Houston VA Researcher recognized by National Academy of Medicine

The Academy selected 11 individuals for the 2023 Scholars in Diagnostic Excellence program.

Run in partnership with the Council of Medical Specialty Societies, the one-year program provides an opportunity for individuals to advance their diagnostic skills and become national leaders in clinical diagnosis.

“We are delighted to continue this important program to minimize diagnostic errors in the U.S. and look forward to working with another impressive cohort of extraordinary scholars,” said Victor J. Dzau, NAM president. 

Kaul is a pulmonary and critical care physician and investigator at the VA Center for Innovation in Quality, Effectiveness, and Safety (IQuESt) in Houston. Her proposed topic of study is: “Lung Texture Analysis: A Novel Machine Learning Tool to Reduce Diagnostic Delays Among Veterans with Pulmonary Fibrosis.”

“Dr. Kaul is a highly effective physician-scientist who has devoted herself to improving the lives of Veterans with serious lung disease like pulmonary fibrosis,” said iQuESt director Dr. Laura Petersen. “Her selection as a Scholar in Diagnostic Excellence not only reflects her dedication to high-quality scientific research, but also her commitment to advancing clinical practice through quality-improvement efforts.”

Kaul is working to improve access to pulmonary fibrosis care for Veterans and address health disparities in treatment outcomes for underrepresented groups like racial minorities and rural populations.

Racial and ethnic minorities face the greatest risk of poor outcomes due to pulmonary fibrosis, according to a JAMA Network Open study published by Kaul and her colleagues. Data for close to 4,800 individuals from the Pulmonary Fibrosis Foundation Registry and an external multicenter validation cohort was assessed for health outcomes.

The researchers found that Black patients with pulmonary fibrosis were younger than white patients and had higher rates of hospitalizations and earlier onset of death compared to white and Hispanic patients. In a study published in CHEST, Kaul suggests that difference in access to antifibrotic medications may be one driver of these disparities.

In the Annuals of the American Thoracic Society, Kaul published a study that examined the prevalence of idiopathic pulmonary fibrosis (IPF) in U.S. Veterans from 2010-2019. The team found that out of 10.7 million Veterans, close to 140,000 (1.26%) were diagnosed with IPF. Over a decade, the prevalence of IPF in the study group doubled. Risk factors included older age, rural residence, and a history of tobacco use.

The researchers suggested that rising prevalence of IPF among Veterans is likely due to a combination of factors, including increasing disease awareness, availability of new antifibrotic therapies, an aging Veteran population, and the implementation of low-dose CT scans for lung cancer screening. Low-dose CT scans can detect pulmonary fibrosis in the early stages due to overlapping risk factors between lung cancer and fibrosis. As a NAM Scholar in Diagnostic Excellence, Kaul will focus on using novel machine learning tools to reduce diagnostic delays among Veterans with pulmonary fibrosis noted on their screening CT scans.

Pulmonary fibrosis is a lung disease that occurs when the lungs become damaged and scarred from inflammation. There are many causes of pulmonary fibrosis, ranging from long-term environmental exposures to irritants like asbestos to viral or bacterial infections. In some cases, the cause is unknown. Over time, people with pulmonary fibrosis find it harder to breathe because their lungs become stiff and won’t expand normally. Treatment depends on the underlying cause of fibrosis. Timely access to pulmonary care is important to improving long-term outcomes.