Karthik Balakrishnan, M.D., M.P.H., studies ways to improve outcomes of pediatric airway reconstruction for diseases such as laryngotracheal, subglottic and tracheal stenosis, congenital tracheal stenosis and complete tracheal rings, laryngeal clefts, and vocal fold immobility and paralysis. He also examines the same questions for vascular malformations such as lymphatic malformations, venous malformations and hemangiomas.
Dr. Balakrishnan's research focuses on ways to standardize treatments and measure outcomes in these complex diseases, as well as ways to reduce treatment costs and medical errors, particularly those related to cognitive bias. He is also interested in finding ways to give patients and families control over the scientific and research process in order to improve patient satisfaction and address the research questions that are most important to them.
- Standardizing outcomes in pediatric airway reconstruction. Dr. Balakrishnan leads a unique international collaborative group of more than 30 physicians from 10 countries to develop standard outcome measures for children who require reconstruction of their larynxes (voice boxes) and tracheae (windpipes) for breathing problems. Similar projects will follow for airway reconstructive procedures for swallowing and voice problems. Dr. Balakrishnan's previous work has led to the development of similar standards for lymphatic malformations in the head and neck.
- Costs of otolaryngology care. Dr. Balakrishnan is studying thousands of patients and otolaryngology operations to identify factors that may predict more costly medical care. This will lead to process improvements that will allow Mayo Clinic and other institutions to reduce the cost burden that patients and the U.S. health care system face while maintaining quality and access to care.
- Cognitive bias and implicit bias and medical error. Dr. Balakrishnan is working to improve otolaryngology resident and provider education related to the effects of cognitive and implicit bias on medical decision-making, and ways to reduce medical errors related to those biases.
- Evidence-based care of vascular anomalies. Dr. Balakrishnan leads a task force of colleagues around the country to develop better scientific evidence to guide the care of challenging vascular anomalies such as lymphatic malformations.
- Patient and family integration into the research process. Dr. Balakrishnan is working to develop new ways to allow patients and their families to guide the questions that medical researchers study and to oversee the research process, using mobile apps and crowdsourcing methods.
- 3-D modeling in pediatric airway reconstruction. Dr. Balakrishnan and several colleagues across Mayo Clinic are studying ways to use 3-D printed models to improve communication, teaching and patient outcomes in complex pediatric airway surgery.
Significance to patient care
Complex and rare conditions such as airway stenosis and vascular malformations greatly impact childrens' survival and quality of life, but treatment pathways and standardization of care are still lacking. Dr. Balakrishnan hopes that increasing standardization of care and outcome reporting for these conditions will help doctors provide better care for these patients.
Meanwhile, by finding ways to help patients and their families drive research, Dr. Balakrishnan hopes to help researchers focus on the questions that are most important to patients and to improve patients' satisfaction with their own health care experiences.
- Member, Patient Safety and Quality Improvement Committee, American Academy of Otolaryngology — Head and Neck Surgery, 2015-2018
- Recipient, Beryl Institute Patient Experience Grant, 2016-2017
- Member, American Academy of Pediatrics Council on Quality Improvement and Patient Safety, 2016-present
- Editorial board, Otolaryngology — Head & Neck Surgery, 2016-present
- Director, American Society of Pediatric Otolaryngology Vascular Anomalies Task Force, 2015-present
- Quality chair, Department of Otolaryngology — Head and Neck Surgery, Mayo Clinic in Rochester, Minnesota, 2015-present