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14 December 2022 | Story André Damons | Photo André Damons
Dr Michael Pienaar, Senior Lecturer and specialist in the UFS Department of Paediatrics and Child Health being presented to the acting Chancellor by his supervisor Prof Stephen Brown.

A lecturer from the University of the Free State (UFS) says the need to improve the care of seriously ill children is a vital part of reducing preventable deaths and diseases, and this led him to investigate the use of artificial neural networks to develop models for the prediction of patient outcomes in children with severe illness. The study was done for his PhD thesis. 

This forms the basis for the PhD thesis of Dr Michael Pienaar, Senior Lecturer and specialist in the UFS Department of Paediatrics and Child Health, called, The Development and Validation of Predictive Models for Paediatric Critical Illness in Children in Central South Africa using Artificial Neural Networks. His thesis reports the development and testing of several machine learning models designed to help healthcare workers identify seriously ill children early in a range of resource-limited settings. Combining a systematic literature search and Delphi technique with clinical data from 1 032 participants, this research led to significant progress towards implementable models for community health workers in clinical practice.

Care for critically ill children is a mission and calling 

Dr Pienaar graduated with a PhD specialising in Paediatrics on Monday (12 December) during the Faculty of Health Sciences’ December graduation ceremony. It took him three years to complete this degree. His supervisor was Prof Stephen Brown, Principal Specialist and Head of the Division of Paediatric Cardiology in the Department of Paediatrics and Child Health in the Faculty of Health Sciences at the UFS. Prof Nicolaas Luwes and Dr EC George were his co-supervisors. 

“I have been working in paediatric critical care since 2019 and see the care of critically ill children as my mission and calling in life. At the outset of the project, I was interested in approaches to complex phenomena and wanted to investigate new methods for tackling these in healthcare. 

“I have been interested in technology since childhood and in collaborating with other disciplines since I joined the university in 2019. Machine learning seemed like a great fit that could incorporate these interests and yield meaningful clinical results,” explains Dr Pienaar the reason why he chose this topic for his thesis.

He hopes that, in time, this work will lead to the implementation of integrated machine learning models to improve care and clinical outcomes for children in South Africa. From a scholarship perspective, he continues, his hope is that this work draws interest to this field in clinical research and encourages a move towards incorporating these new methods, as well as skills in areas such as coding and design in the armamentarium of a new generation of clinicians.

Medicine chooses you

According to Dr Pienaar, he always had broad interests, of which medicine is one. “I am very grateful to have found my way in medicine and am humbled and privileged to be allowed to walk with children and their families on a difficult and important journey. I believe this profession will choose you and put you where you are needed if you give it time and are prepared to listen.”

He describes graduating as a complicated ending to this period of his life and the beginning of a next chapter. He was humbled by the graduation ceremony. 

“It was wonderful to graduate with undergraduates and postgraduates in my profession – I felt great pride and solidarity joining these new colleagues and specialists in taking the oath. I am certainly relieved, proud, excited, and happy. I am also very grateful to the university, my promotors, colleagues, friends, and family for supporting me through this process. I must confess, it is also slightly bittersweet, I loved working on this and do miss it, but look forward to the next exciting project. 

“I would like to thank my Head of Department, Dr (Nomakhuwa) Tabane, my supervisors, my family and friends once again. I would also like to acknowledge and thank the National Research Foundation (NRF) as well as the University of the Free State for their assistance with funding this research.”

News Archive

First doctorate in Thoracic Surgery in Africa awarded
2009-05-12

The University of the Free State (UFS) has become the first university in Africa to award a Ph.D. degree in Thoracic Surgery. The degree was conferred on Prof. Anthony Linegar from the university’s Department of Cardiothoracic Surgery during its recent graduation ceremony.

Thoracic surgery is a challenging subspecialty of cardiothoracic surgery. It began in South Africa in the 1940s and is a broad medico-surgical specialist discipline that involves the diagnosis, operative and peri-operative treatment of acquired and congenital non-cardiac ailments of the chest.

Prof. Linegar became the first academic to conduct a mixed methods analysis of this surgical specialty, which included a systematic review of all the research done in this field in South Africa. The title of his thesis is A Model for the Development of Thoracic Surgery in Central South Africa. The research was based on the hypothesis of a performance gap between the burden of disease in the community and the actual service provision. It makes use of systems theory and project management concepts to develop a model aimed at the development of thoracic surgery.

The research proved that there is a significant under provision of clinical services in thoracic surgery. This was quantified to a factor of 20 times less than should be the case, in diseases such as lung and oesophagus cancer. According to Prof. Linegar, there are multiple reasons for this. Listed amongst these reasons is the fact that thoracic surgery is not part of the undergraduate education in medical training. There tends to be a low level of awareness amongst clinicians as to what the thoracic surgeon offers their patients. The diagnostic and referral patterns in primary and secondary health facilities, where diseases must be picked up and referred early, are not functioning well in this regard. In addition, relatively few cardiothoracic surgeons express an interest in thoracic surgery.

Prof. Linegar’s model is named the ATLAS Mode, which is an acronym for the Advancement of Thoracic Surgery through Analysis and Strategic Planning. It includes the raising of awareness of the role of the specialist thoracic surgeon in the treatment of patients with thoracic diseases as part of the solution to the problem. Furthermore, it aims to develop an accessible and sustainable specialist service that adequately provides for the needs of the community, and that is appropriately represented in health administration circles.

His promoters were Prof. Gert van Zyl, Head of the School of Medicine at the UFS, Prof. Peter Goldstraw, from the Imperial College of London, United Kingdom (UK) and Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the UFS.

Prof. Linegar has been with the UFS since 2004, is a graduate from Stellenbosch University in 1984 and completed his postgraduate training in Cardiothoracic Surgery at the University of Cape Town. He was granted a Fellowship in Thoracic Surgery at the Royal Brompton Hospital in London, UK and has since held consultant positions at the UFS, Stellenbosch University and in private practice. He has been involved in registrar training since returning from the UK in 1994 and has extensive experience in intensive care medicine. He has published widely, has presented papers at many international conferences, has been invited as a speaker on many occasions and has won awards for best presentation on three occasions.

Media Release
Issued by: Lacea Loader
Assistant Director: Media Liaison
Tel: 051 401 2584
Cell: 083 645 2454
E-mail: loaderl.stg@ufs.ac.za  
12 May 2009
 

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