Image courtesy of Alex Dong.
Growing up next to the biggest medical center in the world, James Diao YC ‘18 was meant to be a doctor. A third-year medical school student at Harvard Medical School (HMS) and MIT, Diao was recently awarded the Churchill Scholarship to do a year of master’s study in science policy at the University of Cambridge for the 2022-23 academic year. With this scholarship, he plans to take a deep dive into understanding the regulation of healthcare technology and the efficacy of clinical algorithms across diverse populations.
Diao’s initial interest in medicine and research stems back to his hometown of Sugar Land, Texas, where he shadowed Rachel Rau, a pediatric oncologist at the Texas Medical Center in high school. “I learned a lot about science. I learned a lot about patient care. I thought her job was the coolest job in the world,” Diao said. At Yale, he continued to shadow clinicians at Haven Free Clinic and became a Peer Counselor for Yale’s anonymous and confidential hotline. Now, he’s spending time with patients in his core rotations.
In addition to his clinical experience, Diao has also spent a lot of time on research. In April of 2020, he started studying the misuse of race in kidney function tests with Arjun Manrai at the HMS Department of Biomedical Informatics. Diao’s idea to pursue this project was a bit spontaneous. “My mentor and I had previously worked on equity and representation for cardiovascular genetics, but kidney disease wasn’t on our radar at all. It wasn’t until I learned about the issue on Twitter that I began diving into the literature and thinking about ways to contribute,” Diao said.
The “issue” Diao had stumbled upon was related to the glomerular filtration rate (GFR). GFR measures how well a person’s kidneys can filter substances from their blood, which is essential in the early detection of potential kidney disease. The current test to measure someone’s GFR is an equation that involves several variables, including age, sex, and race, with higher results indicating healthy kidney function. “The main issue is [with] the race and ethnicity component. If you’re Black, your number will be assigned 16% higher,” Diao said. As a result, Black patients with higher GFR numbers may have less access to specialist care, kidney transplants, and coverage by Medicare. Diao’s research quantified the effect of including and removing race from the equation, and he found that up to one million Black Americans may receive unequal kidney care due to their race. When the race variable was eliminated, he found that access to diagnosis and specialist care increased for Black Americans. Race-free equations could also achieve the same performance metrics as the original ones. In October of 2021, the National Kidney Foundation and the American Society of Nephrology officially released national recommendations supporting a new race-free equation, citing Diao’s research.
During Diao’s first year of medical school, he joined the machine learning team at tech startup PathAI, where he worked on deep learning models in pathology. He then joined Apple’s Motion Health team, where he worked on studies to predict cardiovascular risk for the Apple Watch using accelerometer data from consumer wearables. Diao was named to the 2022 Forbes “30 Under 30” List for his work and received the prestigious Paul & Daisy Soros Fellowship in their 2021 cohort.
When he’s not conducting research, Diao is probably ballroom dancing. This hobby started in college when he searched for activities to get involved in. “Ballroom was one cool [club] where they don’t care if you’re new to it all,” Diao said.You don’t need to have any experience, you just show up, and their whole thing is ‘We’ll teach you!’”
As Diao finishes medical school and approaches the next step in his career, he hopes to continue tackling systemic problems in medicine. He wants to become a professor and investigator, studying the performance and equity of medical technology and translating this research to the realms of patient care, company advising, and clinical trials.
Diao advises undergraduates to remember that they are only at the very start of their careers. “There will be so much time to double down on whatever ends up being your life’s work,” Diao said. “I think there’s a lot of value in exploring early and exploring all the different paths that are available to you and not committing so early.”