Imperial College London

Professor the Lord Darzi of Denham PC KBE FRS FMedSci HonFREng

Faculty of MedicineDepartment of Surgery & Cancer

Professor of Surgery
 
 
 
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Contact

 

+44 (0)20 3312 1310a.darzi

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Publication Type
Year
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1460 results found

Orihuela-Espina F, Leff DR, James DRC, Darzi AW, Yang G-Zet al., 2018, Imperial College near infrared spectroscopy neuroimaging analysis framework., Neurophotonics, Vol: 5, ISSN: 2329-423X

This paper describes the Imperial College near infrared spectroscopy neuroimaging analysis (ICNNA) software tool for functional near infrared spectroscopy neuroimaging data. ICNNA is a MATLAB-based object-oriented framework encompassing an application programming interface and a graphical user interface. ICNNA incorporates reconstruction based on the modified Beer-Lambert law and basic processing and data validation capabilities. Emphasis is placed on the full experiment rather than individual neuroimages as the central element of analysis. The software offers three types of analyses including classical statistical methods based on comparison of changes in relative concentrations of hemoglobin between the task and baseline periods, graph theory-based metrics of connectivity and, distinctively, an analysis approach based on manifold embedding. This paper presents the different capabilities of ICNNA in its current version.

JOURNAL ARTICLE

Abeles A, Kwasnicki RM, Darzi A, 2017, Enhanced recovery after surgery: Current research insights and future direction, WORLD JOURNAL OF GASTROINTESTINAL SURGERY, Vol: 9, Pages: 37-45, ISSN: 1948-9366

JOURNAL ARTICLE

Abeles A, Kwasnicki RM, Geoghegan L, Pratt P, Darzi Aet al., 2017, Wearable activity sensors: Using physical activity to predict length of hospital stay?, International Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY, Pages: 53-53, ISSN: 0007-1323

CONFERENCE PAPER

Abeles A, Kwasnicki RM, Pettengell C, Murphy J, Darzi Aet al., 2017, The relationship between physical activity and post-operative length of hospital stay: A systematic review, INTERNATIONAL JOURNAL OF SURGERY, Vol: 44, Pages: 295-302, ISSN: 1743-9191

JOURNAL ARTICLE

Acharya A, Markar SR, Sodergren MH, Malietzis G, Darzi A, Athanasiou T, Khan AZet al., 2017, Meta-analysis of adjuvant therapy following curative surgery for periampullary adenocarcinoma, BRITISH JOURNAL OF SURGERY, Vol: 104, Pages: 814-822, ISSN: 0007-1323

JOURNAL ARTICLE

Alexander J, Gildea L, Balog J, Speller A, McKenzie J, Muirhead L, Scott A, Kontovounisios C, Rasheed S, Teare J, Hoare J, Veselkov K, Goldin R, Tekkis P, Darzi A, Nicholson J, Kinross J, Takats Zet al., 2017, A novel methodology for in vivo endoscopic phenotyping of colorectal cancer based on real-time analysis of the mucosal lipidome: a prospective observational study of the iKnife, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 31, Pages: 1361-1370, ISSN: 0930-2794

JOURNAL ARTICLE

Alexander J, Poynter L, Scott A, Perdones-Montero A, Hughes D, Susova S, Soucek P, Liska V, Mirnezami R, Cunningham D, Darzi A, Teare J, Marchesi J, Kinross Jet al., 2017, A PROSPECTIVE MULTI-CENTERED ANALYSIS OF THE RECTAL CANCER MUCOSAL MICROBIOME DURING NEOADJUVANT LONG COURSE CHEMORADIOTHERAPY., Annual Meeting of the American-Society-of-Colon-and-Rectal-Surgeons, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E118-E118, ISSN: 0012-3706

CONFERENCE PAPER

Appelbaum N, Clarke J, Maconochie I, Darzi Aet al., 2017, Paediatric weight estimation by age in the digital era: optimising a necessary evil., Resuscitation, Vol: 122, Pages: 29-35

BACKGROUND: Age-based weight estimation methods are regularly used in paediatric emergency medicine despite their well-established inaccuracy. AIM: Determine the potential improvement in accuracy achievable by the use of a new mobile application, based on CDC/WHO weight-for-age centile data, which incorporates a gender assignment, a body habitus assessment, and which is capable of an age-in-months based calculation. METHODS: A theoretical, simulated validation study, comparing the performance of the widely used APLS/EPALS formulae against two contemporary habitus-adjusted methods, and the Helix Weight Estimation Tool. 1,070,743 children from the 2015/2016 UK National Child Measurement Program dataset, aged between 4 and 5 and 11 and 12 years, had age-based weight estimates made by all five methods. RESULTS: Primary outcomes were the percentage of weight estimations within 10%, 20%, and those greater than 20% discrepant from actual weight for each method. Our theoretical, gender-dependent, habitus-adjusted method performed better than all other methods across all error thresholds. The overall number of estimations within 10% was 70.4%, and within 20% was 95.45%. The mean percentage error was -1% compared to actual weight. CONCLUSION: The use of a digital tool incorporating a subjective assessment of body habitus, gender assignment, and the ability to estimate weight based on age-in-months might be able optimise the process of paediatric weight estimation by age, making this practice as safe and accurate as possible for the occasions when weight estimation by age is chosen over length-based methods.

JOURNAL ARTICLE

Ashraf H, Sodergren MH, Merali N, Mylonas G, Singh H, Darzi Aet al., 2017, Eye-tracking technology in medical education: A systematic review., Med Teach, Pages: 1-8

BACKGROUND: Eye-tracking technology is an established research tool within allied industries such as advertising, psychology and aerospace. This review aims to consolidate literature describing the evidence for use of eye-tracking as an adjunct to traditional teaching methods in medical education. METHODS: A systematic literature review was conducted in line with STORIES guidelines. A search of EMBASE, OVID MEDLINE, PsycINFO, TRIP database, and Science Direct was conducted until January 2017. Studies describing the use of eye-tracking in the training, assessment, and feedback of clinicians were included in the review. RESULTS: Thirty-three studies were included in the final qualitative synthesis. Three studies were based on the use of gaze training, three studies on the changes in gaze behavior during the learning curve, 17 studies on clinical assessment and six studies focused on the use of eye-tracking methodology as a feedback tool. The studies demonstrated feasibility and validity in the use of eye-tracking as a training and assessment method. CONCLUSIONS: Overall, eye-tracking methodology has contributed significantly to the training, assessment, and feedback practices used in the clinical setting. The technology provides reliable quantitative data, which can be interpreted to give an indication of clinical skill, provide training solutions and aid in feedback and reflection. This review provides a detailed summary of evidence relating to eye-tracking methodology and its uses as a training method, changes in visual gaze behavior during the learning curve, eye-tracking methodology for proficiency assessment and its uses as a feedback tool.

JOURNAL ARTICLE

Ashrafian H, Clancy O, Grover V, Darzi Aet al., 2017, The evolution of robotic surgery: surgical and anaesthetic aspects., Br J Anaesth, Vol: 119, Pages: i72-i84

Robotic surgery pushes the frontiers of innovation in healthcare technology towards improved clinical outcomes. We discuss the evolution to five generations of robotic surgical platforms including stereotactic, endoscopic, bioinspired, microbots on the millimetre scale, and the future development of autonomous systems. We examine the challenges, obstacles and limitations of robotic surgery and its future potential including integrated real-time anatomical and immune-histological imaging and data assimilation with improved visualisation, haptic feedback and robot-surgeon interactivity. We consider current evidence, cost-effectiveness and the learning curve in relation to the surgical and anaesthetic journey, and what is required to continue to realise improvements in surgical operative care. The innovative impact of this technology holds the potential to achieve transformative clinical improvements. However, despite over 30 yr of incremental advances it remains formative in its innovative disruption.

JOURNAL ARTICLE

Bagnall NM, Pucher PH, Johnston MJ, Arora S, Athanasiou T, Faiz O, Darzi LAet al., 2017, Informing the process of consent for surgery: identification of key constructs and quality factors, JOURNAL OF SURGICAL RESEARCH, Vol: 209, Pages: 86-92, ISSN: 0022-4804

JOURNAL ARTICLE

Beyer-Berjot L, Pucher P, Patel V, Hashimoto DA, Ziprin P, Berdah S, Darzi A, Aggarwal Ret al., 2017, Colorectal surgery and enhanced recovery: Impact of a simulation-based care pathway training curriculum, JOURNAL OF VISCERAL SURGERY, Vol: 154, Pages: 313-320, ISSN: 1878-7886

JOURNAL ARTICLE

Bhatti Y, Taylor A, Harris M, Wadge H, Escobar E, Prime M, Patel H, Carter AW, Parston G, Darzi AW, Udayakumar Ket al., 2017, Global Lessons In Frugal Innovation To Improve Health Care Delivery In The United States, HEALTH AFFAIRS, Vol: 36, Pages: 1912-1919, ISSN: 0278-2715

JOURNAL ARTICLE

Bouras G, Burns EM, Howell AM, Bottle A, Athanasiou T, Darzi Aet al., 2017, Linked hospital and primary care database analysis of the impact of short-term complications on recurrence in laparoscopic inguinal hernia repair, HERNIA, Vol: 21, Pages: 191-198, ISSN: 1265-4906

JOURNAL ARTICLE

Bouras G, Markar SR, Burns EM, Huddy JR, Bottle A, Athanasiou T, Darzi A, Hanna GBet al., 2017, The psychological impact of symptoms related to esophagogastric cancer resection presenting in primary care: A national linked database study, EJSO, Vol: 43, Pages: 454-460, ISSN: 0748-7983

JOURNAL ARTICLE

Callender T, Riley J, Broadhurst H, Wiggins N, Shaw A, Archer S, Darzi A, Droney Jet al., 2017, The Determinants of Dying Where We Choose: An Analysis of Coordinate My Care, ANNALS OF INTERNAL MEDICINE, Vol: 167, Pages: 519-521, ISSN: 0003-4819

JOURNAL ARTICLE

Camara M, Mayer E, Darzi A, Pratt Pet al., 2017, Simulation of Patient-Specific Deformable Ultrasound Imaging in Real Time, Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics), Vol: 10549 LNCS, Pages: 11-18, ISSN: 0302-9743

© 2017, Springer International Publishing AG. Intraoperative ultrasound is an imaging modality frequently used to provide delineation of tissue boundaries. This paper proposes a simulation platform that enables rehearsal of patient-specific deformable ultrasound scanning in real-time, using preoperative CT as the data source. The simulation platform was implemented within the GPU-accelerated NVIDIA FleX position-based dynamics framework. The high-resolution particle model is used to deform both surface and volume meshes. The latter is used to compute the barycentric coordinates of each simulated ultrasound image pixel in the surrounding volume, which is then mapped back to the original undeformed CT volume. To validate the computation of simulated ultrasound images, a kidney phantom with an embedded tumour was CT-scanned in the rest position and at five different levels of probe-induced deformation. Measures of normalised cross-correlation and similarity between features were adopted to compare pairs of simulated and ground truth images. The accurate results demonstrate the potential of this approach for clinical translation.

JOURNAL ARTICLE

Carter AW, Mandavia R, Mayer E, Marti J, Mossialos E, Darzi Aet al., 2017, Systematic review of economic analyses in patient safety: a protocol designed to measure development in the scope and quality of evidence, BMJ OPEN, Vol: 7, ISSN: 2044-6055

JOURNAL ARTICLE

Chana P, Joy M, Casey N, Chang D, Burns EM, Arora S, Darzi AW, Faiz OD, Peden CJet al., 2017, Cohort analysis of outcomes in 69 490 emergency general surgical admissions across an international benchmarking collaborative, BMJ OPEN, Vol: 7, ISSN: 2044-6055

JOURNAL ARTICLE

Chow A, Stuckey DJ, Kidher E, Rocco M, Jabbour RJ, Mansfield CA, Darzi A, Harding SE, Stevens MM, Athanasiou Tet al., 2017, Human Induced Pluripotent Stem Cell-Derived Cardiomyocyte Encapsulating Bioactive Hydrogels Improve Rat Heart Function Post Myocardial Infarction, STEM CELL REPORTS, Vol: 9, Pages: 1415-1422, ISSN: 2213-6711

JOURNAL ARTICLE

Cohen D, Vlaev I, McMahon L, Harvey S, Mitchell A, Borovoi L, Darzi Aet al., 2017, The Crucible simulation: Behavioral simulation improves clinical leadership skills and understanding of complex health policy change., Health Care Manage Rev

BACKGROUND: The Health and Social Care Act 2012 represents the most complex National Health Service reforms in history. High-quality clinical leadership is important for successful implementation of health service reform. However, little is known about the effectiveness of current leadership training. PURPOSE: This study describes the use of a behavioral simulation to improve the knowledge and leadership of a cohort of medical doctors expected to take leadership roles in the National Health Service. METHODOLOGY: A day-long behavioral simulation (The Crucible) was developed and run based on a fictitious but realistic health economy. Participants completed pre- and postsimulation questionnaires generating qualitative and quantitative data. Leadership skills, knowledge, and behavior change processes described by the "theory of planned behavior" were self-assessed pre- and postsimulation. RESULTS: Sixty-nine medical doctors attended. Participants deemed the simulation immersive and relevant. Significant improvements were shown in perceived knowledge, capability, attitudes, subjective norms, intentions, and leadership competency following the program. Nearly one third of participants reported that they had implemented knowledge and skills from the simulation into practice within 4 weeks. CONCLUSIONS: This study systematically demonstrates the effectiveness of behavioral simulation for clinical management training and understanding of health policy reform. Potential future uses and strategies for analysis are discussed. PRACTICE IMPLICATIONS: High-quality care requires understanding of health systems and strong leadership. Policymakers should consider the use of behavioral simulation to improve understanding of health service reform and development of leadership skills in clinicians, who readily adopt skills from simulation into everyday practice.

JOURNAL ARTICLE

D'Lima D, Crawford MJ, Darzi A, Archer Set al., 2017, Patient safety and quality of care in mental health: a world of its own?, BJPSYCH BULLETIN, Vol: 41, Pages: 241-243, ISSN: 2056-4694

JOURNAL ARTICLE

Erridge S, Ashraf H, Purkayastha S, Darzi A, Sodergren MHet al., 2017, Comparison of gaze behaviour of trainee and experienced surgeons during laparoscopic gastric bypass., Br J Surg

BACKGROUND: Eye tracking presents a novel tool that could be used to profile skill levels in surgery objectively. The primary aim of this study was to identify differences in gaze behaviour between expert and junior surgeons performing a laparoscopic Roux-en-Y gastric bypass (LRYGB) for obesity. METHODS: This prospective observational study used a lightweight eye-tracking apparatus to determine the difference in gaze behaviours between expert (more than 75 procedures) and junior (75 or fewer procedures) surgeons at defined stages of LRYGB. Primary endpoints were normalized dwell time and fixation frequency. Secondary endpoints were blink rate, maximum pupil size and rate of pupil change. RESULTS: A total of 20 procedures (12 junior, 8 expert) were analysed. Compared with juniors, experts showed a prolonged dwell time on the screen during angle of His dissection (median (range) 91·20 (83·40-94·40) versus 68·95 (59·80-87·60) per cent; P = 0·001), formation of the retrogastric tunnel (91·50 (85·80-95·50) versus 73·60 (34·60-90·50) per cent; P = 0·001) and gastric pouch formation (86·95 (83·60-90·20) versus 67·60 (37·10-80·00) per cent P < 0·001). Juniors had a greater blink frequency throughout all recorded segments (P < 0·010) and had a larger maximum pupil size during all recorded operative segments (P < 0·010). Rate of pupil change was greater in juniors in all analysed segments (P < 0·010). CONCLUSION: These results suggest that experts display more focused attention on significant stimuli, alongside experiencing a reduced mental workload and having increased concentration. This has the potential for future use in validation of surgical skill in high-stakes assessment.

JOURNAL ARTICLE

Erridge S, Pucher PH, Markar SR, Malietzis G, Athanasiou T, Darzi A, Sodergren MH, Jiao LRet al., 2017, Meta-analysis of determinants of survival following treatment of recurrent hepatocellular carcinoma, BRITISH JOURNAL OF SURGERY, Vol: 104, Pages: 1433-1442, ISSN: 0007-1323

JOURNAL ARTICLE

Flott K, Fontana G, Dhingra-Kumar N, Yu A, Durkin M, Darzi Aet al., 2017, Health care must mean safe care: enshrining patient safety in global health, LANCET, Vol: 389, Pages: 1279-1281, ISSN: 0140-6736

JOURNAL ARTICLE

Flott K, Hounsome L, Vuik S, Darzi A, Mayer Eet al., 2017, A patient-centric approach to improving experience in urological cancer care, JOURNAL OF CLINICAL UROLOGY, Vol: 10, Pages: 39-46, ISSN: 2051-4158

JOURNAL ARTICLE

Flott KM, Graham C, Darzi A, Mayer Eet al., 2017, Can we use patient-reported feedback to drive change? The challenges of using patient-reported feedback and how they might be addressed, BMJ QUALITY & SAFETY, Vol: 26, Pages: 502-507, ISSN: 2044-5415

JOURNAL ARTICLE

Garas G, Cingolani I, Panzarasa P, Darzi A, Athanasiou Tet al., 2017, Networks of Surgical Innovation: Measuring Value and the Virality of Diffusion The example of Robotic Surgery, International Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY, Pages: 229-229, ISSN: 0007-1323

CONFERENCE PAPER

Garas G, Cingolani I, Panzarasa P, Darzi A, Athanasiou Tet al., 2017, Network analysis of surgical innovation: Measuring value and the virality of diffusion in robotic surgery, PLOS ONE, Vol: 12, ISSN: 1932-6203

JOURNAL ARTICLE

Garas G, Markar S, Malietzis G, Darzi A, Athanasiou Tet al., 2017, Induced bias due to crossover in randomised controlled trials in surgical oncology, International Congress of the Association-of-Surgeons-of-Great-Britain-and-Ireland, Publisher: WILEY, Pages: 36-37, ISSN: 0007-1323

CONFERENCE PAPER

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