The TOGETHER Trial
An adaptive platform that evaluated repurposed therapies for COVID-19 recruiting more than 12,000 patients at 22 clinical sites.
GLOBAL HEALTH,
INFORMATION & TECHNOLOGY SYSTEMS
Context Matters.
Especially in health.
Health technology is designed in a global context, yet implemented in local conditions. My teaching and scholarship demand an answer: where is this technology's value created, and for whom?
Technology is opinionated.
What counts as innovation depends on who's counting. Five conditions for health technology and value creation. Select one to read how matching projects from 15 years of my portfolio responded to each condition.
Five attributes for successful implementation. Loosely based on the five properties that characterize the diffusion of innovations (Everett Rogers, 1962) Evidence is selected.
How knowledge is generated, evaluated, and made usable amid contested claims with decisions that cannot wait.
I design and ooperate the systems that turn contested treatment claims into usable results. The TOGETHER adaptive platform evaluated more than a dozen therapies across 12,000 patients in six countries—so clinicians and ministries had evidence, not rumours, while the window to act was still open.
See the evidence system →How the work addresses Evidence
Fluvoxamine and metformin for Long COVID fatigue: The TOGETHER REVIVE Platform Trial
Adaptive trial continuation of the TOGETHER research infrastructure, recruiting 399 adults with post-COVID fatigue and found that fluvoxamine reduced fatigue versus placebo at day 60, with a sustained effect at day 90; metformin did not.
Research that speaks to Evidence
2022
Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised platform trial
The Lancet Global Health
Shows how adaptive platform trials can turn contested treatment claims into usable evidence at speed.
2022
Effect of early treatment with ivermectin among patients with Covid-19
New England Journal of Medicine
Tests a widely promoted claim under rigorous conditions—evidence as a public good, not a marketing asset.
2026
The Effect of Fluvoxamine and Metformin for Fatigue in Patients With Long COVID
Annals of Internal Medicine
Extends the platform-trial logic past acute COVID: a contested recovery claim, tested rather than assumed.
2022
Resilient Clinical Trial Infrastructure in Response to the COVID-19 Pandemic: Lessons Learned from the TOGETHER Randomized Platform Clinical Trial
American Journal of Tropical Medicine and Hygiene
Documents the operational conditions—sites, data, partnerships—that made rapid evidence generation possible.
Tools I build and ship.
Independent software for academic work, social signal intelligence, the paper library, and trust defense—available to buy, download, or explore.
Manuscripts
Mac app for academic workflow
Keep every paper, submission, and revision in one local-first record—authors, versions, journal state—without cloud seats or spreadsheet chaos. Built for academics who were tired of losing track of which version went where.
Radar
Social signal intelligence for Mac
Watch topics across social platforms and the web, cluster what emerges into themes, and get digests. Internal Counterforce distribution—password-gated download and setup handbook.
Download & setup →
INFORM! Digital Health Library
Scientific paper library
PDF processing, semantic search, citation formatting, and team annotations for a working paper library. Invite-only—enter the access code, then open library.drjforrest.com when that host is online.
Enter with code →
Counterforce
Detect, map, neutralize misinformation
End-to-end platform for governments and organizations to detect emerging narratives, map amplification networks, and act before harm spreads. First employee and ongoing advisor.
Visit Counterforce →Citation network generator
Explore how publications connect—citation patterns and thematic clusters drawn from the public scholarly record.
Start with my network, or generate a temporary view from a name, ORCID, or OpenAlex profile to see how a research program hangs together.
Ideas, field notes, and explainers.
Writing on technology, health, evidence, and trust. Two blogs share a front door here; each keeps its own theme.
Designed Elsewhere, Deployed Here
An algorithm trained far from the ward it enters does not automatically know the constraints of the system it lands in.
Read the essay →Why clinicians still hesitate at AI decision support
Sixty-six years after computerized diagnosis entered the literature, hesitation may be the right response—if you ask the right questions.
Open →When seeing is no longer believing
Deepfakes turn visual evidence into a contested public-health resource, not a self-evident fact.
Open →Good work requires the right conditions, too.
I collaborate with global researchers, students, ministries, and industry partners working to strengthen health informatics, evidence generation, and clinical and public health research capacity, particularly in contexts where resources, infrastructure and trust are unevenly distributed.