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Questions about the benign or malignant nature of liver tumours are common and pressing since they determine how the patient is managed. Benign masses are frequently encountered; they usually do not require intervention but are easily mistaken for malignancies with conventional imaging methods. Work at Imperial College demonstrated that microbubble contrast agents have the special property of lingering in both normal liver tissue and in benign solid masses, whereas malignancies do not retain microbubble. The discovery of this property at Imperial has led to their use worldwide as a diagnostic tool. In 2012 NICE recommended their use as being cost-effective for this use.
ARTICULATED HEAD (2010-) and EAR ON ARM (2006-) reflect interconnected but different projects within Stelarc's research into alternate anatomical architectures. The ARTICULATED HEAD is the robotic embodiment of Stelarc's Prosthetic Head, a conversational agent that speaks to the person who interrogates it. It was a finalist for the Australian Engineering Excellence Awards 2010 and was exhibited at Powerhouse Museum, Sydney, for two years from January 2011, attracting an estimated 1.8 million visitors.
EAR ON ARM is the first instance of an artist having an ear surgically constructed and cell-grown on his arm and has been disseminated globally through museum, festival, and media representations. In 2010 EAR ON ARM was awarded the Prix Ars Electronica Golden Nica.
Within the art and medical communities, both projects have been acknowledged as pioneering innovations in the conceptualisation and realisation of biotechnological and engineering-based art and media attention for the projects has brought the research to a worldwide public.
The key driver for this research is to provide clinicians with robust tools that they can use to evaluate, treat and therefore improve the clinical outcome in their patients. Our research has assisted the development of the evidence base of many clinical treatments and assessment tools. This has led to the design and development of new rehabilitation products and medical devices in partnership with both large companies and small to medium sized enterprises. The core impact of this work has been improvements in patient care and quality of life by improving the efficacy and effectiveness in these areas with a particular focus on the advancement of conservative management and lower limb rehabilitation.
In response to inadequately designed assessment systems for patients recovering from orthopaedic surgery, researchers from the University of Oxford developed a series highly reliable and sensitive patient recorded questionnaires, known as the Oxford Scores. Providing a set of standardised outcomes for appraisal and on-going monitoring of patients, the Oxford Scores enable the informed assessment of clinical outcomes. Used to predict and detect early failure of poorly performing surgical interventions, the Oxford Scores have been adopted by health providers and regulators worldwide, leading to policy and treatment guideline changes and significant improvements in the quality of life of patients.
Research at University of Oxford led to the development of the Phase 3 Oxford Knee in 1998, a significantly improved and less invasive knee replacement, allowing implantation through a small incision. Due to its many advantages over other knee replacements, including faster recovery, fewer complications and better function, the Phase 3 Oxford Knee is now the most widely used partial knee replacement in the world. Approximately 1 million people have benefitted from this development.
Postoperative local recurrence affects 20-30% of patients with rectal cancer. Between 1993 and 2013, University of Leeds researchers identified the importance of pathology studies to show a disease-free margin around the excised tumour and how to predict this margin routinely and accurately using simple histopathology and preoperative MRI.
We also used photography in the pathological assessment of the quality of surgery and were instrumental in the adoption of modern techniques by professional organisations around the world.
Following adoption of our techniques in England and Scotland, local recurrence has halved with 10% better survival and cost savings of £60 million. Our methods have also become the gold standard in the treatment of rectal cancer patients around the world.
Each year an estimated 1,324,000 artificial knee joints (total knee replacements — TKR) are implanted worldwide; an estimated third of these utilise an implant manufactured by DePuy International. Underlying computer-based research performed by the Bioengineering Sciences Research Group has played a central role during the development of a new design of TKR for DePuy. The design programme, the biggest in DePuy's history, had a budget in excess of US$10 million and aimed to replace the existing TKR system, which had annual sales of approximately US$100 million.
Between 2007-2010, DePuy adopted the computational techniques developed by the group as screening tools to (i) assess polyethylene wear and (ii) account for the effects of surgical variability during the early design phases. DePuy states "This research allowed us to choose the most robust solution when proceeding to mechanical testing and saved years in the design cycle. Patients also benefit from increased confidence in an implant that is able to withstand the rigors of use".
The World Health Organisation's (WHO) Surgical Safety Checklist is the culmination of over 5 years of concerted research effort to better understand, model and intervene in human factors that affect clinical performance and patient safety in operating theatres and surgical care. Imperial researchers were instrumental in the set up and implementation of the WHO `Safe Surgery Saves Lives' working group, launched in 2006, from which the Checklist was a primary outcome. Subsequently, we were co-investigators, and UK-lead, in a global study the implementation of the Checklist in 8 pilot hospitals across 7 continents. The Checklist was demonstrated to significantly improve patient outcomes and was modified and mandated for use in all NHS surgical procedures in England by the National Patient Safety Agency. We have since lead a national study that evaluated the implementation of the Checklist within the NHS and successfully delivered a team training programme aimed at optimising use of the Checklist in our hospitals.
Research at Strathclyde has brought about a change in eye surgery practice throughout Europe and worldwide. A four-year cross-Europe study in collaboration with the European Society of Cataract and Refractive Surgery (ESCRS) investigated antibiotic treatment to prevent endophthalmitis, a complication arising during cataract operations which typically results in loss of sight. The findings showed that when the treatment is given at the start of surgery it leads to a 5-fold reduction in the risk of endophthalmitis. The European Society of Cataract and Refractive Surgery has endorsed the discovery and widely promoted the uptake of the treatment through publications and guidelines, which over the last 6 years has led to the prevention of loss of sight in thousands of patients. In Europe alone it is estimated that each year there have been 7500 fewer cases of blindness following cataract surgery as a result of the ESCRS guidelines.
A team of biomedical engineers at UCL has developed a non-invasive growing implant that improves the health and quality of life of young patients who have suffered from certain bone cancers. The prosthesis avoids the costly and invasive surgical interventions of previous treatment. Instead, the prosthesis can be lengthened in a quick and pain-free procedure conducted at an outpatient clinic. As a result, it reduces the costs of bone reconstruction and growing by around £19,000 per patient, as well as reducing the risk of infection and subsequent treatment. Since 2008, more than 400 devices have been sold; in addition to the cost savings indicated above these devices have generated more than £6 million income for UCL spin-out company Stanmore Implants Ltd, which was sold for £10 million in 2008.