Reuben Arasaratnam, M.D., M.P.H., Assistant Professor of Internal Medicine at UT Southwestern, has been named one of 11 2022 Scholars in Diagnostic Excellence by the National Academy of Medicine (NAM). The award, which comes with a flexible research grant, mentorship, and learning and professional networking opportunities, will help advance his work on correcting penicillin allergy misdiagnoses.
“I am truly honored to be selected as one of the NAM Scholars in Diagnostic Excellence,” said Dr. Arasaratnam, who also serves as Assistant to the Medical Services Chief for Education at the Dallas VA Medical Center, his clinical practice site. “The resources and mentorship of the program will be a tremendous asset in not only advancing my project and tackling the problem of penicillin allergy, but also raising the profile of diagnostic excellence.”
Incorrect penicillin allergy diagnoses are a significant and growing public health problem, Dr. Arasaratnam explained. Approximately 10% of patients carry a diagnostic label of penicillin allergy on their record, but only a tenth of those are truly allergic to penicillin. Patients incorrectly labeled are more likely to develop drug-resistant infections, receive suboptimal antibiotic therapy, and have longer hospital stays.
While penicillin allergies can be corrected by consultation with allergy specialists, many health care facilities do not have direct access to allergy specialists or evaluation services, resulting in a diagnostic equity gap. In 2021, Dr. Arasaratnam began a project at the Dallas VA Medical Center to create a multidisciplinary inpatient penicillin allergy diagnostic evaluation service to screen veterans for penicillin allergies and remove incorrect allergy labels by taking a careful allergy history and using a simple oral amoxicillin challenge – a diagnostic test in which patients receive a dose of amoxicillin by mouth in a controlled setting to determine if they experience an allergic reaction.
Thus far, he and his colleagues have shown that about 5% of veterans admitted to the Medical Center carry a diagnosis of penicillin allergy, and the majority of these patients could have these allergy labels safely removed. As a Scholar in Diagnostic Excellence, Dr. Arasaratnam is planning to pilot a penicillin allergy de-labeling service over the next year while implementing more comprehensive efforts to raise awareness of reevaluating penicillin allergies in patients.
“We are overjoyed to learn that Dr. Reuben Arasaratnam’s work in reducing diagnostic errors is being recognized with his selection as a 2022 Scholar in Diagnostic Excellence by the National Academy of Medicine,” said Kendrick D. Brown, Acting Executive Medical Center Director at VA North Texas Health Care System. “Dr. Arasaratnam’s research and work to identify veterans who carry a misdiagnosis of penicillin allergies and correct those misdiagnoses will unquestionably advance how VA North Texas delivers health care to its patients and improve the lives of North Texas veterans.”
Funded by the Gordon and Betty Moore Foundation and in partnership with the Council of Medical Specialty Societies, the Scholars in Diagnostic Excellence Program offers a one-year, part-time experience for exceptional individuals to advance their diagnostic skills, make significant contributions to reduce diagnostic errors at the national level, and accelerate their career development as national leaders in the field.
About UT Southwestern Medical Center
UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has received six Nobel Prizes, and includes 26 members of the National Academy of Sciences, 17 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 2,900 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 100,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 4 million outpatient visits a year.
