David Stukus | Professor of Clinical Pediatrics, Division of Allergy and Immunology; Director, Food Allergy Treatment Center, Nationwide Children’s Hospital and The Ohio State University College of Medicine, Columbus, Ohio, USA
Citation: EMJ Allergy Immunol. 2023; DOI/10.33590/emjallergyimmunol/10301359. https://doi.org/10.33590/emjallergyimmunol/10301359.
What led you to undertake a career in medicine, and specifically in paediatric allergy and immunology?
I studied both molecular biology and psychology as an undergraduate and loved the intersection of understanding how the complexities of the human body interact with those of the human mind. This translated seamlessly towards a career in medicine and specifically paediatrics, as I love working with children of all ages. My job is simply fun. Allergy and immunology is a specialty that focuses on some of the most common chronic conditions affecting children such as asthma, food allergies, eczema, and environmental allergies. I love being able to help children and their families by applying my understanding of the immune system to their health.
In 2011, you started the Complex Asthma Clinic at Nationwide Children’s Hospital, Columbus, Ohia, USA, which treats children with severe or difficult-to-treat asthma. What drove you to do this and how has this programme evolved over the years?
Asthma is the leading chronic medical condition, and a top cause of emergency room visits and hospitalisations for children. It’s also highly variable in regard to causes and response to treatment. We wanted to provide a focused multispecialty clinic dedicated to helping families who have children with difficult-to-control or severe asthma, as they often require a different approach towards diagnosis and management, including more time and resources. Over the past decade, this clinic has grown and offers state-of-the-art treatment with a focus on understanding how the immune system is involved in various types of asthma.
You have focused a lot of your research on food allergy and are Director of the Food Allergy Treatment Center at Nationwide Children’s Hospital. What recent advances in the treatment of food allergy are you most excited about?
These truly are exciting times in the area of food allergy as we have new approaches towards diagnosis and management. At our centre, we take an individualised approach to provide the most accurate diagnosis possible, discuss management and risk, and help families with daily decisions that truly impact their quality of life. Oral immunotherapy is one treatment option that can help decrease risk for severe food allergy reactions from accidental ingestion of small amounts of food allergens. There are additional areas of research that are very exciting and include alternate ways to desensitise through the oral mucosa or skin. In addition, the new use of biologic treatments towards food allergy are also very promising.
As a board member of the American College of Allergy, Asthma and Immunology (ACAAI), what is your role in this organisation?
It’s been an honour for me to serve in various leadership roles with the ACAAI over the past decade, including as a board member for the past 2 years. Our board helps to make decisions surrounding ACAAI initiatives to benefit our members, as well as within the public to help our patients. Our board isn’t involved in the day-to-day decisions within the organisation per se, but it helps to steer the ship in regard to advocacy efforts, communication, policy, recruitment into our specialty, and educational offerings such as our annual meeting.
You strongly value evidence-based medicine and recently published an article on tackling medical misinformation in allergy and immunology practice. What were the key take-away messages from that paper?
I think that it’s important for everyone to understand the many ways in which we are all influenced in our decision making. We all have cognitive biases that impact how we receive information, which is now mainly through the internet and social media. Even more importantly, there are many areas where clinical practice is simply outdated and not up to date with current evidence-based guidelines. It’s important for clinicians to be aware of how and why inertia impacts the care we offer, and also why we need to remain as current as possible in our approach towards diagnosis and management.
You wrote a book on using social media for medical professionals and are very active on social media yourself. Why do you find this important and what do you aim to achieve through your social media?
Social media has fundamentally changed the manner in which society shares and receives information. Critical thinking skills and the ability to vet information for accuracy is more important than ever. Unfortunately, misinformation and disinformation are everywhere online and truly impact patients in a negative way. I see this in daily practice and online. I hope to provide a source of not only accurate evidence-based information but also perspective to help people better navigate their use of social media.
What topics do you feel merit greater attention in your specialty and what direction would you like to see future research take?
I’d love to see more progress regarding primary prevention of all forms of allergic conditions. We’ve made some progress in this realm with food allergy by recommending early introduction of allergenic foods into baby’s diets but even this isn’t 100% effective. We need better approaches towards asthma, eczema, and environmental allergies.
Which new technologies and recent breakthroughs do you expect will make a real difference in your field in the near future?
Wearable technology holds promise, particularly for asthma and some of the digital monitoring that has been introduced in recent years. Artificial intelligence is only getting more useful over time and I’m sure will have growing importance in healthcare over the next decade. However, we also need to recognise the limitations of technology and how best to apply it for each individual patient or person. Nothing we do in medicine or public health is one size fits all.
As an educator, where do you see your focus lie in the coming years?
I love the opportunity to offer education and perspective to various audiences, particularly the general public and primary care clinicians. I’m still relatively young in the grand scheme, yet also recognise that I’m rapidly becoming ‘the old guy’ to our current generation of trainees. As such, I see my focus transitioning a bit to help others learn from my experience by offering practical approaches towards patient care. I also want to continue to proactively discuss the importance of wellness, gratitude, and priorities to my colleagues and younger generations of healthcare professionals. Having gone through burn out myself, I want to do anything I can to help others on their path.
