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  • Journal article
    Kinross JM, Mason SE, Mylonas G, Darzi Aet al., 2020,

    Next-generation robotics in gastrointestinal surgery

    , Nature Reviews Gastroenterology and Hepatology, Vol: 17, Pages: 430-440, ISSN: 1759-5045

    The global numbers of robotic gastrointestinal surgeries are increasing. However, the evidence base for robotic gastrointestinal surgery does not yet support its widespread adoption or justify its cost. The reasons for its continued popularity are complex, but a notable driver is the push for innovation — robotic surgery is seen as a compelling solution for delivering on the promise of minimally invasive precision surgery — and a changing commercial landscape delivers the promise of increased affordability. Novel systems will leverage the robot as a data-driven platform, integrating advances in imaging, artificial intelligence and machine learning for decision support. However, if this vision is to be realized, lessons must be heeded from current clinical trials and translational strategies, which have failed to demonstrate patient benefit. In this Perspective, we critically appraise current research to define the principles on which the next generation of gastrointestinal robotics trials should be based. We also discuss the emerging commercial landscape and define existing and new technologies.
  • Journal article
    Kassanos P, Berthelot M, Kim JA, Rosa BMG, Seichepine F, Anastasova S, Sodergren MH, Leff DR, Lo B, Darzi A, Yang G-Zet al., 2020,

    Smart sensing for surgery from tethered devices to wearables and implantables

    , IEEE Systems Man and Cybernetics Magazine, Vol: 6, Pages: 39-48, ISSN: 2333-942X

    Recent developments in wearable electronics have fueled research into new materials, sensors, and microelectronic technologies for the realization of devices that have increased functionality and performance. This is further enhanced by advances in fabr ication methods and printing techniques, stimulating research on implantables and the advancement of existing medical devices. This article provides an overview of new designs, embodiments, fabrication methods, instrumentation, and informatics as well as the challenges in developing and deploying such devices and clinical applications that can benefit from them. The need for and use of these technologies across the perioperative surgical-care pathway are highlighted, along with a vision for the future and how these tools can be adopted by potential end users and health-care systems.
  • Journal article
    Black A, Gage H, Norton C, Franklin BD, Murrells T, Courtenay Met al., 2020,

    A comparison between independent nurse prescribing and patient group directions in the safety and appropriateness of medication provision in United Kingdom sexual health services: A mixed methods study

    , INTERNATIONAL JOURNAL OF NURSING STUDIES, Vol: 107, ISSN: 0020-7489
  • Journal article
    Sun L, Joshi M, Khan SN, Ashrafian H, Darzi Aet al., 2020,

    Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis

    , Journal of the Royal Society of Medicine, Vol: 113, Pages: 217-224, ISSN: 0141-0768

    ObjectiveDelayed response to clinical deterioration as a result of intermittent vital sign monitoring is a cause of preventable morbidity and mortality. This review focuses on the clinical impact of multi-parameter continuous non-invasive monitoring of vital signs (CoNiM) in non-intensive care unit patients.DesignSystematic review and meta-analysis of primary studies. Embase, MEDLINE, HMIC, PsycINFO and Cochrane were searched from April 1964 to 18 June 2019 with no language restriction.SettingThe search was limited to hospitalised, non-intensive care unit adult patients who had two or more vital signs continuously monitored.ParticipantsAll primary studies that evaluated the clinical impact of using multi-parameter CoNiM in adult hospital wards outside of the intensive care unit.Main outcome measuresClinical impact of multi-parameter CoNiM.
  • Journal article
    Sounderajah V, Ashrafian H, Aggarwal R, De Fauw J, Denniston AK, Greaves F, Karthikesalingam A, King D, Liu X, Markar SR, McInnes MDF, Panch T, Pearson-Stuttard J, Ting DSW, Golub RM, Moher D, Bossuyt PM, Darzi Aet al., 2020,

    Developing specific reporting guidelines for diagnostic accuracy studies assessing AI interventions: The STARD-AI Steering Group

    , Nature Medicine, Vol: 26, Pages: 807-808, ISSN: 1078-8956
  • Journal article
    Ramdas K, Darzi A, Jain S, 2020,

    'Test, re-test, re-test': using inaccurate tests to greatly increase the accuracy of COVID-19 testing

    , Nature Methods, Vol: 26, Pages: 810-811, ISSN: 1548-7091
  • Journal article
    Wheeler C, Furniss D, Galal-Edeen GH, Blandford A, Franklin BDet al., 2020,

    Patients' Perspectives on the Quality and Safety of Intravenous Infusions: A Qualitative Study

    , JOURNAL OF PATIENT EXPERIENCE, Vol: 7, Pages: 380-385, ISSN: 2374-3743
  • Journal article
    Archer S, Thibaut B, Dewa L, Ramtale S, D'Lima D, Simpson A, Murray K, Adam S, Darzi Aet al., 2020,

    Barriers and facilitators to incident reporting in mental healthcare settings: a qualitative study

    , Journal of Psychiatric and Mental Health Nursing, Vol: 27, Pages: 211-223, ISSN: 1351-0126

    IntroductionBarriers and facilitators to incident reporting have been widely researched in general healthcare. However, it is unclear if the findings are applicable to mental healthcare where care is increasingly complex.AimTo investigate if barriers and facilitators affecting incident reporting in mental healthcare are consistent with factors identified in other healthcare settings.MethodData were collected from focus groups (n=8) with 52 members of staff from across [a large Mental Health] Trust and analysed with thematic analysis.ResultsFive themes were identified during the analysis. Three themes (i)learning and improvement, (ii)time, and (iii)fear were consistent with the existing wider literature on barriers and facilitators to incident reporting. Two further themes (iv)interaction between patient diagnosis and incidents and (v)aftermath of an incident – prosecution specifically linked to the provision of mental healthcare.ConclusionsWhilst some barriers and facilitators to incident reporting identified in other settings are also prevalent in the mental healthcare setting, the increased incidence of violent and aggressive behaviour within mental healthcare presents a unique challenge for incident reporting.Clinical ImplicationsAlthough Interventions to improve incident reporting may be adapted/adopted from other settings, there is a need to develop specific interventions to improve reporting of violent and aggressive incidents.
  • Journal article
    Cresswell K, Sheikh A, Franklin BD, Krasuska M, Hung TN, Hinder S, Lane W, Mozaffar H, Mason K, Eason S, Potts HWW, Williams Ret al., 2020,

    Theoretical and methodological considerations in evaluating large-scale health information technology change programmes

    , BMC HEALTH SERVICES RESEARCH, Vol: 20
  • Journal article
    Kim JA, Wales D, Thompson A, Yang G-Zet al., 2020,

    Fiber-optic SERS probes fabricated using two-photon polymerization for rapid detection of bacteria

    , Advanced Optical Materials, Vol: 8, Pages: 1-12, ISSN: 2195-1071

    This study presents a novel fiber-optic surface-enhanced Raman spectroscopy (SERS) probe (SERS-on-a-tip) fabricated using a simple, two-step protocol based on off-the-shelf components and materials, with a high degree of controllability and repeatability. Two-photon polymerization and subsequent metallization was adopted to fabricate a range of SERS arrays on both planar substrates and end-facets of optical fibers. For the SERS-on-a-tip probes, a limit of detection of 10-7 M (Rhodamine 6G) and analytical enhancement factors of up to 1300 were obtained by optimizing the design, geometry and alignment of the SERS arrays on the tip of the optical fiber. Furthermore, strong repeatability and consistency were achieved for the fabricated SERS arrays, demonstrating that the technique may be suitable for large-scale fabrication procedures in the future. Finally, rapid SERS detection of live Escherichia coli cells was demonstrated using integration times in the milliseconds to seconds range. This result indicates strong potential for in vivo diagnostic use, particularly for detection of infections. Moreover, to the best of our knowledge, this represents the first report of detection of live, unlabeled bacteria using a fiber-optic SERS probe.

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