Medical physics and clinical engineering

One day course in the Safety of Medical Electrical Equipment

Course Introduction

There is a legal requirement under the Medical Devices Directive (MDD) to design and construct equipment in a way that minimises the risk to the patient and the operator. In order to comply with the MDD, manufacturers must demonstrate that they have met its essential requirements for safety. This is demonstrated by compliance with the relevant Harmonised Standards. For Medical Electrical Equipment, the Harmonised Standard for safety is BS EN 60601-1. The third edition of the standard (released 2006) incorporates some of the old collateral standards, with considerable effort in the new edition to align requirements for electrical performance of medical devices with those for IT. There are also considerable additions on risk management issues. 

Check dates and book now: call 0151 706 4202 or email Lynsey at MPandCE@liverpool.ac.uk

Course Details

The course is based on key elements of the Standard, ISO 60601, 3rd Edition and is aimed at Bio-medical Engineers and Technicians.

Delegates are provided with a thorough knowledge of the safety aspects of the Standard and an improvement in their competence to perform field safety testing.​

Learning Method

Each course contains both taught and practical sessions. Three weeks prior to the course, participants will receive a questionnaire to be completed before attending.  This requires study of the BS EN 60601-1:2006 standard.

Learning Structure

The course is designed to be free standing, however, we recommend the Safety of Medical Electrical Systems course is also attended in order to give a more complete learning experience.​

Who Should Attend

The course is aimed at Biomedical Engineers and Technicians who are required to configure, test or approve medical equipment/systems.  It is also aimed at manufacturers/suppliers of medical electrical equipment and systems and electrical safety testers.

Check dates and book now: call 0151 706 4202 or email Lynsey at MPandCE@liverpool.ac.uk

Short courses on the Safety of Medical Electrical Systems

Course Introduction

The aim of these courses is to provide Clinical Engineers and Technicians with a thorough knowledge of the safety aspects of the 60601 standard related to medical electrical systems such as theatre trolleys, infusion stacks, endoscopy towers, image recording systems, ITU networks, etc.

On completion of the course, participants should be competent to configure medical/non-medical equipment systems and know the extra protection methods recommended in the standard. 

Check dates and book now - call us on 0151 706 4202 or email Lynsey at MPandCE@liverpool.ac.uk

Course Details

The following topics are covered:

• Relevant items from the 60601-1 standard
• Main points from the systems chapter
• Management of leakage currents
• Exercises on test requirements
• System configurations and solutions
• Practical test configuration session
• Who is the manufacturer of a system
• Remaining hazards.

Target Audience

The courses are aimed at Clinical Engineers and Technicians who are required to configure, test or approve medical electrical systems. They are also aimed at manufacturers and suppliers of systems and electrical safety testers.

Accreditation

Participants will receive a full set of lecture notes and a certificate of attendance for their CPD records.​

Check dates and book now - call us on 0151 706 4202 or email Lynsey at MPandCE@liverpool.ac.uk

Short Courses on Medical Statistics

Course introduction

The aim of these course is to understand how statistical analysis and decision theory can be applied in medicine. You will learn how to analyse data and correctly interpret statistical findings in scientific publications. The course is backed up by a number of examples from the medical literature with practical demonstrations and exercises on how to carry out the analysis.

Check dates and book now: call 0151 706 4202 or email Lynsey at MPandCE@liverpool.ac.uk

Course details

Topics covered include:

• Hypothesis testing
• Type I and type II errors
• Power calculations
• Non-parametric tests
• Analysis of variance
• Correlation and regression
• Relative risks and odds ratio
• ROC analysis
• More on regression analysis
• Bayesian inference
• Logistic regression 
• Survival analysis
• Making sense of statistics
• Clinical decision making

Who should attend?
Target audience:

• Clinical Scientists
• Doctors
• Nurses
• Healthcare Scientists 
• Allied Health Professionals
• PhD students 
• Medical Researchers 
• Trainees

Accreditation

These courses meet the CPD requirements for the IPEM and HCPC schemes. Participants will receive a full set of lecture notes and a certificate of attendance for their CPD records. 

Check dates and book now: call 0151 706 4202 or email Lynsey at MPandCE@liverpool.ac.uk

Currently the clinical measurement section is most concerned with:

• Electrophysiology of the heart
• Vision
• Audiology and vestibular function(for more information, click the Vestibular Function Testing tab below this one).

Previous interests have included:

• Spinal cord measurement
• Dermatology testing

The main focus of the section is patient testing and diagnosing patients. However, healthcare is rapidly evolving and no more so than in a medical physics department where new technologies, techniques and equipment are being formulated, developed and tested for patient benefit.

The Clinical Measurement Section is heavily involved in teaching and training by providing training for:

• NHS medical physics trainees (Liverpool) STP
• Neurophysiologists STP (Manchester and Walton Centre)
• Audiologists (week long secondments-super regional).

We also provide:

• A national/international recognised short course (1 week) in audiology and vestibular function
• Lectures in the University of Liverpool Medical Physics MSc
• Final year orthoptics lectures BSc.

​​In addition, Manchester University have asked for lectures on some of their BSc & MSc courses.

For more information about clinical measurement services phone +44 (0)151 7064202 or email Richard Hagan​. 

​

A number of commercial medical products have been developed by the medical physicists involved in patient care, a spin off they have achieved when identifying a problem and finding a solution by exploiting their mastery of physics.

Vestibular function testing and Diagnostic Audiology

The Department of Medical Physics and Clinical Engineering provides clinical testing of Vestibular function (balance) and diagnostic audiology (hearing).  Referrals are mainly via Ear Nose and Throat Consultants or Neurological Consultants throughout Merseyside and Wirral regions.  

The Department provides medico-legal testing to Consultants and Solictors, including medico-legal hearing threshold estimation using cortical Evoked response audiometry (Cortical ERA, CERA).  

We support teaching and training for various NHS training schemes in areas of Audiology, Medical Physics and Clinical Engineering.

Balance testing (Vestibular function testing)

Patients suffering from dizziness or balance difficulties may be referred for balance testing for further investigations.  This involves assessing how different elements of the balance system are working.   For further information on balance testing click the Vestibular Function Testing tab below.

Testing and treatment for Benign Paroxysmal Positional Vertigo (BPPV)

We perform testing and treatment for all forms of BPPV and provide short-term follow-up.  Testing and treatment of BPPV may be performed as part Vestibular function testing or on its own.

Diagnostic Hearing testing (Diagnostic Audiology )

Patients suffering from hearing loss may be referred to us for further investigation.

Please not we do not fit hearing aids or provide routine hearing tests, for these contact the Audiology Department. 

Staff details

These services are provided by Vicki Kennedy, Principal Clinical Scientist.

 Secretarial duties relating to this service are provided by Miss Laura Guido.

These clinical services form part of the Department’s Clinical Measurement division, managed by Consultant Clinical Scientist, Dr Richard Hagan.

All contact details can be found below under 'the team'.

For medical professionals wishing to refer to our service please post or fax referral to:

Vicki Kennedy
Principal Clinical Scientist. 
Department of Medical Physics and Clinical Engineering,
1^st Floor Duncan Building
Daulby Street
Royal Liverpool University Hospital
Liverpool
L69 3GA.

Telephone: 0151 706 4202

Fax: 0151 706 4925

In the referral letter please state the patient’s details and reasons for request.   A telephone number is useful as we operate a reminder service. If an interpreter is required, please state this clearly. 

For ENT at the Royal Liverpool and Broad Green hospital referral can be made via the hospitals ICE system.

Specialised hearing tests (Diagnostic Audiology)

These tests involve assessing different parts of the hearing pathway from ear to the brain. Testing lasts between 1 and 2 hours. 

All test sessions begin with a history.  Next we perform Otoscopy (look into your ears) to check for wax and assess general ear health.  We provide a range of specialised hearing tests and the scientist will decide which tests are most appropriate from the referral and the history you provide. Some tests involve doing something (like pressing a button) whilst in other tests your brains responses are analysed by computer to provide accurate information about your hearing. 

Queries

If you have any queries relating to your appointment or require any further information then please  feel free to call 0151 706 4202.  If an appropriate member of staff is not available at that time please leave your contact details and we will call back.  

Below are questions and answers that patients frequently ask us prior to their appointment.

• Do I need to bring anything with me?

To help pass the time during certain tests you can bring something to read (e.g. newspaper, magazine, book, kindle or tablet), and for this reason if you wear glasses please bring them with you.

• I have been told some tests involve electrodes, what do the electrodes do?

The electrodes are position on your skin (mainly on your head) using a paste.  The electrodes do not do anything to you, they pick up the tiny electrical responses generated by you.

• I cannot attend my appointment on the date you have given me, what should I do? 

Please call 0151 706 4202 and we can arrange another date for your appointment. 

Useful links

• Action on hearing loss

This eye movement assessment is done in a variety of situations, for example, when tracking targets on a screen, or when simply sitting or lying or moving in a particular way.

One test that we may wish to perform involves stimulating the balance organ in the ear by running some warm or cool water into the outer ear canal (if it is not appropriate to use water we can alternatively gently blow warm or cool air into the outer ear canal ).  This usually results in a sensation of movement or turning lasting 1-2 minutes.  The test does not trigger an attack of dizziness.

Queries

If you have any queries relating to your appointment or require any further information then please  feel free to call 0151 706 4202.  If an appropriate member of staff is not available at that time please leave your contact details and we will call back. 

Below are questions and answers that patients frequently ask us prior to their appointment.

• Will you make me dizzy during testing? 

 Potentially some, but not all of our tests could result in the feeling of turning/movement for short periods (1-2 minutes).  We perform a range of tests and all tests will be explained to you and will only be carried out with your agreement.

• Should I attend my appointment if my balance is okay on the day?

Yes, you should attend even if you feel okay on the day as some balance conditions can fluctuate or even come and go.  Even if you feel okay on the day the tests can still provide useful diagnostic information.

• Why do you suggest I bring someone with me to the appointment?

Some patients feel reassured by bringing a friend or family member with them. Some patients can feel unsteady for a short period after testing and again feel reassured bringing someone with them.    It is up to you whether your friend or family member comes into the test room with you or not.  It is not advisable to drive immediately after testing.

• Why can’t I wear eye make-up at the appointment?

Many of our balance tests involve using cameras that follow eye movement by locating your pupils.  Sometimes dark coloured eye make-up can cause problems for the equipment to successfully locate your pupils.   

• Why do I need to get my ears checked for wax before the appointment?

Even small amounts of wax can affect our results.  If wax is present when you attend for your appointment we may have to reschedule your appointment till after the wax has been removed.  There is no facility to remove the wax at your appointment.  Please note you cannot check your own ears for wax, either your GP or practice nurse will need to check for you.

• I cannot attend my appointment on the date you have given me, what should I do? 

Please call 0151 706 4202 and we can arrange another date  for your appointment. 

Useful links

• Dizziness and Balance fact sheet by Action on hearing loss (formerly RNID, Royal National Institute for the Deaf)
• Ménière’s Society

Dr Ayesh Alshukri

Ayesh has a BSc degree in Internet Computing, an MSc and Advanced Computer Science, and a PhD in Data Mining.  He works on the data management team as an applications developer on the NIHR funded Individual risk-based Screening for Diabetic Retinopathy (ISDR) study. Under the supervision of Prof. Simon Harding and Prof. Tony Fisher. This team is responsible for processing, storage and management of large data sets from multiple sources within the NHS. This team also supports a Randomised Control Trial (RCT), a Risk Calculation Engine (RCE) and an Observational Cohort Studies (OCS) for the ISDR programme.

Dr Christine Denby

Christine has a PhD in Neuroimaging and has previously held research posts in Neuroimaging at the Universities of Liverpool and Manchester.  She also provides research support to and collaborates with The Walton Centre.  Her research interests and activities include cardiac electrophysiology, cardiac MRI, neuroimaging, structural and functional MRI, MRI physics and quality assurance and MR sequence development.  Christine also lectures on the MSc Clinical Science – Medical Physics course in neuroanatomy, neurophysiology, clinical measurement, neuroimaging and functional MRI.  She is also a regular reviewer for the British Journal of Radiology and is a member of the British Institute of Radiology.

Dr Antonio Eleuteri

Antonio has a Ph.D. in Applied Mathematics and Computer Science, with a specialisation in Probability and Statistics. He is also a Chartered Scientist and is a member of IPEM.  His research interests focus on statistical learning theory, survival analysis, machine learning, pattern recognition, information geometry, stochastic processes, probability theory and graphical models; with applications to medicine and health care.  In the past he has worked on statistical models applied to biology and astrophysics.

Matt Elt

Matt studied Medical Engineering at Cardiff University and then was accepted onto the Scientific Training Program, graduating in September 2015 in Clinical Measurement.  He also gained a Master’s degree in Clinical Science through the scheme. During the training scheme, Matt was based in the Medical Physics and Clinical Engineering (MPCE) where he worked on several interesting projects ranging from statistically analysing medical research data, to designing software and electronic hardware for developing products.  Matt has been employed as a Research Scientist in MPCE since graduating the training scheme and I mainly work on research and development projects.

Waiel Elzamzami 

Waiel is a Visual Electrophysiologist.  His duties involve supporting service delivery, research, te​aching and training, mainly, but not exclusively, in visual electro-diagnostics.  Waiel’s background is in bioengineering, with postgraduate clinical and research experience in Assistive Technology, Biomechanics and Electrophysiology.  He has a special interest in research relating to the development of innovative medical/rehabilitative treatments and technologies, for people with long term medical conditions.

Prof Tony Fisher

Professor Tony Fisher is a Consultant Clinical Scientist and Head of Department, Director of the Merseyside Training Consortium in Medical Physics and Clinical Engineering and a Non-executive Director of the Academy for Healthcare Science (AHCS). He is a Fellow of the Institute of Engineering and Technology (FIET CEng) and a Fellow of the Institute of Physics and Engineering in Medicine (FIPEM CSci). He holds an MSc in Biomedical Engineering (Surrey) and a PhD in Medical Physics and Bioengineering (Liverpool). His principal research interest is the analysis of electrophysiological signals. 

Prof David Groves

David has a degree in Physics and a PhD in Bioengineering and is a member of the Institute of Physics and a Chartered Physicist. Following employment as a medical physicist in nuclear medicine, lecturer and senior lecturer in physics, computing and mathematics at a number of UK universities and as a senior scientist in the UK nuclear industry, David established a commercial medical technology company which he directed for 15 years. The company developed innovative 3D scanner technologies and commercial computer systems. His company developed, manufactured, installed and maintained ionising radiation free 3D body scanners, based on structured light technology, for clinical assessment of spinal deformities in the standing patient. The UK developed and manufactured scanners were licensed and sold in the USA, Europe and the former Eastern Block, winning 4 dti awards. Additionally David established and co-directed a medical company offering clinical assessment and treatment of spinal disorders and sports injuries. Other commercial interests included provision of fully integrated computer services to the chemical manufacturing industry and consultancy to the AMDG group of companies. David retired from full time commercial activity in 1999 returning to the NHS in 2000 as director of research at the National Refractory Angina Centre (NRAC). At NRAC he helped establish the award winning NRAC angina management programme, developed novel ECG clinical assessments and non-surgical therapies in collaborations with a number of UK university based cardiology centres and commercial companies. He was appointed adjunct professor of healthcare and education technology at Hope University in 2008. He has recently moved to the RLBUHT Medical Physics and Clinical Engineering department to develop wider research collaborations between scientists and clinicians within and beyond the Trust. He is a member of the Japanese Soto Zen Buddhist Order and is on the executive and an active member of a multi-faith charity established to feed and support the homeless.

Laura Guido

Laura joined MP&CE in 2016 as a Medical Secretary.  She provides administrative support to the diagnostic audiology and vestibular testing service run by Vicki Kennedy.

Dr Richard Hagan

Richard is employed as a consultant Clinical Scientist, who has worked for the NHS for more than 18 years, at present he is the acting head of Clinical Measurement which consists of Visual Electrophysiology and Audiology & Vestibular testing.  His main interest is in visual electrophysiology.  He is currently responsible for Adult and Paediatric Visual Electrophysiology services at RLUH & Alder with around 100 consultant ophthalmologists referring in for his opinion.  Richard has been involved in training clinical scientist for the last 12 years and has been an examiner for 5 years.  Richard’s main research interests involve the mfERG both in large clinical studies with Prof Simon Harding and signal processing with Prof Tony Fisher.  Other research interests are concerned with developing new technologies for the benefit of patient testing.

Lynsey Holmes

Lynsey joined the department in 2001 as Administrative Secretary.  Her work includes organising short courses and conferences, assisting in upkeep of the department Quality Management System and work with the MTC and the University of Liverpool in recruiting and training STP Trainee Healthcare Scientists.

Deepthy Jayakrishnan

Deepthy is a Healthcare Scientist in Visual Electrophysiology. She has extensive clinical experience of over 9 years at different departments in the UK including Nottingham University Hospitals NHS Trust and NHS Greater Glasgow and Clyde, both in adult and paediatric settings.  Deepthy joined the department in 2013 as a Research Scientist.  She has an MSc in Medical Physics from the University of Aberdeen.

Vicki Kennedy

Vicki is a Principal Clinical Scientist who joined the department in 1999.  Her main areas of interest are Vestibular medicine and Auditory electrophysiology, but in the past she has also worked in Visual electrophysiology plus other areas of physiological measurement.    Since 2013 Vicki has worked in vestibular function testing and diagnostic audiology service provision for the Merseyside region and Wirral, and has lead these services for the past 3 years.   Currently Vicki sits on the committee of the British Society of Audiology specialist interest group for Balance.   Vicki has a keen interest in teaching and training, and she lectures on Medical Physics Masters course, and is an assessor for Clinical Scientist registration final exams.

Steve Lake

Steve is a Clinical Scientist with over 25 years experience of developing prototype ICT and embedded microprocessor solutions to help clinical professionals progress their innovative ideas. Projects have covered areas including electro-physiology of the eye, monitoring of radiation treatment of children with leukaemia, planning the fluid replacement for children suffering from severe burns, management of medical equipment, charting of vital signs during surgery and decision support for pre-op nurses preparing patients for surgery. Steve is a past examiner for the IPEM training scheme on ICT and a past ACS assessor.

Mehrdad Mobayen Rahni

Mehrdad has a BSc in Networks and Telecommunication Engineering and an MSc in Computer Networks Security from Liverpool John Moore’s University and has over 7 years experience of working in web development and systems administration.  He joined the department in 2013 as a Research & Teaching Assistant.

Dr Tristan Payne

Tristan Payne (PhD) joined the department in 2013 as a trainee clinical scientist under the Scientist Training Programme (STP), having previously worked for 4 years in the NHS as a Medical Engineering Technician.  In 2015, while continuing to complete his STP, he became a permanent member of staff with responsibilities including: facilitating Quality, co-ordinating Commercial Products and providing Computer Support.  Tristan is developing the department’s ISO 13485- and ISO 9001-accredited Quality Management System, and also contributes to Research, Development and Innovation work in the department.

Prof Azzam Taktak

Prof. Taktak is a Consultant Clinical Scientist at the Royal Liverpool University Hospital and an Honorary Professor at the University of Liverpool. He is lead assessor at the National School for Healthcare Scientists. He is Chair of Course Accreditation Panel, a former Vice President and Director at the IPEM. His main research interests are mathematical and statistical modelling and the use of artificial intelligence and machine learning in medicine. To date he has published more than 75 peer-reviewed articles and edited 2 books, the first on Outcome Prediction in Cancer and the second on Clinical Engineering.

Elaine Verdin

Elaine is the Medical Secretary to Dr Richard Hagan and is responsible for the keeping of patient records, database and general office duties.  

Peter Watt

Peter has an OTEC and HTEC in Electrical and Electronic Engineering. He has worked in medical electronics since 1977 and as designer in the department since 1984, initially in association with Merseyside Innovation Centre and then with the charity Lasers for Life. Since then activities have included project development, solo and team roles; clinical physics support for Photo Dynamic Therapy laser; photography and video production.​

Lynsey Holmes

Lynsey joined the department in 2001 as Administrative Secretary.  Her work includes organising short courses and conferences, assisting in upkeep of the department Quality Management System and work with the MTC and the University of Liverpool in recruiting and training STP Trainee Healthcare Scientists.

Deepthy Jayakrishnan

Deepthy is a Healthcare Scientist in Visual Electrophysiology. She has extensive clinical experience of over 9 years at different departments in the UK including Nottingham University Hospitals NHS Trust and NHS Greater Glasgow and Clyde, both in adult and paediatric settings.  Deepthy joined the department in 2013 as a Research Scientist.  She has an MSc in Medical Physics from the University of Aberdeen.

Vicki Kennedy

Vicki is a Principal Clinical Scientist who joined the department in 1999.  Her main areas of interest are Vestibular medicine and Auditory electrophysiology, but in the past she has also worked in Visual electrophysiology plus other areas of physiological measurement.    Since 2013 Vicki has worked in vestibular function testing and diagnostic audiology service provision for the Merseyside region and Wirral, and has lead these services for the past 3 years.   Currently Vicki sits on the committee of the British Society of Audiology specialist interest group for Balance.   Vicki has a keen interest in teaching and training, and she lectures on Medical Physics Masters course, and is an assessor for Clinical Scientist registration final exams.

Steve Lake

Steve is a Clinical Scientist with over 25 years experience of developing prototype ICT and embedded microprocessor solutions to help clinical professionals progress their innovative ideas. Projects have covered areas including electro-physiology of the eye, monitoring of radiation treatment of children with leukaemia, planning the fluid replacement for children suffering from severe burns, management of medical equipment, charting of vital signs during surgery and decision support for pre-op nurses preparing patients for surgery. Steve is a past examiner for the IPEM training scheme on ICT and a past ACS assessor.

Mehrdad Mobayen Rahni

Mehrdad has a BSc in Networks and Telecommunication Engineering and an MSc in Computer Networks Security from Liverpool John Moore’s University and has over 7 years experience of working in web development and systems administration.  He joined the department in 2013 as a Research & Teaching Assistant.

Dr Tristan Payne

Tristan Payne (PhD) joined the department in 2013 as a trainee clinical scientist under the Scientist Training Programme (STP), having previously worked for 4 years in the NHS as a Medical Engineering Technician.  In 2015, while continuing to complete his STP, he became a permanent member of staff with responsibilities including: facilitating Quality, co-ordinating Commercial Products and providing Computer Support.  Tristan is developing the department’s ISO 13485- and ISO 9001-accredited Quality Management System, and also contributes to Research, Development and Innovation work in the department.

Prof Azzam Taktak

Prof. Taktak is a Consultant Clinical Scientist at the Royal Liverpool University Hospital and an Honorary Professor at the University of Liverpool. He is lead assessor at the National School for Healthcare Scientists. He is Chair of Course Accreditation Panel, a former Vice President and Director at the IPEM. His main research interests are mathematical and statistical modelling and the use of artificial intelligence and machine learning in medicine. To date he has published more than 75 peer-reviewed articles and edited 2 books, the first on Outcome Prediction in Cancer and the second on Clinical Engineering.

Elaine Verdin

Elaine is the Medical Secretary to Dr Richard Hagan and is responsible for the keeping of patient records, database and general office duties.  

Peter Watt

Peter has an OTEC and HTEC in Electrical and Electronic Engineering. He has worked in medical electronics since 1977 and as designer in the department since 1984, initially in association with Merseyside Innovation Centre and then with the charity Lasers for Life. Since then activities have included project development, solo and team roles; clinical physics support for Photo Dynamic Therapy laser; photography and video production.​

2016

Denby CE, Walsh E, Das H, Biswas S, Das K.  Can fMRI reliably detect activation within the vicinity of an AVM?  Poster. British Society of Neuroradiologists (BSNR) Annual Scientific Meeting. October 2016. 

Sampson CJ, James M, Fisher AC and Harding SP, Cost-effectiveness of a risk-based screening programme for diabetic retinopathy: a modelling approach, Poster at ESDEC 2016 Manchester, 23 Jun 2016 - 25 Jun 2016

Amu Wang. Ayesh Alshukri. Mehrdad Mobayen-Rahni. Anthony Fisher. Deborah Broadbent. Duncan Appelbe. Simon Harding.  Building a dynamic functional clinical data warehouse (CDW) for personalised health care - lessons from the Individualised Screening for Diabetic Retinopathy (ISDR) study.  Poster at 26th Meeting of the European Association for the Study of Diabetes eye complications Study Group, Manchester, 23 Jun 2016 - 25 Jun 2016

Ayesh Alshukri.  Building a dynamic functional clinical data warehouse (CDW) for personalised health care - lessons from the Individualised Screening for Diabetic Retinopathy (ISDR) study.  Poster at 26th Meeting of the European Association for the Study of Diabetes eye complications (EASDec) Study Group, Manchester, 23 Jun 2016 - 25 Jun 2016

Simon Harding. Christopher Sampson. Christopher Cheyne. Deborah Broadbent. Amu Wang. Mehrdad Mobayen-Rahni. Ayesh Alshukri. Anthony Fisher. Jiten Vora. Marta Garcia Finana.  10 year observational study of patient related outcomes during expansion to full population coverage of a systematic diabetes eyecare programme - the Liverpool Diabetic Eye Study.  In The association of research in vision and ophthalmology annual conference, Seattle, USA. 01 May 2016 - 05 May 2016. Investigative Ophthalmology & Visual Science. Association for Research in Vision and Ophthalmology (ARVO), 2016.

Biswas S, Denby CE, Das K.  Does Cerebrovascular Reserve measured by CT Perfusion using Acetazolamide challenge predict future Stroke/TIA in Cerebro-vascular Steno-occlusive Disease.   ASNR 54th Annual Meeting, May 2016.

S.P. Lake. Strategic Technological Assets Network (STAN): Managing Health Technology and the Technologists’ Role. Presentation at IPEM Meeting: Medical Technology of the Future, Manchester, January 2016.

2014

Denby CE, Smith N.  Performing QA in a Small MR Centre on a Budget: Evaluation and Future Direction. Oral Presentation at the IPEM Quality Assurance in Magnetic Resonance Conference, British Dental Association, London, November 2014.

Taktak, Azzam.  Postgraduate Conference on Biomedical Engineering and Medical Physics (PGBiomed), IEEE EMBS UKRI Chapter, Warwick, 16-17 July 2014 (Invited Speaker)

2013

G.R. Lightfoot.  Does caffeine enhance the N1-P2 cortical response? Presentation at the XXIII Biennial Symposium of the IERASG, New Orleans, USA, June 2013.

G.R. Lightfoot.  The effects of artefact rejection and Bayesian averaging on ABR efficiency. Presentation at the XXIII Biennial Symposium of the IERASG, New Orleans, USA, June 2013.

G.R. Lightfoot.  Validation of objective measures of response quality and residual noise in two ABR systems. Presentation at the XXIII Biennial Symposium of the IERASG, New Orleans, USA, June 2013.

2012

A.F.G. Taktak. Medical Physics & Engineering Conference (MPEC), Oxford, 10-12 September 2012.

A.F.G. Taktak. The 5th International Conference in Medical Signal and Information Processing (MEDSIP), IET, Liverpool, 5-6 July 2012.

A.F.G. Taktak. ARVO (The Association of Research in Vision and Ophthalmology) Annual Conference, Fort Lauderdale, Florida, 6-10 May 2012.

G.R. Lightfoot.  A strategy for selecting the optimum artifact rejection level during diagnostic ABR testing. Presentation at the NHS 2012 conference, Como, Italy, June 2012.

G.R. Lightfoot.  Do frequency specific chirps offer a quicker ABR assessment in newborns compared to tone pips? Poster presentation at the NHS 2012 conference, Como, Italy, June 2012.

1. P. Lake.  Providing scientific solutions as an online service: a SOAP solution

Bespoke Software in Medical Physics & Clinical Engineering

29^th May 2012, UCL Institute of Child Health, London.

Cubbon RM, Ruff N, Groves D, Eleuteri A, Denby C, Kearney L, Ali N, Walker AM, Jamil H, Gierula J, Gale CP, Batin PD, Nolan J, Shah AM, Fox KA, Sapsford RJ, Witte KK, Kearney MT.

Ambulatory heart rate range predicts mode-specific mortality and hospitalisation in chronic heart failure.  Heart, 2016; 102(3): 223-9.

S. W. DeParis, A. Taktak, A. Eleuteri, W. Enanoria, H. Heimann, S. E. Coupland, B. Damato

External validation of the Liverpool uveal melanoma prognosticator online. Investigative Ophthalmology and Visual Science, 57, 6116 – 6122 (2016)

2015

Denby C, Groves DG, Eleuteri A, Tsang HK, Leach A, Hammond C, Bridson JD, Fisher M, Elt M, Laflin R, Fisher AC. 

Temporary sympathectomy in chronic refractory angina: a randomised, double-blind, placebo-controlled trial.  British Journal of Pain, 2015; 9(3): 142-8.

Broadbent, D. M., Harding, S. P., Garcia-Finana, M., Fisher, A. C., Bennett, A., Appelbe, D. E., & Wang, A.

INTRODUCING PERSONALISED RISK BASED INTERVALS IN SCREENING FOR DIABETIC RETINOPATHY: THE ISDR STUDY. EUROPEAN JOURNAL OF OPHTHALMOLOGY, 2015, 25(3), E20-E21.

Harding, S. P., Eleuteri, A., Broadbent, D. M., Van der Hoek, M., Cheyne, C., Wang, A., . . . Fisher, A. C.

INDIVIDUALISED RISK-BASED SCREENING FOR DIABETIC RETINOPATHY – THE LIVERPOOL RISK CALCULATION ENGINE. In European Journal of Ophthalmology, 2015, June 26, Vol. 25 (pp. e7-e30). Turin. doi:10.5301/ejo.5000612

Harding, S. P., Eleuteri, A., Broadbent, D. M., van der Hoek, M., Cheyne, C. P., WANG, A., . . . Fisher, A. C.

Individualised risk-based screening for sight threatening diabetic retinopathy – the Liverpool Risk Calculation Engine (Conference Paper) (2015). Individualised risk-based screening for sight threatening diabetic retinopathy – the Liverpool Risk Calculation Engine. In Investigative Ophthalmology & Visual Science Vol. 56. Denver: Association for Research in Vision and Ophthalmology (ARVO).  http://iovs.arvojournals.org/article.aspx?articleid=2331769

Appelbe, D., Broadbent, D. M., Mobayen Rahni, M., Eleuteri, A., Bennett, A., Moitt, T., . . . Harding, S. P.

Introducing personalised risk based intervals in screening for diabetic retinopathy: development, implementation and assessment of safety, cost-effectiveness and patient experience (ISDR): a case study in the use of automated systems in trials (Conference Paper 2015, November 16). Introducing personalised risk based intervals in screening for diabetic retinopathy: development, implementation and assessment of safety, cost-effectiveness and patient experience (ISDR): a case study in the use of automated systems in trials. In Trials Vol. 16. Glasgow.  http://www.trialsjournal.com/content/16/S2/O59

Broadbent, D. M., Bennet, A., Appelbe, D., Wang, A., Van der Hoek, M., Fisher, A. C., & Harding, S. P.

Introducing personalised risk based intervals in screening for diabetic retinopathy: the ISDR study (Conference Paper 2015, June 26). Introducing personalised risk based intervals in screening for diabetic retinopathy: the ISDR study. In European Journal of Ophthalmology Vol. 25 (pp. e7-e30). Turin. doi:10.5301/ejo.5000612

S. Middle, S. E. Coupland, A. Taktak, V. Kidgell, J. Slupsky, A. R. Pettitt, K. J. Till

Immunohistochemical analysis indicates that the anatomical location of B-cell non-Hodgkin's lymphoma is determined by differentially expressed chemokine receptors, sphingosine-1-phosphate receptors and integrins, Experimental Hematology & Oncology, 4, 10 (2015) 

R. Caines, A. Eleuteri, H. Kalirai, A.C. Fisher, H. Heimann, B.E. Damato, S.E. Coupland, A.F.G. Taktak

Cluster analysis of multiplex ligation-dependent probe amplification data in choroidal melanoma, Molecular Vision, 21, 1-11 (2015)

2014

Galarza M, Isaac C, Pellicer O, Mayes A, Broks P, Montaldi D, Denby C, Simeone F.  Jazz, guitar, and neurosurgery: the Pat Martino case report. World Neurosurgery, 2014; 81(3-4): 651.

2013

S.L. Lake, B.E. Damato, H. Kalirai, A.R. Dodson, A.F.G. Taktak, B.H. Lloyd, S.E. Coupland

Single nucleotide polymorphism array analysis of uveal melanomas reveals amplification of CNKSR3 is correlated with improved patient survival, American Journal of Pathology, 182, 3, 678-687

Ferm, I., Lightfoot, G., Stevens, J.

Comparison of ABR response size, test time and estimation of hearing threshold using frequency specific chirps and tone pips stimuli in newborns. Int J Audiol 2013 Jun;52(6):419-23.

Clinical Engineering. Eds: A. Taktak, P. Ganney, D. Long, P. White, Elsevier, Oxford (2013)

2012

O.K. Idowu, Q. Ding, A.F.G. Taktak, C.R. Chandrasekar, Q. Yin

Clinical implication of pre-treatment Nuetrophil lymphocyte ratio in soft tissue sarcoma, Biomarkers, 17, 6, 539-544

F. Jmor, H. Kalirai, A.F.G. Taktak, B. E. Damato, S.E. Coupland

HSP-27 protein expression in uveal melanoma: correlation with survival, Acta Ophthalmologica, 90, 6, 534-539

A. Eleuteri, B.E. Damato, S.E. Coupland, A.F.G. Taktak

Enhancing survival prognostication in patients with choroidal melanoma by integrating pathologic, clinical and genetic predictors of metastasis. Int J Biomedical Engineering and Technology, 8,1, 18-35

A. Taktak, A. Eleuteri, A. Fisher, S.E. Coupland, B.E. Damato

A web-based tool for prognosis of patients with choroidal melanoma using accelerated failure time model. IOVS, ARVO E-Abstract, 5254 

R.P. Hagan, K.A. Quinn, L. Milner, R. Robinson, A. Taktak, A. Fisher

Reproducibility of visual electrophysiology recordings between laboratories: the importance of regular calibration. IOVS, ARVO E-Abstract, 5707 

Neary W, Lightfoot G.

Auditory neuropathy spectrum disorder: Examples of poor progress following cochlear implantation.  Audiological Medicine, 2012; Early Online: 1–8.

A.C.Fisher, A.Eleuteri, D. Groves, C. Dewhurst

The Ornstein-Uhlenbeck third-order Gaussian process (OUGP) applied directly to the un-resampled heart rate variability (HRV) tachogram for detrending and low-pass filtering. Med Biol Eng Comput 50(7):737-42 (2012)

A. Eleuteri, A. Taktak

Support Vector Machines for Survival Regression. Lecture Notes in Computer Science, Springer (special issue CIBB2011), 2012

2011

S.L. Lake, F. Jmor, J. Dopierala, A.F.G. Taktak, S.E. Coupland, B. E. Damato 

Multiplex ligation-dependent probe amplification of conjunctival melanoma reveals common BRAF V600 gene mutation and gene copy number changes. Invest Ophthalmol Vis Sci, 52,85598-5604 (2011).

S.L. Lake, B.E. Damato, J. Dopierala, M.M. Baudo, A.F.G. Taktak, S.E. Coupland

Multiplex ligation-dependent probe amplification analysis of uveal melanoma with extraocular extension demonstrates heterogeneity of gross chromosomal abnormalities. Invest Ophthalmol Vis Sci, 52,8, 55595564 (2011).

B.E. Damato, A. Eleuteri, A.F.G. Taktak, S.E. Coupland

Estimating prognosis for survival after treatment of choroidal melanoma. Prog Retin Eye Res, 30,5, 285-295 (2011).

S. Harigopal, H.P. Satish, A.F.G. Taktak, K.W.Southern, N.J. Shaw

Oxygen saturation profiles in healthy preterm infants. Archives of Disease in Childhood Fetal and Neonatal Edition, 96,5, F339-F342 (2011).

M. Angi, B. Damato, H. Kalirai, A. Dodson, A. Taktak, S. Coupland

Immunohistochemical assessment of mitotic count in uveal melanoma. Acta Ophtalmologica, 89, e155-e160 (2011)

Campa C, Hagan R, Sahni JN, Brown MC, Beare NA, Heimann H, Harding SP.

Early Multifocal Electroretinogram Findings during Intravitreal Ranibizumab treatment for neovascular Age-related Macular Degeneration.  Invest Ophthalmol Vis Sci Epub 2011 Feb 25.

Saeed MU, Noonan C, Hagan R, Brown M. 

Relatively spared central multifocal electroretinogram responses in acute quinine toxicity.  BMJ case rep. 2011 Jul 7.

Hagan RP, Fisher AC, Brown MC.

Investigation of the temporal properties of the retina using the m-sequence.  Doc Ophthalmol. 2011 Oct 22 (Epub ahead of print).

2010

J. Dopierala, B.E. Damato, S.L. Lake, A.F.G. Taktak, S.E. Coupland

Heterogeneity of genetic abnormalities in uveal melanoma assessed by multiplex ligation-dependent probe amplification. Invest Ophthalmol Vis Sci. 51,10, 4898-4905 (2010).

S.L. Lake, S.E. Coupland, A.F.G. Taktak and B.E. Damato.

Whole genome microarray detects deletions and loss of heterozygosity of chromosome 3 occurring exclusively in metastasizing uveal melanoma. Invest Ophthalmol Vis Sci. 51,10, 4884-4891 (2010).

R.N.G. Naguib, A.F.G. Taktak

Decision support in Medicine. Int J Biomedical Engineering and Technology; Editorial. 3, 3/4, 209-211 (2010)

D.M.Broadbent, A.Stangos, A.C.Fisher, A.Eleuteri, N.Collaer, S.P.Harding.

An expert system for the risk estimation of the presence of sight threatening diabetic retinopathy and its implementation as an Internet resource. Medical Ophthalmological Society UK proceedings, 2010.

Hagan RP, Small A, Fisher AC, Brown MC. 

Can central hexagon peak latency provide a clue to fixation with the mfERG.  Doc Ophthalmol. 2010 Apr:120(2):159-64. 2009 Dec 1 [EPUB]

Raja V, Kumar A, Durnian J, Hagan R, Buxton N, Newman W.

The role of visual evoked potentials in the management of hemispheric arachnoid cyst compressing the posterior visual pathways.  JAAPOS 2010 Feb:14(1):85-7. Epub 2009 Dec 31.

A. C. Fisher, S. P. Lake, I. P. Cunningham, A. Chandna

Web-StrabNet: a web-based expert system for the differential diagnosis of vertical strabismus Computational and Mathematical Methods in Medicine, Vol. 11, No. 1, March 2010, 89-97

Research and development in MRI Imaging

Clinical Scientists at the Department of Medical Physics and Clinical Engineering provide cutting edge research and development in MRI Myocardial Imaging with the objective of providing innovation in front line cardiology services. 

Currently we are developing more refined clinical assessment of myocardial infarction following heart attack, enabling the degree of infarction throughout the myocardium to be measured in addition to its spatial distribution using conventional MRI tracers. 

Additionally, we are investigating and developing new methods of MRI measurement of myocardial perfusion which will not require injection of any tracer, reducing both cost of assessment and making this clinical assessment available to significant numbers of patients intolerant of the dye tracers.

Research and Development in Heart Rate Variability

Clinical Scientists at the Department of Medical Physics and Clinical Engineering have developed optimal methods of measuring Heart Rate Variability (HRV) from real world ECG data. 

Clinical measurement of HRV enables the non-invasive assessment/monitoring of the autonomic nervous system which controls and organises the functioning of the major organs. HRV analysis therefore has clinical application in many areas of medicine including cardiology, diabetes, obesity and neonatal medicine. 

The department’s expertise in this area has resulted in:

• The development of accurate prognostic assessment of heart failure patients (RLBUHT and Leeds University Cardiology Dept)
• Assessment of angina and its treatment (RLBUHT Liverpool Angina Management Programme)
• Assessment and monitoring of premature babies (RLBUHT and Liverpool Women Hospital)
• The investigation of the relationship between psychological stress and cardiac autonomic control (RLBUHT and UCL Cardiology Dept).

This area of work into HRV and its application has lead to publication of many technical and clinical papers.

For more information call us on 0151 706 4202.

Supporting clinical service in Ocular Oncology

Clinical Scientists at the Department of Medical Physics and Clinical Engineering provide support to the clinical service in ocular oncology backed up by cutting edge translational research. 

One of the main strengths of this group is the close collaboration with ocular oncologists, surgeons, pathologists and life scientists. 

The group has built a significant portfolio of peer-reviewed papers and contribution to key national and international conferences with the aim that the research we conduct addresses the key questions that will bring about improved survival and quality of life for ocular oncology patients.

We have also been instrumental in guiding clinical practice with the development of numerous web-based tools to aid the clinician in making decisions. 

The Anaesthetic Charting System captures patients’ vital signs and the anaesthetic machine settings electronically during surgery and enables the anaesthetist to add:

• Medications
• Apparatus used
• Block/special technique
• RCoA structured incidents
• Scoring
• Investigations
• Fluids, infusion details and fluid balance
• Operation details.

The system enables a complete record of the anaesthetic care provided during surgery to be captured and printed out for the patient’s notes.

For more details:

• email the developer - Stephen Lake​ 

Or call +44 (0)151 706 4202

Optimised Surgery Care and Anaesthesia Record (OSCAR)

OSCAR is an intranet based computer system used by nurses to predict preoperative investigations and gain advice on how to prepare a patient for surgery based on the patients’ medical history and localised guidelines. OSCAR also passes information onto others involved in the patient’s care.

The benefits include:

• Reduces the number of cancelled operations due to clinical reasons
• Improves the effectiveness of pre-operative practices
• Establishes a framework into which new hospital policy can be introduced
• Communicates information to other groups involved in surgery
• Produces a letter providing patient specific advice, e.g. which medications to stop and when
• Encourages a high standard of screening that raises the quality of the whole surgical pathway which impacts on mortality and morbidity
• During 2008/09 it was estimated that by using OSCAR the Trust made cost savings of approximately £375k.

Why does OSCAR work?

Our own research¹ has demonstrated that by using OSCAR we can improve the nurses’ ability to identify the necessary preoperative investigations from 91.5% to 98.2%, which explains part of the reason why OSCAR works. Introducing a clinical decision support system not only encourages a consistently high standard of assessment but it also raises staff awareness of quality.

Contact the developer for further details on splake@nhs.net​

¹ Murthy, B., Lake, S. and Fisher, A. (2008) Evaluation of a decision support system to predict preoperative investigations, British Journal of Anaesthesia, January, Volume 100, Number 3, pp 315-321