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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.

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Letter to students from Prof Jonathan Jansen about student protest action at the UFS

2015-10-21

Dear Students

Student protest action at the University of the Free State

I wish to make clear that the senior leadership of the University of the Free State understands and supports the demands from students and their leaders that higher education be accessible to all students, especially the poor. For the past six years we have done everything in our power to meet that commitment to students who are academically talented, but simply cannot afford to pay; that is why our tuition fees remain among the lowest in the country. Our efforts to raise private funding have enabled thousands more students to study at the UFS than would have been possible on the government subsidy only. Whether it is the Staff Fund contributions (yes, our staff empty their pockets to support student fees) or the No Student Hungry (NSH) bursary programme (yes, we raise funds for food bursaries), we will continue our drive to fund students who cannot afford higher education. Let me repeat, no student with a solid academic record will be denied access to studies simply because they cannot pay.

Now, to the matter at hand. There is a national demand from students for a 0% fee increment for 2016. The Minister’s response, after consultation with stakeholders, was that universities should cap their 2016 fee increases at 6%. Despite this initiative from government, the protests continue on virtually all campuses across South Africa for the ‘no fee’ increase.

Our response, as the UFS leadership, is to continue engaging the SRC as the chosen leadership of our students in trying to negotiate a settlement on the matter. We have worked around the clock to be available to student leaders to find some resolution on 2016 fees. While we understand the demands of students, as university leaders, we can only work with the government subsidy we receive. Any agreement reached, cannot and must not place the university at academic and financial risk in its ability to deliver public higher education to the country - if that happens, everybody loses. Still, no matter what happens in terms of the response from government, the leadership door at the UFS remains open to finding a mutually acceptable solution to all parties in these deliberations.

Students, we are deeply concerned by the violence, intimidation and threats from the small group of protesting students. These dangerous and demeaning behaviours, like disrupting classes and verbally abusing students and staff, undermine the legitimate quest of students for relief concerning tuition fees. Such behaviour is completely unacceptable and the university will take action where required. We must also remember that we have an obligation to all 30 000 students whose right to learn without fear of violence and intimidation must be respected.

In conclusion, over the past few years we have worked hard to build a culture of mutual respect and embrace as we worked through some very difficult challenges on campus. You would have noticed that the university leadership responded quickly and sympathetically to reason and respect in difficult situations of rage and demonstration. A minority of students, with some outsiders, have come onto the campus to break down that culture in which, while we might disagree, we continue to work on the basis of mutual respect. I urge all students that, as we engage of this important problem of enabling greater access to higher education, we continue to remain true to the core values of our Human Project.

Best Regards

Prof Jonathan Jansen
Vice-Chancellor and Rector
University of the Free State

Letter to students from Prof Jonathan Jansen about student protest actions at the UFS (Pdf format)

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