Innovator/Healthcare Professional/Academic Feedback on Surgical MIC PPI activities
When we set up our MedTech Focus Groups, we wanted patients and members of the public to have the opportunity to learn about new technology being developed, and to gain a better understanding of the medical conditions these technologies are addressing.
This page contains feedback from the different companies and researchers that have utilised our patient and public expertise for their devices and technologies.
The preoperative assessment of the frail patient having major cancer surgery – is a well-studied area that is coming into sharper focus as the UK population ages. To help ensure that we conduct meaningful research for patients in this busy research area we approached the NIHR Surgical MIC for their help in developing a panel of patients to guide the development of a grant proposal. This ranged from identifying potential participants to helping organise and facilitate sessions. Panel participants gave consistently good feedback about the ease and efficiency of communication while clinicians were given an excellent platform to learn from panel participants about how to structure their work. An excellent experience for all.
Intelligent Surgical Sensor – A company is developing an intelligent surgical sensor for real-time and learning-free detection of the in vivo presence of tumour tissue. This decision-making aid for the surgeon allows them to optimise the results, improve the patient’s quality of life and reduce health care costs. The meeting with the PPI focus group was overall very positive. We were impressed by the quality of questions asked by the group and the feedback was encouraging, enhancing our focus and confidence in our product and confirming our priorities.
Device to enhance rehabilitation in patients pre and post surgery – The device has been designed to meet the ongoing rehabilitative needs of the elderly at-risk population. A PPI session was organised, conducted and a report was produced which will act as a great point of reference, moving forward. We were further supported in a grant application to NIHR Fast. We continue to benefit greatly from the support provided by the Surgical MIC.
Light-based treatment for proctitis & bowel inflammation – Diversion proctitis is characterised by inflammation of a defunctioned rectum, after a diverting stoma has been performed. The condition may lead to symptoms such as abdominal/pelvic pain, mucous discharge, tenesmus, fever, and rectal bleeding. Definitive treatment involves reversal of the diverting stoma to restore gastrointestinal continuity, however this is not possible in all patients. Thank you very much for managing the event. We thought it was well organised and very beneficial for us. Our main take-away points are:
- The Proctitis treatment device would be mostly beneficial in the home setting and not in a clinic/hospital setting.
- The patients are expecting to see improvement in pain and symptoms as the main parameter for the success of the treatment.
We will include these points in our product and clinical development plan.
Improving the quality of research in emergency surgery – This main aim of this body of work is to find out how to improve the quality of research into emergency surgery. At this focus group, individuals with personal experience of unplanned surgery were invited to share their views on the collection of quality of life data in the emergency surgery setting. The participants included people of different genders and from diverse ethnic groups, and one participant identified herself as having an autistic spectrum condition. The purpose of the event was to determine the participants’ opinions on collecting quality of life data after surgery. Emergency Surgery Feedback
Surgery for Bowel Cancer – Researchers were interested in how information is provided to patients undergoing surgery for bowel cancer. Through an initial focus group, we discovered that information-giving around the time of surgery is a key unmet challenge. It prompted us to work alongside public members to co-create a package of novel education resources and then to explore their feasibility in clinical practice. We were recently awarded an NIHR grant to take this work forward, with public members being prominent members of the team. The work will explore if and how we can role out these resources to the wider NHS.
Low cost device to prevent accidental retention of surgical swabs – Over 100 retained surgical items every year in England, in the USA -over 3000 every year and in Canada -around 160 every year. Thousands of these incidents over the world happen every week. The commonest item left behind is a ‘surgical swab or sponge’(published NHS England/Improvement data). Effects are pain, infection, re-operation, psychological trauma, inability to bond with the baby, long term discomfort and rarely, death. Retained swabs are called surgical “Never Events” which should never really happen. ‘NIHR Surgical MIC facilitated patient and public involvement(PPI) during the early development of our system. This provided us a unique insight that the problem we were trying to solve was considered important by members of public. They felt strongly that this patient harm should be eliminated and
our device as an engineering solution to reduce human error along with encouraging human behaviour could be effective solution. The PPI exercise was crucial in helping us shape further development so that the innovation remained relevant to the public good. They also helped us design information that is provided to patients during the clinical evaluation research study. Some members of the PPI group offered valuable suggestions regarding how the technical development could be more inclusive towards all users and to write an effective public description of the innovation which was easy to understand. Healthcare users feedback was an important part of the conference poster presentation at RCOG World Congress 2021 which won a top scoring abstract and the William Gilliatt award. We would highly recommend NIHR Surgical MIC for their ability to conduct PPI and facilitate innovation.’
Novel intelligent device for the non-invasive engineered securement device for surgical drains – The drains are a key component of post-operation recovery for surgical operations. Drains can monitor the patient and promote recovery. Different drains are used for different parts of the body and examples were given of some of the different types of drains that are currently being used across the NHS. The common problems with drains include dislodging and falling out. NIHR Surgical MIC have been a supportive and accessible organisation for us as a start-up seeking to develop early patient engagement and feedback for our technology. The PPI Focus Group enabled us to refine the value proposition and identify patient champions for the technology. Written reports and outputs have served as valuable inputs for further device development and as evidence for non-dilutive grant funding applications. We look forward to continuing and engagement with NIHR Surgical MIC and strongly recommend them.
Bellowscope – Stomach cancer is the 5th most common cancer globally, with an incidence rate accounting for approximately 7% of new cancer cases each year. To screen for stomach cancer, a visual inspection of the stomach cavity is performed by passing a flexible endoscope into the stomach via the mouth or nose. With the implementation of adequate screening programs, a significant reduction in mortality rates has been demonstrated through early detection of disease. However, screening programmes in many low-to-middle income countries are non-existent or ineffective due to economic and logistical limitations in providing the sedation, monitoring and reprocessing equipment associated with traditional endoscopy. I had the pleasure of working with the NIHR Surgical MIC during the PPI work for a medical device trial. They were extremely helpful in the design of our PPI work and helped immensely with the advertising and organisation of our focus groups. The experience of the Surgical MIC team meant that I felt confident organising and delivering our PPI work, despite it being my first time working on a PPI project. The output from the work was extremely useful in informing the need for the device and shaping device development.
New solution for the prevention of diabetic foot ulcer – Diabetic foot ulcers are slow, poor healing wounds. Diabetes can also reduce the ability of the skin to heal itself. Even small cuts on the feet can develop into diabetic foot ulcers—chronic, non-healing wounds that are vulnerable to infection. Diabetic foot ulcers are a major cause of lower limb amputations, disability, and death. People with diabetes are 20x more likely to suffer an amputation due to a combination of vascular and neuronopathic disorders. 1 in 4 of these patients will have to undergo an amputation (surgical removal) of the infected wound. I want to thank the Surgical MIC, from the first meeting we had they were extremely welcoming to all questions that we had. They also provided a great deal of constructive feedback which was then translated into impactful actions. This saw the hosting of a patient focus group targeted on addressing the remote home monitoring and care of patients with diabetic foot ulcers; of which one of the patients has also joined the research project we are looking to conduct. I would also like add a special thanks to Roxana Dumitrache who chaired this meeting and did a fantastic job of communicating the outcomes.
This has been vital as we work towards conducting a clinical trial in collaboration with NIHR in the form of an i4i PDA project. With regards to this the Surgical MIC have also been able to provide support on how to engage the patient/clinical focus groups during the research and consider when commercialisation should take place. All of this support adds up especially to aid a growing health-technology start-up.
Contactless Vital Sign Assessment – a smart phone application which uses facial recognition to obtain a video feed, allowing for the detection of facial surface skin blood volume changes. The changes in skin blood volume allow for obtaining a photoplethysmography (PPG) waveform and with application of validated algorithms we are able to obtain an array of vital sign; including heart rate, respiratory rate, oxygen saturation, blood pressure and stress levels. The PPI group meeting was a large success with positive feedback from many participants, who gave some very insightful ideas and proposals to help support the project’s future. The PPI group generated many discussions and really helped me understand what questions need to be answered when completing research using this technology. The questions raised were the effects on ethnicity and the applications accuracy, whether medication can impact the applications results and where this application can be used to help widen the application and acceptability of vital signs observations. Sheila was central to the success of the PPI group meeting and provided guidance and organisation throughout the whole process. I received contacts of participants who were interested in being involved in future work and look forward to continual engagement with the patients and the public to help support my research goals.
Assessing cardio-respiratory fitness without exercise – In recent years, the importance of measuring, estimating, and monitoring cardiorespiratory fitness (CRF) has been increasing. CRF is a good indicator of overall health and, according to a statement paper from the American Heart Association, it is potentially a stronger predictor of mortality, compared to commonly used risk factors. Each heart has its own signature relating to the opening and closing of valves and the contraction and relaxation of the heart chambers. The system measures these vibrations, the signal is transferred to a smartphone app and a cloud-based algorithm analyses the signal. The estimated VO2-max is returned to the application. Cardiorespiratory Fitness reflects metabolism and, as the name indicates, the lungs and heart interact by supplying oxygen to tissues and organs and by eliminating carbon dioxide. The maximal oxygen capacity of a person means the maximal oxygen consumption determined until exhaustion and is called VO2-max. “PPI is an eye opener on how patients can perceive new health solutions, and the concerns they may have towards adoption, which are very personal and as diverse as the sample can be. Thus a great insight with implications that can span across a variety of topics for the company.”