Dr. Soh Jian Yi


Dr. Jian Yi Soh

Dr. Jian Yi Soh completed his Pediatric training, as well as Allergy and Immunology sub specialty training, in Singapore. In addition to general pediatrics, his clinical work encompasses various aspects of allergy, including asthma, allergic rhinitis, eczema, food and drug allergy. His research interest lies in the fields of Allergy and Immunology. And he has a particular focus on food allergy and desensitization.

On the side, he contributes articles regularly to the Straits Times: Mind Your Body on child health. 

Additional interests: Volunteer, TOUCH Community services

Correspondence with Dr. Soh:
“I can understand your frustration on the private vs researchers-debate and if you will permit me? – I happen to have concerns for both sides’ arguments. It helps if I paint my own background as a starting point.

Summary of it is that I’ve been doing immunotherapy research – clinical research – for a few years. That gave us plenty of experience with what works, what doesn’t, patient experiences on a small scale, and I took that as a learning opportunity to iron out the logistics, communications rigor, and other factors needed to translate into a working, safe clinical service. It also gave us a good idea of what happens when you challenge patients with allergies to the food – what usually happens and the anxieties they have.

Subsequently, translation into the clinical service has been smooth. The well-oiled team, including nurses, are fully familiar with possible reactions and know what to do even if I was physically absent (which is uncommon; it’s only professional that a physician should be near at hand, and ideally the patient’s personal physician. I disdain the idea of giving someone else my work/responsibilities.). Having said that they still obey the rules and chain of communication – it’s just that they know what to do and prepare things instead of waiting for someone to tell them “ok let’s go, now we begin preparation only after the doctor has said we do this.”.

It’s all about speed, reliability and efficiency, and the last few years’ of research and clinical work has taught us that patients+families on OIT are understandably anxious and on the trigger’s edge. The balm to that is a team that moves fast, communicate clearly to each other, is available, and are totally familiar with reactions, including being prepared to handle severe ones (even if they might only occur once in many years…). I’m speaking from the patient-centric view here, and my whole team understands this.

The researchers in the USA have done a lot of work in this. Given the tense medicolegal atmosphere in the USA, plus the lack of Study on long-term risk-taking behavior in this group of patients, it is understandable that they don’t want to be seen or contribute to just any allergist trying to do the same thing. Copying what is published in the literature isn’t difficult. But if these are the private allergists who didn’t do the research, means that you are talking about a group of doctors who are, though trained allergists, were never trained in oral immunotherapy (it’s that new) and didn’t do the years of research and experience that gives the lessons I outlined above. On top of that, good research planning requires one to protect the patient at all costs; that kind of planning and execution forces the rigors in communication and foresight I mentioned above in the execution of the project, which serves one well when planning to translate it into real practice.

Hence I share the researchers’ reservations, since I am one of them. I know how much I and my team learned from the research in terms of familiarity and communication and how exacting it has to be. Not just for patient reassurance but patient safety. On the same note of patient reassurance, confidence is hard to fake to patients if something goes wrong, yet you don’t know how to handle the reaction because it’s something you haven’t had years of practice handling…and sometimes the unsure physician sidesteps the issue. Which doesn’t help.

I am not gainsaying the training of allergists in the USA; but I do know oral immunotherapy is still research and hence, is not part of the training in practice. They can read all they want, but theory is only theory. I am merely pointing out the very real concern that a private allergist can take the protocol that was published, use it, and because it generally works, is okay most of the time. Hence I am unsurprised by the variety of difficult patient experiences you cited below.

Conversely I understand the frustration of the private allergists, though I wonder if they realise the exact concern I mentioned above, having never gone through the kind of research planning and training needed to do this safely, nor the experience of seeing the worse reactions so that when they do it in real practice, they are totally familiar and comfortable. I also understand the frustration of the patients – most researchers pursue the research path, and the potential improvements to their protocols stay in Research trials (or are set aside to try another route of immunotherapy), leaving patients to know it’s Research and it works…”but hey why are you guys who have done this, the experienced and experts in this, just doing more research instead of starting to bring it out to us all waiting out here?”

Seeing all sides of the coin means I will also have to say this up front – I will not reveal a protocol to just any doctor who asks. I will not give a non-expert, a tool they can try when they are unfamiliar with this field, because the patient’s safety comes first. I am sorry if this might offend any doctor who asks for a protocol just-like-that, but you can see what I’ve outlined above. If it were one of the researchers – the experts – who ask, I am happy to share my expertise because they’ve done their work, know what this is, and I can trust them to use the tool, modify it, and not endanger patients if an unexpected reaction occurs.” Dr. Soh.


Contact

NUHS Tower Block Level 12, 1E Lower Kent Ridge Road, Singapore 119228
https://www.nuh.com.sg/…/paedia…/allergy-and-immunology.html
Email: allergy_kids@nuhs.edu.sg

OIT Details

Doctor Name: Dr. Soh
State: Singapore
Allergen: Peanut, cashew, pistachio, egg, milk, and wheat.
Treats single/multi allergens at once: Single
Offers SLIT for food allergens: No

Additional Features:

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Publications:
1. Hossny E, Rosario N, Lee BW, Singh M, El-Ghoneimy D, Soh JY, Le Souef P. The use of inhaled corticosteroids in pediatric asthma: update. World Allergy Organ J. 2016 Aug 12;9:26. doi: 10.1186/s40413-016-0117-0.
2.Caraballo L, Zakzuk J, Lee BW, Acevedo N, Soh JY, Sánchez-Borges M, Hossny E, García E, Rosario N, Ansotegui I, Puerta L, Sánchez J, Cardona V. Particularities of allergy in the Tropics. World Allergy Organ J. 2016 Jun 27;9:20. doi: 10.1186/s40413-016-0110-7
3. Tham EH, Huang CH, Soh JY, Thayalasingam M, Lee AJ, Lum LH, Poon LM, Lye DC, Chai LY, Tambyah PA, Lee BW, Shek LP. Neutralizing Anti-Interferon-Gamma Autoantibody Levels May Not Correlate With Clinical Course of Disease. Clin Infect Dis. 2016 Aug 15;63(4):572-3.
4. Soh JY, Thalayasingam M, Ong S, Loo EX, Shek LP, Chao SS. Sublingual immunotherapy in patients with house dust mite allergic rhinitis: prospective study of clinical outcomes over a two-year period. J Laryngol Otol. 2016 Jan 19:1-6.
5. Soh JY, Huang CH, Chiang WC, Llanora GV, Lee AJ, Loh W, Chin YL, Tay VY, Chan YH, Dianne D, Lee BW. Anaphylaxis to galacto-oligosaccharides – an evaluation in an atopic population in Singapore. Allergy 2015 Aug;70(8):1020-3
6. Soh JY, Huang CH, Lee BW. Carbohydrates as food allergens. Asia Pac Allergy. 2015;5(1):17-24.
7. Hardjojo A, Goh A, Shek LP, Van Bever HP, Teoh OH, Soh JY, Thomas B, Tan BH,Chan YH, Ramamurthy MB, Goh DY, Soh SE, Saw SM, Kwek K, Chong YS, Godfrey KM,Gluckman PD, Lee BW. Rhinitis in the first 18 months of life: exploring the role of respiratory viruses. Pediatr Allergy Immunol. 2015;26(1):25-33.
8. Thalayasingam M, Allameen NA, Soh JY, Bigliardi P, Van Bever H, Shek LP. Wheat-dependent exercise-induced anaphylaxis: a retrospective case review from a tertiary hospital. Postgrad Med J. 2014;90(1067):488-92.
9. Soh JY, Ng B, Tan Z, Xu S, Hing WC, Wu TS, Chan YH, Lee BW. Ten-year prescription trends of asthma medications in the management of childhood wheeze. Allergy Asthma Proc. 2014;35(1):e1-8.
10. Ang EY, Soh JY, Liew WK, Chan KW, Thoon KC, Chong CY, Lau YL, Lee BW. Reliability of acute illness dihydrorhodamine-123 testing for chronic granulomatous disease. Clin Lab. 2013;59(1-2):203-6.

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