About

Alfred Chen is an Assistant Professor at UC Irvine's Donald Bren School of Information & Computer Sciences, where he leads the AS^2Guard (Autonomous & Smart Systems Guard) research group. His research broadly focuses on the security and privacy of computer technologies that are of high criticality to daily life and society. He concentrates on security and privacy issues in emerging AI, systems, and network technologies, especially those with significant societal impacts such as AI-enabled autonomous vehicles and intelligent transportation systems. His major research theme involves proactively addressing security challenges through systematic problem analysis and design, utilizing techniques such as optimization, static and dynamic program analysis, formal methods, defense principles, and data-driven approaches. His work has developed methods to systematically discover, analyze, detect, and fix security vulnerabilities in a wide range of important computer systems and components, including AI and software stacks in autonomous cars, drones, robots, intelligent traffic lights, smartphone systems, critical network protocols like TCP and DNS, GUI systems, and access control systems.

Research topics

• Medicine
• Surgery
• Computer Science
• Medical physics
• Nuclear medicine
• Radiology
• Psychology
• Family medicine
• Pathology
• Library science
• Internal medicine

Selected publications

• Re-evaluating the access imperative in healthcare in the United States

  Journal of Public Health Policy · 2026-01-03 · 1 citations

  articleOpen access1st authorCorresponding

  Access to healthcare, defined by the Institute of Medicine as "the timely use of personal health services to achieve the best health outcome" represents one of the most critical issues facing modern societies. However, barriers to access are increasingly being recognized across all populations especially as the boundaries between technology, medicine, business, public health, and policy become blurred. Given that resource and infrastructural constraints have been well established to influence access, organizations have the responsibility to continually evaluate this concept in the context of inclusivity and social determinants of health. Ultimately, improving access requires thoughtful engagement from a myriad of stakeholders with the goal of prioritizing timely, equitable, personalized, and high-quality care, while empowering patients to take charge of their own health. While a profound challenge, the journey toward bridging the many gaps is just beginning, and how society re-defines the access imperative in healthcare in an ever-evolving landscape represents one of the foremost issues of the future. Indeed, the implications for society are tremendous given that access is central to quality of care, profoundly impacts the patient experience, and influences health outcomes. The purpose of this review is to outline the core issues that contribute to access focusing on barriers, social determinants, quality of care, and potential interventions.

  PublisherOA PDFDOI

• Epidemiological Trends in the Characterization of Human Papillomavirus Virus-Related Oropharyngeal Cancer: A Global Perspective

  Current Oncology Reports · 2025-08-20 · 4 citations

  reviewOpen access1st authorCorresponding

  PURPOSE OF REVIEW: The incidence of human papillomavirus (HPV)-positive oropharyngeal cancer has increased to epidemic-like proportions in the United States and other industrialized nations. However, geographical variations are notable across the world. While significant progress has been made in the understanding of this disease with respect to its etiology, underlying biology, and pathogenesis, numerous uncertainties persist. The purpose of this review is to thus present some of the controversies and questions surrounding this disease focusing on its unique epidemiology. A selected series of critical points were presented related to the epidemiology, pathogenesis, and diagnosis of HPV-positive oropharyngeal cancer. Interpretive viewpoints were provided after a comprehensive review of the literature. RECENT FINDINGS: HPV is now estimated to cause approximately 70% of oropharyngeal cancers in the United States and other developed countries. However, in developing countries, the incidence of HPV-positive oropharyngeal cancer is significantly lower. Data has also established that HPV-positive and HPV-negative oropharyngeal cancer represents distinct entities that generally originate in different settings. Since HPV-positive oropharyngeal cancer is increasingly being recognized as a sexually transmitted disease with unique modes of transmission, the epidemiological implications are of practical relevance. The resultant geographical variation in incidence rates among countries across the world is thus believed to be due to differing lifestyles and sexual norms. Although there is currently no role for screening, efforts to promote general awareness particularly among high-risk groups should be prioritized. The development of a novel staging system specific for patients with HPV-positive oropharyngeal cancer also has important ramifications with respect to treatment. HPV-positive oropharyngeal cancer is increasingly recognized as a public health problem with a unique worldwide geographical distribution. As the etiology of this disease is increasingly elucidated, efforts to promote awareness and education are warranted.

  PublisherOA PDFDOI

• Digital Disparities in Healthcare: A Tale of the Haves and Have-Nots?

  Journal of Patient Experience · 2025-05-21 · 2 citations

  articleOpen access1st authorCorresponding

  While the digitalization of healthcare and the advent of consumer-centered technologies have led to advancements in patient engagement, it is evident that certain, underprivileged segments of society might not be benefiting. The purpose of this review was to thus analyze the expanding data focusing on digital disparities in healthcare and was designed based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement. First, a literature search of original, peer-reviewed publications was undertaken to identify studies pertaining to disparities in the utilization of digital technologies in healthcare using a variety of customized retrieval terms. Articles published from January 2014 to January 2024 were included. Subsequently, a total of 247 peer-reviewed studies were identified which were used to construct a framework for interpretation. The core themes could broadly be categorized into digital health portals ( N = 74), telemedicine ( N = 57), healthcare wearables ( N = 49), digital intervention tools ( N = 35), and virtual education ( N = 32). While the potential of digital health to fundamentally transform the nature of patient-centric care is increasingly being recognized, the growing “digital divide” between the “haves” and “have-nots” with respect to nearly every facet of technology implementation raises concern regarding the perpetuation of inequities across society.

  PublisherDOI

• Lessons in leadership: Developing a longitudinal evidence‐based teaching curriculum on professionalism in healthcare

  Journal of Healthcare Risk Management · 2025-04-24 · 2 citations

  articleOpen access1st authorCorresponding

  Given the responsibility of healthcare organizations to promote positive workplace cultures, the development of appropriate teaching material focused on professionalism is of relevance. A longitudinal evidence-based educational curriculum was thus constructed to equip participants with tools to enhance team-based care and to create an inclusive, respectful environment. Core themes on which to center the curriculum were identified based on the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement. A MEDLINE search was undertaken to identify original peer-reviewed works using terms associated with professionalism in healthcare with the goal of building a foundational basis. Articles published from January 2014 to January 2024 and restricted to the English language were included. Based on the search results, a 12-month curriculum designed to promote workforce engagement and discussion was established. The 537 peer-reviewed publications selected to develop this thematic framework were broadly categorized as follows: ethics/accountability (N = 131); conflict resolution (N = 120); collaboration (N = 107); interpersonal communication (N = 70); empathy (N = 57); and wellness (N = 52). Between November 2023 and November 2024, a total of 12 sessions were scheduled. The feasibility of developing a standardized, evidence-based curriculum on workplace professionalism was demonstrated. The practical implications are discussed.

  PublisherOA PDFDOI

• Re‐Evaluating Access in Healthcare: Focus on Quality of Care

  Public Health Challenges · 2025-11-11 · 1 citations

  articleOpen access1st authorCorresponding

  The ability of patients to readily and seamlessly obtain healthcare services is a crucial element of high-quality medical care. Access-defined by the National Academy of Medicine as "the timely use of personal health services to achieve the best health outcome"-directly impacts individual and population health as efforts to optimize access inherently promote well-being and reduce disparities. The link between access and quality is so fundamental to the patient experience that they have become increasingly intertwined as a unified concept. However, due to the sheer complexity of the healthcare system, barriers to access are gradually being recognized as the boundaries among technology, medicine, business, public health, and policy become blurred. The contribution of many human elements, including those stemming from the provider-patient relationship, in optimizing access must also be recognized. Ultimately, improving access requires concerted engagement from a myriad of stakeholders with the goal of prioritizing timely, equitable, personalized, and high-quality care, while empowering patients to take charge of their own health. Although it presents a profound challenge, the journey toward bridging the many gaps is just beginning, and how society re-defines the access imperative in healthcare in an ever-evolving landscape represents one of the foremost issues of the future. This is because access is dependent on ensuring that high-quality, evidence-based healthcare resources are available for everyone. Indeed, the implications for society are tremendous given that access is central to quality of care, profoundly impacts the patient experience, and influences health outcomes. The purpose of this review is to outline the core issues that contribute to this paradigm while focusing on exploring the relationships between access and quality of care.

  PublisherOA PDFDOI

• De-escalation for Human Papillomavirus-Positive Oropharyngeal Cancer: A Look at the Prospective Evidence

  Current Oncology Reports · 2025-02-26 · 1 citations

  reviewOpen access1st authorCorresponding

  PURPOSE OF REVIEW: Although it is now firmly established that the presence of human papillomavirus (HPV) expression in oropharyngeal cancer is associated with a favorable prognosis, the implications with respect to treatment remain uncertain. However, the recognition that HPV-positive oropharyngeal cancer is exquisitely sensitive to radiation and chemotherapy has raised questions regarding the appropriateness of historical treatment paradigms, and clinical trials have been conducted to assess whether patients can be treated with less intensive regimens. The fundamental goal of de-escalation is to preserve the high rates of cure and survival from traditional approaches while reducing the incidence of both short- and long-term side effects. However, the data reporting on de-escalation is relatively limited. RECENT FINDINGS: While the evidence to date has been promising, the heterogeneity of the published studies particularly with trial design, de-escalation approach, inclusion criteria, and treatment selection has made drawing definitive conclusions difficult. The use of differing endpoints related to disease control and quality of life have also complicated the comparison of trials across the literature. Multiple uncertainties continue to exist with respect to the current state of de-escalation for HPV-positive oropharyngeal cancer, and how to consider the growing evidence in the context of clinical decision-making in the future is the subject of this review.

  PublisherOA PDFDOI

• Oligometastatic squamous cell carcinoma treated with and without involved site radiation

  Oral Oncology Reports · 2025-01-09

  articleOpen access1st authorCorresponding

  Comprising a heterogenous population, the optimal management of oligometastatic head and neck cancer is uncertain. We sought to report outcomes among patients treated with and without stereotactic body radiotherapy (SBRT) to local sites of disease. A review of institutional registries identified 49 patients with metastatic squamous cell carcinoma of the head and neck limited to 5 sites of disease or less. Patients with intact disease at primary local-regional sites; those treated by palliative radiation; and those who had previously received first-line systemic therapy were excluded. A total of 20 patients met eligibility criteria. Treatment included systemic therapy alone (10 patients) and systemic therapy with SBRT (10 patients). The median progression-free survival was 11 months and 6 months, respectively (p=0.09). The 2-year overall survival was 29% and 15% for patients treated by SBRT and systemic therapy compared to systemic therapy alone, respectively (p=0.21). There were no differences in the development of grade 3+ toxicity between the 2 groups, with the incidence of grade 3+ toxicity being 20% and 30% for patients treated with and without SBRT, respectively (p=0.61). Local SBRT was associated with trends in improved progression-free survival among patients with oligometastatic head and neck cancer. Prospective studies with larger datasets are warranted to further evaluate the role of this modality in this setting. • Significant variability exists in the management of oligometastatic head and neck cancer. • Local stereotactic body radiotherapy (SBRT) was associated with trends in improved progression-free survival among patients with oligometastatic head and neck cancer. • No difference in the incidence of acute toxicity was observed between patients treated with and without local SBRT.

  PublisherDOI

• Evidence‐based framework for the management of disruptive physician behavior

  Journal of Healthcare Risk Management · 2025-09-09 · 1 citations

  articleOpen access1st authorCorresponding

  The consistent promotion of a culture of respect and accountability in the workplace is vital to the success of healthcare organizations. However, the existing literature on practical strategies for addressing misconduct, particularly with respect to physician behavior, is relatively sparse. The aim of this review was to thus devise an evidence-based, empirical framework for the management and remediation of disruptive physician actions. Core themes on which to center the framework were initially identified based on the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement. A MEDLINE search was undertaken to identify original peer-reviewed works using terms associated with unprofessionalism with the goal of building a foundational basis. Articles published from January 2014 to March 2025 and restricted to the English language were included. Among the 1123 original articles that entered the final selection process, 1112 were excluded because they were focused solely on the characterization of disruptive behavior (n = 429); limited to trainees (n = 277), limited to ancillary staff (n = 150); concentrated on prevention (n = 148); and described consequences (n = 108). A total of 11 original publications thus met criteria for inclusion and differed in their design, methods, and endpoints. The core themes that emerged for framework construction were expectation setting (four studies); climate/organizational analysis (three studies); peer involvement (two studies); and professional training (two studies). The feasibility of developing an evidence-based framework to address disruptive physician behavior was demonstrated. The management implications specific to risk are discussed.

  PublisherOA PDFDOI

• Extra-capsular nodal extension after surgical resection for HPV-positive oropharyngeal Cancer: Adjuvant radiation versus chemoradiation

  American Journal of Otolaryngology · 2025-04-21 · 1 citations

  articleOpen access1st authorCorresponding

  PURPOSE: The prognostic significance of extra-capsular nodal extension (ECE) after surgical resection for human papillomavirus (HPV)-positive oropharyngeal cancer is controversial, and the optimal choice of adjuvant therapy is uncertain in this setting. METHODS AND MATERIALS: A review of institutional databases identified a total of 63 patients with pathological evidence of ECE in at least 1 cervical lymph node after transoral robotic surgery and neck dissection for HPV-positive squamous cell carcinoma of the oropharynx. Clinical outcomes were compared based on whether patients received adjuvant radiation (20 patients) or chemoradiation (43 patients). The Kaplan Meier method was used to determine survival statistics with comparisons between groups conducted with the log-rank test. RESULTS: With a median follow-up of 50 months (range, 6 to 110 months), the 3-year overall survival for the entire population was 87 %. No significant difference was observed between patients treated by adjuvant radiation and chemoradiation with respect to 3-year overall survival (86 % versus 87 %, p = 0.45), local-regional control (91 % vs. 90 %, p = 0.71), and progression-free survival (83 % vs. 85 %, p = 0.57). Exploratory subset analysis of competing variables failed to identify any group in which the addition of chemotherapy to radiation improved outcome. CONCLUSIONS: While the presence of ECE after surgical resection has historically been considered an indication for the use of concurrent chemoradiation in the adjuvant setting, these data suggest that this paradigm should be re-evaluated in the setting of HPV-positive oropharyngeal cancer.

  PublisherDOI

• LBA22 Patient-reported outcomes (PROs) with sacituzumab govitecan (SG) + pembrolizumab (pembro) vs chemotherapy (chemo) + pembro in patients (pts) with previously untreated PD-L1+ metastatic triple-negative breast cancer (mTNBC) in the phase III ASCENT-04/KEYNOTE-D19 study

  Annals of Oncology · 2025-09-01 · 2 citations

  articleOpen access
  PublisherOA PDFDOI

Frequent coauthors

• D. Gregory Farwell

  Hospital of the University of Pennsylvania

  54 shared

• James A. Purdy

  49 shared

• Megan E. Daly

  University of California, Davis

  48 shared

• Quang Luu

  27 shared

• Srinivasan Vijayakumar

  20 shared

• Derick Lau

  19 shared

• Paul J. Donald

  18 shared

• M. Kara Bucci

  17 shared

Awards & honors

• ICS Researchers Awarded Best Technical Poster at NDSS (2024)