Dr. Arnav Agarwal
A Recipient of the 2020 CSIM Education and Research Fund
Dr. Arnav Agarwal
Arnav Agarwal is an Internal Medicine resident at the University of Toronto. He completed his undergraduate training at McMaster University, and his medical training at the University of Toronto. He is interested in clinical questions across the spectrum of General Internal Medicine. His research passions are centered around clinical epidemiology and knowledge translation, with a specific focus on systematic reviews and clinical guideline development. Arnav has authored over 160 peer-reviewed articles and book chapters. He has parallel interests in research methods related to evaluation of quality of evidence, overdiagnosis and overtreatment, health advocacy related to migrant health and the uninsured, and medical education focused on innovations in curriculum development. He is keen to pursue a Clinician-Scientist path moving forward, with ongoing contributions to medical education and advocacy.
Acute exacerbations of chronic obstructive pulmonary disease (COPD) are associated with significant morbidity. The role of antibiotics is unclear in exacerbations without radiographic evidence of pneumonia. This multi centre retrospective cohort study uses the General Medicine Inpatient Initiative (GEMINI) database to examine physician-level variation in antibiotic prescribing for patients with COPD exacerbations, and the association between antibiotic use and clinical outcomes among patients with COPD exacerbations and no radiographic evidence of pneumonia. The clinical outcomes of interest are hospital length of stay, in-hospital mortality, 30-day re-admission, and Intensive Care Unit transfer after 48 hours post-admission. In an area with clinical equipoise where international guidelines and existing evidence are discordant, this study will be the first large multi-centre study to explore variation in antibiotic prescribing among patients with COPD exacerbations, and may highlight significant practice variation and the need for a sufficiently-powered randomized trial examining treatment differences.