Physician Investigator (NonCl) General Internal Medicine, Mass General Research Institute

Physician (Non-Clinical) Medicine-General Internal Medicine, Massachusetts General Hospital

Professor of Medicine Harvard Medical School

MD Harvard Medical School 1974

anticoagulants; atrial fibrillation; brain ischemia; cerebrovascular disorders; hemorrhage; international normalized ratio; pneumonia; stroke; thromboembolism; warfarin

Dr. Daniel E. Singer, MD, is a professor of medicine at Harvard Medical School and also professor in the Department of Epidemiology at the Harvard School of Public Health. He is a graduate of Yale College, Oxford University (as a Rhodes Scholar) and Harvard Medical School. He is associate chief for research in the Division of General Internal Medicine at Massachusetts General Hospital and Director of the Mass General General Medicine Research Fellowship Program.

Dr. Singer is widely recognized for his research in the prevention of stroke in atrial fibrillation (AF). He was the epidemiologist for the NHLBI-funded Boston Area Anticoagulation Trial for Atrial Fibrillation (BAATAF) and lead author for several of its publications. BAATAF was a landmark trial demonstrating the marked efficacy of warfarin anticoagulation in preventing stroke in AF. He was an active member of the Atrial Fibrillation Investigators (AFI) working group, analyzing the pooled data from randomized trials of vitamin K antagonist anticoagulant therapy and aspirin for AF. These analyses identified the core risk factors for stroke in AF, among other findings.

Other highly cited studies by Dr. Singer and colleagues have established the precise relationship between anticoagulation intensity, as INR, and risk of both ischemic stroke and intracranial haemorrhage in patients with AF taking warfarin. With Dr. Alan Go, Dr. Singer leads the ATRIA studies which have followed large cohorts of individuals with AF in the Kaiser Permanente Medical Care Program in California assessing antithrombotic therapy and stroke prevention in “real-world” clinical care. Publications from ATRIA have provided United States estimates of current and future AF prevalence, “the net clinical benefit” of anticoagulation for AF, as well as numerous other findings. 

Dr. Singer is a member of the Executive Committee of the ROCKET AF trial that demonstrated the “non-inferiority” of the novel anticoagulant, rivaroxaban, versus warfarin as stroke preventive therapy in AF. 

Dr. Singer’s current research addresses numerous areas relevant to optimizing stroke prevention for patients with AF including improving prediction of net clinical benefit of anticoagulation for subgroups with AF, estimating the impact of screening for AF, specifying the relationship of paroxysmal AF burden and stroke risk, and identifying barriers to anticoagulation in AF patients at high stroke risk.

Dr. Singer was chair for the chapter on AF in the 2004 and 2008 American College of Chest Physicians Consensus Conference on Antithrombotic and Thrombolytic Therapy and lead author of these guidelines.  He continued as a co-author on the 2012 version of these guidelines. Dr. Singer received the 1993 Nellie Westerman Prize on Clinical Research Ethics, from the American Federation of Clinical Research, for his paper on stopping rules in trials of warfarin therapy, the 2003 John Eisenberg Award from the National Society for General Internal Medicine for Career Achievements in Research and the 2008 C. Miller Fisher Award from the New England chapter of the American Stroke Association/American Heart Association for his contributions to stroke research.  He was awarded a 2007-2008 Harvard Medical School William Silen Award for Lifetime Achievement in Mentoring.

For almost two decades, Dr. Singer has directed or co-directed courses in clinical research methods in the Program in Clinical Effectiveness (PCE) at the Harvard School of Public Health and he serves as associate director of the PCE.

Dr. Singer was an invited participant in a Joint Commission conference on quality standards for stroke prevention in AF, an invited speaker at the 2014 European Cardiac Arrhythmia Society meeting in Munich, and an invited speaker at the FDA in the Duke University/FDA Cardiac Safety Research Consortium meeting on approving reversal agents for novel anticoagulants.