• Seear, Michael

    Titles

    Investigator, BC Children's Hospital
    Clinical Professor, Division of Respiratory Medicine, Department of Pediatrics, Faculty of Medicine, University of British Columbia

    Degrees / Designations
    MB ChB, BSc (Eng), FRCPC
    Primary Area of Research
    Healthy Starts
    Secondary Area(s) of Research
    Phone
    604-875-2119
    Fax
    Lab Phone
    Mailing Address
    Affiliate Websites
    Research Areas
    1. International health - mainly respiratory diseases of children in low-resource areas but also research into pharmaceutical quality in developing countries.
    2. Clinical pediatric respiratory medicine.
    3. Home ventilation - epidemiology and clinical management of children who need ventilatory support in their homes.
    Summary

    I grew up and took my basic medical training in what used to be called Rhodesia (now Zimbabwe). After graduating, I worked as a district health doctor in remote rural hospitals. My continuing interest in the health of people living in poverty dates to that time. After moving to Canada with my family, I worked as a resident at BC Children's Hospital before taking further sub-specialty training in pediatric respiratory diseases plus a second fellowship in pediatric intensive care. After completing this training I joined the BC Children's Hospital
    staff, splitting my time between the intensive care unit and the respiratory division. More recently, I have left the ICU and I am currently the head of the division of respiratory medicine. 

    My research interests reflect my past clinical experience. My primary interest has always been international health. I have published two books on the subject and also teach a credit course on international health at UBC. I currently run a large multi-centre trial in India looking into childhood pneumonia. I also like investigating topical questions in clinical respiratory medicine, including the very specialised respiratory topic of children that need mechanical ventilation in their homes.  

    Current Projects

    I currently run three funded prospective clinical studies. Their topics follow my major research interests outlined in the summary above.

    1. Improving the diagnosis of respiratory diseases in children living in low-resource conditions. Each year, over a million children die from lung infections. Accurate diagnosis is a fundamental requirement for the improved treatment protocols needed to reduce this terrible annual mortality. During the last winter we organised a large study involving 5 Indian hospitals. The aim was to define accurate diagnostic criteria to improve the prediction of the major respiratory illnesses affecting children. The organisation worked well. We stopped the study at the end of the viral season in May. At that stage, we had enrolled over 700 patients. The data analysis is not yet complete but clear diagnostic criteria have emerged that will be valuable in advancing the fight against pediatric respiratory deaths.
    2. The use of hi-flow nasal oxygen in the treatment of viral bronchiolitis. Bronchiolitis is the single most common cause for admission to pediatric hospitals, including our own. The disease has enormous economic and health consequences. Survivors are frequently left with significant long term health problems including asthma. Despite considerable research, there are no effective therapies other than symptom support. Over this last winter, we conducted a prospective controlled study of the use of hi-flow nasal oxygen in children with bronchiolitis. It was a low-incidence winter so we only managed to enroll 50 patients. Fortunately, we registered our study and it was noticed by staff at Children's Hospital in Sydney, Australia. They now have research clearance to run the same protocol during their bronchiolitis season which starts in June. Hopefully this will allow us to get over 100 patients which will allow us to analyse the data. If numbers are low then we will run the study again in our next winter. This has the potential to improve the care of this common condition so we hope to finish the analysis and submit the work as soon as possible.
    3. Quality of life for children who need home ventilation and their caregivers. Medical advances over the last 20 years have produced a revolution in child survival. Many of these survivors lead normal lives but a few require some form of assisted ventilation. The trend is to manage these patients in their homes. Numbers have risen steadily to the point that there are now 150 patients registered in the home ventilation clinic from places all over BC. This is now the largest home ventilation clinic in Canada. We are just starting a questionnaire-based study of the quality of life of the affected children and their caregivers. We will also be monitoring extra health-related expenses the family must meet. This is the first study of this kind ever undertaken in children. The results will be a valuable addition to home care planning.
    Selected Publications

    During the last few years, I have published three books and a steady output of journal articles. Examples are listed below: 

    Books:

    1. Seear M. A manual of tropical pediatrics. Overseas edition. Pub: Cambridge University Press, 2006 
    2. Seear M. An introduction to international health. Pub: Canadian Scholars' Press. 2008 
    3. Seear M. An introduction to international health. Second edition. Pub: Canadian Scholars' Press, 2012

    Journal articles:

    Hathorn C, Seear M, et. al. Bronchial occlusion in children with complex pulmonary air leaks. Arch Dis Child 2013;98:136. PMID: 23220206

    Seear M. The need for coordinated action against falsified and substandard medicines. Int J Tuberc Lung Dis 2013;17:286. PMID: 23407216

    Seear M, Ensuring pharmaceutical quality in emerging countries: an urgent and unresolved problem. Lancet Infect Dis. June 2012;12:428. 

    McDougall C, Seear M, et.al. Superior eventration of the mediastinum presenting as a neck mass on straining.  Accepted by Pediatric Pulmonology 2012;47:710-712

    Seear, M, et. Al. Fifty years of pediatric asthma in developed countries: how reliable are the basic data sources? Pediatric Pulmonology 2012, 47: 211-219. PMID: 21905263

    Seear M, Ghandi D, et al. The need for better data about counterfeit drugs in developing countries. J. Clin Pharm Therapeut 2011; 36: 488-495. PMID: 21729113

    Del Bel KL, Ragotte RJ, Saferali A, Lee S, Vercauteren SM, Mostafavi SA, Schreiber RA, Prendiville JS, Phang MS, Halperin J, Au N, Dean JM, Jewels E, Junker AK, Rogers PC, Seear M, McKinnon ML, Turvey SE. JAK1 gain-of- function causes an autosomal dominant immune dysregulatory and hypereosinophilic syndrome. J Allergy Clin Immunol. 2017 Jan 19. PMID: 28111307 Impact Factor: 12.485 

    Ragotte RJ, Dhanrajani A, Pleydell-Pearce J, Del Bel KL, Tarailo-Graovac M, van Karnebeek C, Terry J, Senger C, McKinnon ML, Seear M, Prendiville JS, Tucker LB, Houghton K, Cabral DA, Guzman J, Petty RE, Brown KL, Tekano J, Wu J, Morishita KA, Turvey SE. The importance of considering monogenic causes of autoimmunity: A somatic mutation in KRAS causing pediatric Rosai-Dorfman syndrome and systemic lupus erythematosus. Clin Immunol. 2016 Dec 31 PMID: 28043923 
    Grants
    Most of our research work in the respiratory division is supported by our own divisional fund. In the last few years, we have had two grants outside this mechanism:
    • $10,000 grant from the BC Children's Hospital Centre for International Child Health (CICH) in 2007. This was partial support for a joint study of drug quality in Chennai, India.
    • $25,000 grant from the BC Children's Hospital Auxilliary to support general respiratory research.
    Honours & Awards
    Research Group Members

    I only run clinical studies so have no full time managers and technicians. I usually hire temporary research assistants for the duration of a study. For example, in order to organize the multi-centre study of respiratory diseases in India, I hired a research coordinator at each of the 5 partner sites. Both the home ventilation study and the hi-flow oxygen study are coordinated by paid nurse researchers.