About

Professor David D. Kim's fields of interest include Yiddish Language and Literature. The provided page text does not include additional biographical details, research background, or key contributions beyond his area of focus.

Research topics

• Medicine
• Surgery
• Internal medicine
• Computer Science
• Microbiology
• Composite material
• Crystallography
• Chemistry
• General surgery
• Intensive care medicine
• Nanotechnology
• Physical therapy
• Radiology
• Chemical physics
• Pediatrics
• Emergency medicine
• Materials science

Selected publications

• Analysis of Outcomes Associated With Outpatient Management of Nonoperatively Treated Patients With Appendicitis

  JAMA Network Open · 2022 · 49 citations

  • Medicine
  • Emergency medicine
  • Pediatrics

  <h3>Importance</h3> In the Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial, which found antibiotics to be noninferior, approximately half of participants randomized to receive antibiotics had outpatient management with hospital discharge within 24 hours. If outpatient management is safe, it could increase convenience and decrease health care use and costs. <h3>Objective</h3> To assess the use and safety of outpatient management of acute appendicitis. <h3>Design, Setting, and Participants</h3> This cohort study, which is a secondary analysis of the CODA trial, included 776 adults with imaging-confirmed appendicitis who received antibiotics at 25 US hospitals from May 1, 2016, to February 28, 2020. <h3>Exposures</h3> Participants randomized to antibiotics (intravenous then oral) could be discharged from the emergency department based on clinician judgment and prespecified criteria (hemodynamically stable, afebrile, oral intake tolerated, pain controlled, and follow-up confirmed). Outpatient management and hospitalization were defined as discharge within or after 24 hours, respectively. <h3>Main Outcomes and Measures</h3> Outcomes compared among patients receiving outpatient vs inpatient care included serious adverse events (SAEs), appendectomies, health care encounters, satisfaction, missed workdays at 7 days, and EuroQol 5-dimension (EQ-5D) score at 30 days. In addition, appendectomy incidence among outpatients and inpatients, unadjusted and adjusted for illness severity, was compared. <h3>Results</h3> Among 776 antibiotic-randomized participants, 42 (5.4%) underwent appendectomy within 24 hours and 8 (1.0%) did not receive their first antibiotic dose within 24 hours, leaving 726 (93.6%) comprising the study population (median age, 36 years; range, 18-86 years; 462 [63.6%] male; 437 [60.2%] White). Of these participants, 335 (46.1%; site range, 0-89.2%) were discharged within 24 hours, and 391 (53.9%) were discharged after 24 hours. Over 7 days, SAEs occurred in 0.9 (95% CI, 0.2-2.6) per 100 outpatients and 1.3 (95% CI, 0.4-2.9) per 100 inpatients; in the appendicolith subgroup, SAEs occurred in 2.3 (95% CI, 0.3-8.2) per 100 outpatients vs 2.8 (95% CI, 0.6-7.9) per 100 inpatients. During this period, appendectomy occurred in 9.9% (95% CI, 6.9%-13.7%) of outpatients and 14.1% (95% CI, 10.8%-18.0%) of inpatients; adjusted analysis demonstrated a similar difference in incidence (−4.0 percentage points; 95% CI, −8.7 to 0.6). At 30 days, appendectomies occurred in 12.6% (95% CI, 9.1%-16.7%) of outpatients and 19.0% (95% CI, 15.1%-23.4%) of inpatients. Outpatients missed fewer workdays (2.6 days; 95% CI, 2.3-2.9 days) than did inpatients (3.8 days; 95% CI, 3.4-4.3 days) and had similar frequency of return health care visits and high satisfaction and EQ-5D scores. <h3>Conclusions and Relevance</h3> These findings support that outpatient antibiotic management is safe for selected adults with acute appendicitis, with no greater risk of complications or appendectomy than hospital care, and should be included in shared decision-making discussions of patient preferences for outcomes associated with nonoperative and operative care. <h3>Trial Registration</h3> ClinicalTrials.gov Identifier:NCT02800785

  DOI

• Patient Factors Associated With Appendectomy Within 30 Days of Initiating Antibiotic Treatment for Appendicitis

  JAMA Surgery · 2022 · 64 citations

  • Medicine
  • General surgery
  • Intensive care medicine

  IMPORTANCE: Use of antibiotics for the treatment of appendicitis is safe and has been found to be noninferior to appendectomy based on self-reported health status at 30 days. Identifying patient characteristics associated with a greater likelihood of appendectomy within 30 days in those who initiate antibiotics could support more individualized decision-making. OBJECTIVE: To assess patient factors associated with undergoing appendectomy within 30 days of initiating antibiotics for appendicitis. DESIGN, SETTING, AND PARTICIPANTS: In this cohort study using data from the Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) randomized clinical trial, characteristics among patients who initiated antibiotics were compared between those who did and did not undergo appendectomy within 30 days. The study was conducted at 25 US medical centers; participants were enrolled between May 3, 2016, and February 5, 2020. A total of 1552 participants with acute appendicitis were randomized to antibiotics (776 participants) or appendectomy (776 participants). Data were analyzed from September 2020 to July 2021. EXPOSURES: Appendectomy vs antibiotics. MAIN OUTCOMES AND MEASURES: Conditional logistic regression models were fit to estimate associations between specific patient factors and the odds of undergoing appendectomy within 30 days after initiating antibiotics. A sensitivity analysis was performed excluding participants who underwent appendectomy within 30 days for nonclinical reasons. RESULTS: Of 776 participants initiating antibiotics (mean [SD] age, 38.3 [13.4] years; 286 [37%] women and 490 [63%] men), 735 participants had 30-day outcomes, including 154 participants (21%) who underwent appendectomy within 30 days. After adjustment for other factors, female sex (odds ratio [OR], 1.53; 95% CI, 1.01-2.31), radiographic finding of wider appendiceal diameter (OR per 1-mm increase, 1.09; 95% CI, 1.00-1.18), and presence of appendicolith (OR, 1.99; 95% CI, 1.28-3.10) were associated with increased odds of undergoing appendectomy within 30 days. Characteristics that are often associated with increased risk of complications (eg, advanced age, comorbid conditions) and those clinicians often use to describe appendicitis severity (eg, fever: OR, 1.28; 95% CI, 0.82-1.98) were not associated with odds of 30-day appendectomy. The sensitivity analysis limited to appendectomies performed for clinical reasons provided similar results regarding appendicolith (adjusted OR, 2.41; 95% CI, 1.49-3.91). CONCLUSIONS AND RELEVANCE: This cohort study found that presence of an appendicolith was associated with a nearly 2-fold increased risk of undergoing appendectomy within 30 days of initiating antibiotics. Clinical characteristics often used to describe severity of appendicitis were not associated with odds of 30-day appendectomy. This information may help guide more individualized decision-making for people with appendicitis.

  DOI

• Self-selection vs Randomized Assignment of Treatment for Appendicitis

  JAMA Surgery · 2022 · 30 citations

  • Medicine
  • Internal medicine
  • Physical therapy

  Importance: For adults with appendicitis, several randomized clinical trials have demonstrated that antibiotics are an effective alternative to appendectomy. However, it remains unknown how the characteristics of patients in such trials compare with those of patients who select their treatment and whether outcomes differ. Objective: To compare participants in the Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) randomized clinical trial (RCT) with a parallel cohort study of participants who declined randomization and self-selected treatment. Design, Setting, and Participants: The CODA trial was conducted in 25 US medical centers. Participants were enrolled between May 3, 2016, and February 5, 2020; all participants were eligible for at least 1 year of follow-up, with all follow-up ending in 2021. The randomized cohort included 1094 adults with appendicitis; the self-selection cohort included patients who declined participation in the randomized group, of whom 253 selected appendectomy and 257 selected antibiotics. In this secondary analysis, characteristics and outcomes in both self-selection and randomized cohorts are described with an exploratory analysis of cohort status and receipt of appendectomy. Interventions: Appendectomy vs antibiotics. Main Outcomes and Measures: Characteristics among participants randomized to either appendectomy or antibiotics were compared with those of participants who selected their own treatment. Results: Clinical characteristics were similar across the self-selection cohort (510 patients; mean age, 35.8 years [95% CI, 34.5-37.1]; 218 female [43%; 95% CI, 39%-47%]) and the randomized group (1094 patients; mean age, 38.2 years [95% CI, 37.4-39.0]; 386 female [35%; 95% CI, 33%-38%]). Compared with the randomized group, those in the self-selection cohort were less often Spanish speaking (n = 99 [19%; 95% CI, 16%-23%] vs n = 336 [31%; 95% CI, 28%-34%]), reported more formal education (some college or more, n = 355 [72%; 95% CI, 68%-76%] vs n = 674 [63%; 95% CI, 60%-65%]), and more often had commercial insurance (n = 259 [53%; 95% CI, 48%-57%] vs n = 486 [45%; 95% CI, 42%-48%]). Most outcomes were similar between the self-selection and randomized cohorts. The number of patients undergoing appendectomy by 30 days was 38 (15.3%; 95% CI, 10.7%-19.7%) among those selecting antibiotics and 155 (19.2%; 95% CI, 15.9%-22.5%) in those who were randomized to antibiotics (difference, 3.9%; 95% CI, -1.7% to 9.5%). Differences in the rate of appendectomy were primarily observed in the non-appendicolith subgroup. Conclusions and Relevance: This secondary analysis of the CODA RCT found substantially similar outcomes across the randomized and self-selection cohorts, suggesting that the randomized trial results are generalizable to the community at large. Trial Registration: ClinicalTrials.gov Identifier: NCT02800785.

  DOI

• Determining the three-dimensional atomic structure of a metallic glass

  Nature · 2020 · 405 citations

  • Computer Science
  • Materials science
  • Chemical physics

  Amorphous solids such as glass are ubiquitous in our daily life and have found broad applications ranging from window glass and solar cells to telecommunications and transformer cores. However, due to the lack of long-range order, the three-dimensional (3D) atomic structure of amorphous solids have thus far defied any direct experimental determination without model fitting. Here, using a multi-component metallic glass as a proof-of-principle, we advance atomic electron tomography to determine the 3D atomic positions in an amorphous solid for the first time. We quantitatively characterize the short-range order (SRO) and medium-range order (MRO) of the 3D atomic arrangement. We find that although the 3D atomic packing of the SRO is geometrically disordered, some SRO connect with each other to form crystal-like networks and give rise to MRO. We identify four crystal-like MRO networks - face-centred cubic, hexagonal close-packed, body-centered cubic and simple cubic - coexisting in the sample, which show translational but no orientational order. These observations confirm that the 3D atomic structure in some parts of the sample is consistent with the efficient cluster packing model. Looking forward, we anticipate this experiment will open the door to determining the 3D atomic coordinates of various amorphous solids, whose impact on non-crystalline solids may be comparable to the first 3D crystal structure solved by x-ray crystallography over a century ago.

  DOI

• Preperitoneal packing for pelvic fracture-associated hemorrhage: A systematic review, meta-analysis, and practice management guideline from the Eastern Association for the Surgery of Trauma

  The American Journal of Surgery · 2020 · 21 citations

  • Medicine
  • Surgery
  • Radiology
  PublisherDOI

Frequent coauthors

• Bishwajit Bhattacharya

  Yale New Haven Hospital

  465 shared

• John J. Como

  Case Western Reserve University

  426 shared

• George Kasotakis

  Memorial Hermann

  421 shared

• Bryce R. H. Robinson

  University of California, San Francisco

  420 shared

• Caleb J. Mentzer

  Mount Sinai Hospital

  418 shared

• Edgardo S. Salcedo

  California State University, Sacramento

  416 shared

• Rondi B. Gelbard

  University of Alabama at Birmingham

  416 shared

• Stephen Gondek

  Vanderbilt University Medical Center

  416 shared

Education

• Behavioral Neurology and Neuropsychiatry Fellowship, Psychiatry

  Harvard Medical School

• Resident, Clinical Neurological Sciences

  Western University

• MD, Medicine

  McMaster University Michael G DeGroote School of Medicine

  2015

• Bachelor of Medical Sciences

  Western University

  2012

Awards & honors

• Gold Shield Faculty Prize (2023-24)
• Humboldt Research Fellowship for Experienced Researchers (Fa…
• ACLS Fellowship (2020-21)
• The UCLA Academic Senate Distinguished Teaching Award, Unive…
• The Volkswagen Foundation Interdisciplinary Symposium Award…

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