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Clinical Measurement

Clinical Measurement

The Clinical Measurement Section is concerned with measuring physiological performance via techniques developed from a deep understanding of physics. At present the section is mainly concerned with electrophysiology, though measurements based on flow and pressure are (have been) exploited to provided significant clues to pathology and to help in patient management.

Clinical measurement is often considered to sit at the fringes of medical physics and often, to the expert physicist, the novel anatomy and physiology of the various biological systems studied may appear daunting.  Underpinning the service is complex physics and engineering.

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,
1st 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

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, family member or chaperone 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

General Information

Hospital Directions

Map

CD1905/00 ref. Clinical (October 2019)