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The Variable Life-Adjusted Display (VLAD) is a graphical tool for monitoring clinical outcomes. It has been widely adopted by UK cardiac surgery centres, and has helped a shift in culture towards more open outcome assessment in adult cardiac surgery, which has been credited with reduced mortality rates. VLAD is also being used for a broad range of other clinical outcomes by regulatory bodies worldwide. For example, Queensland Health uses VLAD as a major part of its Patient Safety and Quality Improvement Service to monitor 34 outcomes across 64 public hospitals, and NHS Blood and Transplant uses VLAD to monitor early outcomes of all UK transplants.
The Boutelle team has developed a biosensor that uses rapid-sampling microdialysis (rsMD) to detect ischaemia (restricted blood supply to tissue) during surgery and intensive care. The rsMD biosensor is implanted into tissue at risk and provides a real-time readout of chemical markers of metabolism. By 2009, technical improvements researched in the Department of Bioengineering had made the system suitable for routine clinical use. The system has reduced morbidity and mortality by alerting the surgical team to otherwise undetected ischaemia. It has been used by an international consortium of clinical centres to help decide treatment in approximately 100 patients with brain injury. More recently it was adopted by a Portsmouth hospital to monitor cancer patients undergoing reconstruction of the face and jaw; the biosensor detected a failure of perfusion in transplanted tissue in two of the first ten patients, prompting the surgical team to remove otherwise undetected blood clots that could have led to death from septicaemia.
The GRANIT system is a non-destructive technique for assessing the condition of rock bolts and ground anchors used to support structures such as tunnels. It applies a small impulse to the bolt and interprets the resulting vibration response to provide estimates of load and unbonded length. Initial development of the system was based on the findings of EPSRC projects in tunnels undertaken by the Universities of Aberdeen and Bradford from 1989-1997, resulting in an empirically based method. However, research undertaken at the University of Aberdeen since 1998 has provided the understanding of the process and developed the fundamental engineering science needed to underpin the development of a full commercial system. The GRANIT system is patented, and has been subject to worldwide licence to Halcrow who have undertaken testing and provided a method of ensuring the safety of mines, tunnels and similar structures. Halcrow received the NCE award for Technical Innovation Award for GRANIT in December 2010. The impact of the research has been in part economic, but largely on practitioners and professional services.
Between 1996 and 2013 researchers at Swansea University evaluated service initiatives and changing professional roles associated with the management of patients with debilitating gastrointestinal disorders. This work showed the clinical and cost effectiveness of two main innovations: open access to hospital services for patients with inflammatory bowel disease; and increased responsibility for nurses, particularly as endoscopists. Our evidence has had a broad, significant impact on: national policy through incorporation in NHS strategies, professional service standards and commissioning guides; service delivery through the provision of increasing numbers of nurse endoscopists and the wide introduction of nurse-led open access to follow-up; and patient care, as documented in sequential national audits in 2006, 2008 and 2010.
Imperial College researchers have developed methods and indicators for highlighting potential variations in healthcare performance and safety using routinely collected health data. Analytical tools based on our methodological research are used by managers and clinicians in over two thirds of NHS hospital trusts, and hospitals throughout the world. The results of our analyses helped detect problems at Mid Staffordshire NHS Foundation Trust and triggered the initial investigation and subsequent public inquiry with wide ranging recommendations based on the recognition of their value and their use in enhancing the safety of healthcare.
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.
Bio-inspired computer algorithms, developed by Dr Stephen Smith at the University of York, have been integrated with commercially available hardware that analyse patients' movements to diagnose and monitor a range of neurodegenerative conditions including Parkinson's disease and Alzheimer's disease. Clinical studies undertaken in the UK and USA report a diagnostic accuracy exceeding 90% - a 15% improvement on current clinical practice. A new spinout company, ClearSky Medical Diagnostics Ltd, has licenced four products exploiting this technology to nine health centres in the UK, USA, Singapore, Australia and UAE, transforming clinical testing with improved diagnosis and monitoring of patients in hospitals and their own homes.
Based on his research at the UCL Institute of Cognitive Neuroscience, Professor Paul Burgess invented and co-invented several cognitive tests (known as the Hayling and Brixton Tests, and the BADS and BADS-C assessment batteries) which are used to detect dysfunction of the frontal lobes of the brain. These were developed for commercial production by Burgess and are now produced and marketed by the largest test publisher in the world (Pearson Assessment). There are versions in several different languages, and they are used in clinics worldwide to diagnose problems in a wide variety of patients with neurological, psychiatric and developmental problems. The tests are now administered around the world to around 55,000 patients per year.
Age Related Macular Degeneration (AMD) is by far the leading cause of blindness in older people in the developed world, affecting 30% of those aged over 65, and is set to increase. The naturally-occurring carotenoids lutein (L) and zeaxanthin (Z) are located in the central retina (macula) and are collectively called the macular pigment (MP). High MP levels confer protection from AMD. Murray and colleagues have developed a new instrument, the Macular Pigment Screener (MPS), which allows regular, non-invasive monitoring of MP in ophthalmic practice. This means that, for the first time, the MPS can show the effect of intervention on the MP, providing a management strategy for AMD patients, and allowing early identification of those at risk of developing AMD. Over 750 instruments have been sold to date, with more than 1M patients in the US alone estimated to be benefiting from routine MP testing.