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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

Multi-disciplinary research approach at UFS

2005-10-25

UFS follows multi-disciplinary research approach with opening of new centre

“A new way of doing business in necessary in the research and teaching of agriculture and natural sciences in South Africa. We must move away from departmentalised research infrastructures and a multi-disciplinary approach to research involving several disciplines must be adapted,” said Prof Herman van Schalkwyk, Dean: Faculty of Natural and Agricultural Sciences at the University of the Free State (UFS).

Prof van Schalkwyk delivered the keynote address during the launch of the Centre for Plant Health Management (CePHMa) at the Main Campus in Bloemfontein today (21 October 2005). CePHMa is an initiative of the UFS Department of Plant Sciences.

According to Prof van Schalkwyk a tertiary institution must practice multi-disciplinary research to be a world-class research institution. “It is difficult for researchers to admit that they do not know a lot about each other’s area of speciality. It is therefore necessary for researchers to make a paradigm shift and to focus on inter-disciplinary co-operation. To do this, we must encourage them to work together and to find a common language to communicate ideas en establish symbiotic relationships,” said Prof Van Schalkwyk.

“We tend to think that research is better and faster if it is specialised. This is not true. The new generation of scientists are young and they are trained to form a concept of the total system and not to focus on a specific area of speciality. At the UFS we encourage this approach to research. This was one of the main reasons for the establishment of CePHMa,” said Prof Van Schalkwyk.
CePHMa is the only centre of its kind in Africa and is established to extend the expertise in plant health management in South Africa and in Africa, to train experts in plant health and to conduct multi-disciplinary research about the health of agricultural crops.

“CePHMa is a virtual centre comprising of ten disciplines applicable to crop production and crop protection,” said Prof Wijnand Swart, Chairperson of CePHMa during the opening ceremony.

“The UFS is the leading institution in Africa in terms of news crop development and manages three research programmes that concentrate on new crops, i.e. the New Crop Pathology Programme, the New Crop Development Programme and the Insects on New Crops Programme. Other applied research programmes that are unique to the UFS are genetic resistance to rust diseases of small grain crops and sustainable integrated disease management of field crops,” said Prof Swart.

“Because the expected growth in population will be 80% in 2020 in sub-Saharan Africa, the future demands of food produce in Africa will be influenced. Therefore research will in future be focused on ways to improve food security by employing agricultural systems that are economically viable and environmentally sound,” said Prof Swart.

“Thorough knowledge of the concept of holistic plant health management is crucial to meet the challenge and it is therefore imperative that innovative crop protection and crop production strategies, with particular emphasis on plant health, be adopted. This is why the Department of Plant Sciences initiated the establishment of CePHMA,” he said.

According to Prof Swart there is a shortage of expertise in plant health management. “The UFS has shown the potential to address the demand of the sub-continent of Africa regarding expertise training and CePHMa is the leader in southern Africa to provide in this need,” he said.

The appropriateness and quality of training in plant health management is reflected in the fact that students from Ethiopia, Eritrea, Malawi, Uganda, Zambia, Ghana, Tanzania, Cameroon, Angola, Mozambique and Lesotho have already been trained or are in the process of being trained in at the UFS.

Scientists from CePHMa have forged partnerships with numerous national and international institutions including the Agricultural Research Council (ARC), various community trusts, seed, pesticide and agricultural chemical companies, in addition to overseas universities.

Media release
Issued by: Lacea Loader
Media Representative
Tel: (051) 401-2584
Cell: 083 645 2454
E-mail: loaderl.stg@mail.uovs.ac.za
21 October 2005

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