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Brennan Spiegel

Professor-in-Residence, UCLA
Director of Health Services Research, Cedars-Sinai Health System
Director, Cedars-Sinai Center for Outcomes Research and Education (CS-CORE)


DepartmentsType of Faculty
Health Policy and ManagementPart Time
Contact Information

UCLA/VA Center for Outcomes Research and Education (CORE)
11301 Wilshire Blvd
Building 115, Room 215
Los Angeles, California

Areas of Interest: 
  • Decision analysis / healthcare decision making
  • Cost-effectiveness analysis
  • Patient reported outcomes (PROs)
  • Clinical trial design
  • Patient-provider portals / electronic health records (EHRs)
  • Social media in healthcare 
  • Wireless healthcare technologies
  • Colon cancer screening
  • Managing chronic diseases
  • Gastrointestinal disorders      
  • Developing quality indicators (QIs)
  • Threat detection

Brennan Spiegel, MD, MSHS, is director of Health Services Research for Cedars-Sinai and Professor of Medicine and Public Health at UCLA. He directs the Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), a multidisciplinary team that investigates how digital health technologies; including wearable biosensors, smartphone applications, virtual reality (VR) and social media; can strengthen the patient-doctor bond, improve outcomes and save money. CS-CORE unites clinicians, computer scientists, engineers, statisticians and health services researchers to invent, test and implement digital innovations, always focusing on the value of technology to patients and their providers. His team developed one of largest and most widely-documented medical VR programs at Cedars-Sinai, and his work has helped to support a new field of medicine called Medical Extended Reality, in which doctors use immersive technologies like VR to help treat conditions ranging from pain, to anxiety and depression, to irritable bowel syndrome.

Spiegel has published numerous best-selling medical textbooks, editorials and more than 230 articles in peer-reviewed journals. He is listed in the Onalytica "Top 100 Influencer" lists for digital health and virtual reality. His digital health research has been featured by major media outlets, including Bloomberg, CBS News, Forbes, Huffington Post, LA Times, NBC News, Reuters, The Washington Post, and the Wall Street Journal. Dr. Spiegel published the book "How Immersive Therapeutics Will Revolutionize Medicine" (Basic Books, NY, NY), which was named by Wired Magazine as one of its top 8 science books of 2020.

Beyond his focus on digital health innovations, Spiegel conducts psychometric, health-economic, epidemiologic and qualitative research across a wide range of healthcare topics. His research team has received funding from the National Institutes of Health, Robert Wood Johnson Foundation, Hearst Foundation, State of California Precision Medicine Program, PCORI, Veterans Administration and industry sources. Spiegel is editor-in-chief of the American Journal of Gastroenterology, the leading clinical gastroenterology journal in North America. He was among the first group of clinical researchers to examine the gastrointestinal manifestations of COVID-19. He continues to practice clinical medicine and maintains an academic teaching practice at Cedars-Sinai. A prolific speaker, Spiegel is frequently invited to present on his areas of expertise at national and international events.

Dr. Spiegel earned his bachelor's degree from Tufts University, his medical degree from New York Medical College where he received Alpha Omega Alpha honors, and his master's from the University of California, Los Angeles Fielding School of Public Health. He completed his residency in internal medicine at Cedars-Sinai and his fellowship at UCLA Medical Center.

MD, New York Medical College
BS, Philosophy and Community Health, Tufts University
Selected Courses: 
HPM 239A: Decision Analysis and Cost-Effectiveness Analysis
HPM 239B: Advanced Topics in Decision Analysis and Cost-Effectiveness Analysis
HPM 441: Health Analytics: Identifying, Collecting, and Analyzing Big Data in Healthcare
Selected Publications: 

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 [with editorial]  

 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. [with editorial] [113 citations]

 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.

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.

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.

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.

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.

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. 

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 BMRThe 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.

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 Endoscopy2007;66:679-92 [

Huang E, Esrailian E, Spiegel BMRThe cost-effectiveness of competing therapies for hepatic encephalopathy: a decision analysis. Alimentary Pharmacology and Therapeutics. 2007;26:1147-61.

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 

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 [Epub ahead of print]

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.

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. [157 citations]

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.  

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]

Spiegel BM, 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

Desai A, Farid M, Singh I, van Oijen MGH, Esrailian E, Solomon MD, Spiegel BM.  The relationship between laboratory-based outcomes and mortality in end-stage renal disease: a systematic review.  Hemodialysis International 2009[Epub ahead of print]

Spiegel BM, 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. 2009 Dec [Epub ahead of print]

Spiegel BM, Camilleri M, Bolus R, Andresen V, Chey WD, Fehnel S, Mangel A, Talley NJ, Whitehead WE.  Psychometric evaluation of endpoints in IBS randomized controlled trials: a Rome Foundation Working Group report.  Gastroenterology [Epub ahead of print]

Weinberg B, Spiegel BM, Tomlinson J, Farrel J.  Asymptomatic Pancreatic cysts: maximizing survival and quality of life using Markov-based clinical nomograms.  Gastroenterology. 2010

Spiegel BM, 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 expertsAm J Gastroenterol. 2010 Apr;105(4):848-58. Epub 2010 Mar 2.

Spiegel BM, 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. Am J Kidney Dis. 2010 May 19. [Epub ahead of print]

Kanwal F, Barkun A, Gralnek IM, Asch SM, Kuipers EJ, Bardou M, Sung J, Enns R, Agreus L, Armstrong D, Spiegel BM.  Measuring quality of care in patients with nonvariceal upper gastrointestinal hemorrhage: development of an explicit quality indicator set.  Am J Gastroenterol 2010;105:1710-8  

Spiegel BM, Roberts L, Mody R, Harding G, Kothari-Talwar S, Kahrilas PJ, Camilleri ML, Dabbous O, Revicki DA.  The Development and validation of a Nocturnal Gastro-oesophageal Reflux Disease Symptom Severity and Impact Questioninaire for adults.  Aliment Pharmacol The 2010;32:591-602  

Spiegel BM, 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 facilities with below versus above-average mortality.  Am J Kidney Dis. 2010; 56:86-94.

Spiegel BM, Bolus R, Harris L, Lucak S, Mayer E, Naliboff B, Esrailian E, Chey WD, Lembo A, Karsan H, Tillisch K, Dulai G, Talley J, Chang L.  Characterizing abdominal pain attributes in IBS: guidance for study inclusion and outcome assessment.  Aliment Pharmcol Ther 2010 Nov; 32(9):1192-202

Spiegel BM, Bolus R, Agarwal N, Harris L, Lucak S, Sayuk G, Esrailian E, Chey WD, Lembo A, Karsan H, Tillisch K, Dulai G, Talley J, Chang L.  Measuring symptoms in irritable bowel syndrome: development of a framework for clinical trials.  Aliment Pharmacol Ther 2010 Nov;32(10):1275-91.

Kaneshiro M, Ho A, Chan M, Cohen H, Spiegel BM.  Colonoscopy yields fewer polyps as the day progresses despite using social influence theory to reverse the trend.  Gastrointest Endosc 2010;72:1233-40.

Chan M; Cohen H; Spiegel BM. Colonoscopy yields fewer polyps as the day progresses: Experience in a Veteran Administration teaching hospital. Clinical Gastroenterology and Hepatology [Epub ahead of print] 2010 Dec 

Spiegel BMR, Talley J, Shekelle P, Bolus R, Kurzbard N, Chan M, Ho A, Kaneshiro M, Cordasco K, Cohen H.  Development and validation of a novel patient educational booklet to enhance colonoscopy preparation.  Am J Gastroenterol. 2011 May; 106(5):875-83.

Solomon M, Bonafede M, Pan K, Wilson K, Beam C, Chakravarti P, Spiegel B.  Direct medical care costs among pegylated infereron plus ribavirin-treated and untreated chronic hepatitis C patients.  Dig Dis Sci 2011 Jun 30 [Epub ahead of print].

Huang ES, Karsan S, Kanwal F, Singh I, Makhani M, Spiegel BM. Impact ofnasogastric lavage on outcomes in acute GI bleeding. Gastrointest Endosc. 2011Jul 6.

Foster T, Hon H, Kanwal F, Han S, Spiegel B.  Screening for high risk individuals for hepatitis B: physician knowledge, attitudes, and beliefs. Dig Dis Sci 2011; 56:3471-87.

Wang HS, Pisegna J, Modi R, Liang LJ, Atia M, Nguyen M, Cohen H, Ohning G, van Oijen M, Spiegel BM. Adenoma detection rate is necessary but insufficient for distinguishing high versus low endoscopist performance. Gastrointest Endosc. 2013 Jan;77(1):71-78.

Whitman CB, Shreay S, Gitlin M, van Oijen MG, Spiegel BM. Clinical Factors and the Decision to Transfuse Chronic Dialysis Patients. Clin J Am Soc Nephrol. 2013 Aug 8.

Shahedi K, Fuller G, Bolus R, Cohen E, Vu M, Shah R, Agarwal N, Kaneshiro M, Atia M, Sheen V, Kurzbard N, van Oijen MG, Yen L, Hodgkins P, Erder MH, Spiegel B. Long-term Risk of Acute Diverticulitis Among Patients With Incidental Diverticulosis Found During Colonoscopy. Clin Gastroenterol Hepatol. 2013 Jul 12.

 Spiegel BM. Patient-reported outcomes in gastroenterology: clinical and research applications. J Neurogastroenterol Motil. 2013 Apr;19(2):137-48.

Cohen E, Fuller G, Bolus R, Modi R, Vu M, Shahedi K, Shah R, Atia M, Kurzbard  N, Sheen V, Agarwal N, Kaneshiro M, Yen L, Hodgkins P, Erder MH, Spiegel B. Increased Risk for Irritable Bowel Syndrome After Acute Diverticulitis. Clin Gastroenterol Hepatol. 2013 Mar 21

 Spiegel B. Polarizing or paralyzing? Moving forward with patient reported outcome measurement in irritable bowel syndrome. Rev Gastroenterol Mex. 2013;78(1):1-4.