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
to

1476 results found

Appelbaum N, Clarke J, Maconochie I, Darzi Aet al., 2018, Paediatric weight estimation by age in the digital era: optimising a necessary evil, RESUSCITATION, Vol: 122, Pages: 29-35, ISSN: 0300-9572

JOURNAL ARTICLE

Appelbaum N, Clarke J, Maconochie I, Darzi Aet al., 2018, A model for habitus-adjusted paediatric weight estimation by age and data concerning the validation of this method on a large dataset of English children., Data Brief, Vol: 16, Pages: 771-774, ISSN: 2352-3409

It is often not possible to weigh children upon arrival at an emergency room before commencing the provision of emergency care. Because drugs for children are prescribed on the basis of age and body weight, estimations of weight are necessitated. Age-based equations have been one of the most commonly used weight estimation strategies historically. Due to the variability of weight for age in children, and variations in body habitus, these methods are inaccurate by design (Young and Korotzer, 2016) [1].

JOURNAL ARTICLE

Ashraf H, Sodergren MH, Merali N, Mylonas G, Singh H, Darzi Aet al., 2018, Eye-tracking technology in medical education: A systematic review, MEDICAL TEACHER, Vol: 40, Pages: 62-69, ISSN: 0142-159X

JOURNAL ARTICLE

Erridge S, Ashraf H, Purkayastha S, Darzi A, Sodergren MHet al., 2018, Comparison of gaze behaviour of trainee and experienced surgeons during laparoscopic gastric bypass, BRITISH JOURNAL OF SURGERY, Vol: 105, Pages: 287-294, ISSN: 0007-1323

JOURNAL ARTICLE

Garas G, Markar SR, Malietzis G, Ashrafian H, Hanna GB, Zacharakis E, Jiao LR, Argiris A, Darzi A, Athanasiou Tet al., 2018, Induced Bias Due to Crossover Within Randomized Controlled Trials in Surgical Oncology: A Meta-regression Analysis of Minimally Invasive versus Open Surgery for the Treatment of Gastrointestinal Cancer, ANNALS OF SURGICAL ONCOLOGY, Vol: 25, Pages: 221-230, ISSN: 1068-9265

JOURNAL ARTICLE

Hassen Y, Singh P, Pucher PH, Johnston MJ, Darzi Aet al., 2018, Identifying quality markers of a safe surgical ward: An interview study of patients, clinical staff, and administrators., Surgery

BACKGROUND: Postoperative care quality is variable. Risk-adjusted mortality rates differ between institutions despite comparable complication rates. This indicates that there are underlying factors rooted in how care is delivered that determines patient safety. This study aims to evaluate systematically the surgical ward environment with respect to process-driven and structural factors to identify quality markers for safe care, from which new safety metrics may be derived. METHODS: Semistructured interviews of clinicians, nurses, patients and administrators were undertaken for the study. RESULTS: In the study, 97% of staff members recognized the existence of variation in patient safety between surgical wards. Four main error-prone processes were identified: ward rounds (57%), medication prescribing and administration (49%), the presence of outliers (43%), and deficiencies in communication between clinical staff (43%). Structural factors were categorized as organizational or environmental; organizational included shortage in staffing (39%) and use of temporary staff (27%). Environmental factors considered layout and patient visibility to nurses (49%) as well as cleanliness (29%). Safety indicators identified included staff experience level (31%), overall layout of the ward, cleanliness and leadership (all 27% each). The majority of patients (87%) identified staff attentiveness as a safety indicator. CONCLUSION: This study demonstrates that there are a number of factors that may contribute to safety on the surgical ward spanning multiple processes, organizational, and environmental factors. Safety indicators identified across all these categories presents an opportunity to develop broader and more effectual safety improvement measures focusing on multiple areas simultaneously.

JOURNAL ARTICLE

Johnston MJ, Arora S, King D, Darzi Aet al., 2018, Improving the Quality of Ward-based Surgical Care With a Human Factors Intervention Bundle, ANNALS OF SURGERY, Vol: 267, Pages: 73-80, ISSN: 0003-4932

JOURNAL ARTICLE

Lami M, Singh H, Dilley JH, Ashraf H, Edmondon M, Orihuela-Espina F, Hoare J, Darzi A, Sodergren MHet al., 2018, Gaze patterns hold key to unlocking successful search strategies and increasing polyp detection rate in colonoscopy., Endoscopy

BACKGROUND:  The adenoma detection rate (ADR) is an important quality indicator in colonoscopy. The aim of this study was to evaluate the changes in visual gaze patterns (VGPs) with increasing polyp detection rate (PDR), a surrogate marker of ADR. METHODS:  18 endoscopists participated in the study. VGPs were measured using eye-tracking technology during the withdrawal phase of colonoscopy. VGPs were characterized using two analyses - screen and anatomy. Eye-tracking parameters were used to characterize performance, which was further substantiated using hidden Markov model (HMM) analysis. RESULTS:  Subjects with higher PDRs spent more time viewing the outer ring of the 3 × 3 grid for both analyses (screen-based: r = 0.56, P = 0.02; anatomy: r = 0.62, P < 0.01). Fixation distribution to the "bottom U" of the screen in screen-based analysis was positively correlated with PDR (r = 0.62, P = 0.01). HMM demarcated the VGPs into three PDR groups. CONCLUSION:  This study defined distinct VGPs that are associated with expert behavior. These data may allow introduction of visual gaze training within structured training programs, and have implications for adoption in higher-level assessment.

JOURNAL ARTICLE

Malik HT, Marti J, Darzi A, Mossialos Eet al., 2018, Savings from reducing low-value general surgical interventions, BRITISH JOURNAL OF SURGERY, Vol: 105, Pages: 13-25, ISSN: 0007-1323

JOURNAL ARTICLE

Murray AC, Markar S, Mackenzie H, Baser O, Wiggins T, Askari A, Hanna G, Faiz O, Mayer E, Bicknell C, Darzi A, Kiran RPet al., 2018, An observational study of the timing of surgery, use of laparoscopy and outcomes for acute cholecystitis in the USA and UK., Surg Endosc

BACKGROUND: Evidence supports early laparoscopic cholecystectomy for acute cholecystitis. Differences in treatment patterns between the USA and UK, associated outcomes and resource utilization are not well understood. METHODS: In this retrospective, observational study using national administrative data, emergency patients admitted with acute cholecystitis were identified in England (Hospital Episode Statistics 1998-2012) and USA (National Inpatient Sample 1998-2011). Proportions of patients who underwent emergency cholecystectomy, utilization of laparoscopy and associated outcomes including length of stay (LOS) and complications were compared. The effect of delayed treatment on subsequent readmissions was evaluated for England. RESULTS: Patients with a diagnosis of acute cholecystitis totaled 1,191,331 in the USA vs. 288 907 in England. Emergency cholecystectomy was performed in 628,395 (52.7% USA) and 45,299 (15.7% England) over the time period. Laparoscopy was more common in the USA (82.8 vs. 37.9%; p < 0.001). Pre-treatment (1 vs. 2 days; p < 0.001) and total ( 4 vs. 7 days; p < 0.001) LOS was lower in the USA. Overall incidence of bile duct injury was higher in England than the USA (0.83 vs. 0.43%; p < 0.001), but was no different following laparoscopic surgery (0.1%). In England, 40.5% of patients without an immediate cholecystectomy were subsequently readmitted with cholecystitis. An additional 14.5% were admitted for other biliary complications, amounting to 2.7 readmissions per patient in the year following primary admission. CONCLUSION: This study highlights management practices for acute cholecystitis in the USA and England. Despite best evidence, index admission laparoscopic cholecystectomy is performed less in England, which significantly impacts subsequent healthcare utilization.

JOURNAL ARTICLE

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

Soukup T, Lamb BW, Arora S, Darzi A, Sevdalis N, Green JSAet al., 2018, Successful strategies in implementing a multidisciplinary team working in the care of patients with cancer: an overview and synthesis of the available literature, JOURNAL OF MULTIDISCIPLINARY HEALTHCARE, Vol: 11, Pages: 49-61, ISSN: 1178-2390

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 Scientific Meeting of the American-Society-of-Colon-and-Rectal-Surgeons, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E118-E118, ISSN: 0012-3706

CONFERENCE PAPER

Archer S, Hull L, Soukup T, Mayer E, Athanasiou T, Sevdalis N, Darzi Aet al., 2017, Development of a theoretical framework of factors affecting patient safety incident reporting: a theoretical review of the literature., BMJ Open, Vol: 7

OBJECTIVES: The development and implementation of incident reporting systems within healthcare continues to be a fundamental strategy to reduce preventable patient harm and improve the quality and safety of healthcare. We sought to identify factors contributing to patient safety incident reporting. DESIGN: To facilitate improvements in incident reporting, a theoretical framework, encompassing factors that act as barriers and enablers ofreporting, was developed. Embase, Ovid MEDLINE(R) and PsycINFO were searched to identify relevant articles published between January 1980 and May 2014. A comprehensive search strategy including MeSH terms and keywords was developed to identify relevant articles. Data were extracted by three independent researchers; to ensure the accuracy of data extraction, all studies eligible for inclusion were rescreened by two reviewers. RESULTS: The literature search identified 3049 potentially eligible articles; of these, 110 articles, including >29 726 participants, met the inclusion criteria. In total, 748 barriers were identified (frequency count) across the 110 articles. In comparison, 372 facilitators to incident reporting and 118 negative cases were identified. The top two barriers cited were fear of adverse consequences (161, representing 21.52% of barriers) and process and systems of reporting (110, representing 14.71% of barriers). In comparison, the top two facilitators were organisational (97, representing 26.08% of facilitators) and process and systems of reporting (75, representing 20.16% of facilitators). CONCLUSION: A wide range of factors contributing to engagement in incident reporting exist. Efforts that address the current tendency to under-report must consider the full range of factors in order to develop interventions as well as a strategic policy approach for improvement.

JOURNAL ARTICLE

Ashrafian H, Clancy O, Grover V, Darzi Aet al., 2017, The evolution of robotic surgery: surgical and anaesthetic aspects, BRITISH JOURNAL OF ANAESTHESIA, Vol: 119, Pages: I72-I84, ISSN: 0007-0912

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

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