60500002

    View details for PubMedID 8776783

Stanford Medicine Resources: