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Developing models to predict patient outcomes in children with severe illness

28 December 2020 | Story André Damons | Photo Supplied

A lecturer from the University of the Free State’s (UFS) department of Paediatrics and Child Health is investigating the use of artificial neural networks to develop models for the prediction of patient outcomes in children with severe illness.

Dr Michael Pienaar, senior lecturer and specialist, is conducting this research as part of his doctoral research and the study deals primarily with the development of models that are designed and calibrated for use in South Africa. These artificial neural networks are computer programs designed to mimic some of the learning characteristics of biological neurons.

The potential applications of models

According to Dr Pienaar these models have traditionally been developed in high-income nations using conventional statistical methods.

“The potential applications of such models in the clinical setting include triage, medical research, guidance of resource allocation and quality control. Having initially begun this research investigating the prediction of mortality outcomes in the paediatric intensive care unit (PICU) I have broadened my scope to patients outside of PICU, seeking to identify children early during their illnesses who are at risk of serious illness requiring PICU,” says Dr Pienaar.

The research up until now has been directed towards the identification of characteristics that are both unique to children with serious illness in South Africa, but also accessible to clinicians in settings where expertise and technical resources are limited.

Research still in the early changes

The research is still in its early stages but next year a series of expert review panels will be held to investigate the selection of variables for the model, after which the collection of clinical data will begin. Once the data has been collected and prepared, a number of candidate models will be developed and evaluated. This should be concluded by the end of 2022.

Says Dr Pienaar: “The need to engage with the rapid proliferation of technology, particularly in the realms of machine learning, mobile technology, automation and the Internet of Things is as great in medical research now as it is in any academic discipline.

“It is critical that research, particularly in South Africa, engage with this in order to take advantage of the opportunities offered and avoid the dangers that go paired with them. Together with the technology as such, it has been essential to pursue this project as an interdisciplinary undertaking involving clinicians, biostatisticians and computer engineers.”

Hope for the research

Dr Pienaar says he was very fortunate and grateful to be the recipient of a generous interdisciplinary grant from the UFS which has allowed him to procure software and equipment that is critical to this project.

“The hope for this research is that the best performing of these models can be integrated with a mobile application that assists practitioners in a wide range of settings in the identification, treatment and early referral of children at high risk of severe illness. I would like to expand this research project to include other countries in Africa and South America and to use it as a bridge to collaboration with other clinical researchers in the Global South,” says Dr Pienaar.

As an early career researcher, Dr Pienaar hopes that this research can serve as a platform to build a body of research that uses the rapid technological advances of these times together with a wide range of collaborations with other disciplines in the pursuit of better child health.

He concludes by saying that he has had excellent support thus far from his supervisors, Prof Stephen Brown (Faculty of Health Sciences, UFS), Dr Nicolaas Luwes (Faculty of Computer Science and Engineering, Central University of Technology) and Dr Elizabeth George (Medical Research Council Clinical Trials Unit, University College London). I have also been supported by the Robert Frater Institute in the Faculty of Health Sciences.

News Archive

Workplace discrimination and unfair practices explored in new book

2017-09-13

Dr Denine Smit
Photo: Supplied

Two law scholars, Dr Denine Smit and Dr Damian Viviers, from the Faculty of Law at the University of the Free State (UFS) recently launched a book titled Vulnerable Employees, which was inspired by their interest in researching, creating awareness and providing a legal exposition in relation to employees who are vulnerable and experience prejudice and dignity violations in the workplace. These include workplace bullying, appearance-based discrimination, those who are gender fluid or have mental-health conditions.
“Dr Viviers, who is also a former student of mine, and I, have been working together for years and share a common understanding in relation to our various topics of interest. We often share the same train of thought. This is how we came to work together to produce this book,” said Dr Smit.

Research focused on employee challenges in the workplace
The book expands on the field of knowledge regarding certain categories of employees who, as a consequence of various mutable, immutable and semi-immutable characteristics, as well as behavioural experiences, are rendered vulnerable in their employment relationships. The book draws on various social, psychological and other empirical considerations, as well as comparative legal research from foreign and international law, in order to expand on the legal position under the South African legal framework governing these conditions. While the book first and foremost constitutes a compendium of research to be used for this purpose, it also serves as a practical guide for all legal practitioners, human resources managers, other labour stakeholders and the judiciary.

Book draws strength in other academic fields
Vulnerable Employees was launched on 28 July 2017 at the UFS library, to an audience of academics and students, with a panel discussion made up of the authors and two other panellists. One of the panellists was Dr Katinka Botha, a leading psychiatrist in the Free State who has a wealth of experience in this field. “Her selection as a panellist was motivated by the various significant inter-disciplinary considerations and intersections between psychology, psychiatry and law, contained in the book,” said Dr Smit.
“Dr Botha’s expertise was invaluable in shedding light on mental-health considerations during the panel discussion.”
Mr Lesley Mokgoro, the other panellist, is a leading labour law practitioner, as well as director and head of the Dispute Resolution Practice Group at Phatshoane Henney Attorneys. “His years of experience working with all role players in the employment domain, as well as his extensive legal knowledge and expertise, made him uniquely qualified to serve on the panel and deliver an opinion of the practical and academic value of the book,” said Dr Smit.

Workplace policies key to securing employee rights
There are a number of growing trends in the workplace that could shape the practice of labour law or workplace policies. Dr Smit said the need for employers to regulate workplace culture, particularly in relation to bullying, harassment and unfair discrimination, in line with the South African legal framework, was a fundamental need in all workplaces. Effective workplace policies may be used to clearly outline the relevant “dos and don’ts” to employees, as well as the procedures and processes that may be followed in order to address such conduct. Workplace policies serve to advance legal certainty and efficiency, since the rights and obligations of all role players are clearly demarcated, or should be, in terms of a well-drafted and considered policy.
The book is one of several publications produced by Dr Smit in collaboration with Dr Viviers on the topic of workplace discrimination and the law. The two scholars are working on another book to be published at the end of 2017.

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