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Barrier to adoption study - Associate Professor Ludovica Griffanti

Can you tell us about your innovation project?

Magnetic Resonance Imaging (MRI) scans are used to detect changes in brain volume and can help to confirm a clinical diagnosis of dementia. However, subtle changes in brain volume can be hard to identify by eye from brain scans alone. FSL is a software platform which can extract metrics from brain scans. We are looking to leverage FSL to create a tool that can accurately extract quantitative data of brain structures to support the dementia diagnosis process. The Oxford AHSN (now Health Innovation Oxford and Thames Valley) carried out a barrier to adoption study to evaluate the potential clinical applications of FSL (‘FSL-clinical’) in the dementia diagnostic pathway in the NHS in England.

How was your innovation project funded? What was the funding application process/timeline like?

This barrier to adoption study did not require funding. This report fit within the scope of funding that Health Innovation Oxford already had from the Office of Life Sciences. The study took 4 months to complete.

How was your project evaluated, and what were some of the main findings?

This project was not formally evaluated. The main findings of the barrier to adoption study were:

  • For radiologists, the software would increase their diagnosis confidence. For clinicians, the creation of a structured report was also seen as helpful. It could reduce the variability between reporters and decrease the subjectivity of the report, a point seen as important by clinicians in a context of shortage of neuroradiologists.
  • This software could find its place in the dementia pathway either as a diagnostic tool to better identify the subtype of dementia and/or a tool to support the delivery of the new dementia drugs soon to be available (at screening to select eligible patients and reduce the need for further investigation like nuclear imaging, and for safety monitoring of potential bleeds caused by the drug)
  • Overall, stakeholders were very positive to having an analysis software like FSL-clinical in the dementia diagnosis pathway.

How did you and your research benefit from the innovation project?

The Health Innovation Oxford team provided an excellent mix of quantitative and qualitative information that can be used to advocate for the importance of the technology.

Feedback from clinical end-users was invaluable and allowed us to learn what additional features should be included to add further value to the tool. This report has allowed us to build the tool around the needs of the clinical end user. 

We now have a clear idea of the current NHS dementia diagnosis pathway and where imaging is used and who by. This has helped us define who are primary and secondary users are and identify their needs when reporting scans. Additionally, we understand how we can improve the reporting of scans for the end user in the NHS. 

Consequently, the results from this barrier to adoption study has helped guid the next steps of the research project.

What's next for your future innovation plans?

  • We will perform some technical validation studies to improve the confidence in the software.
  • A clinical evaluation study involving clinical end-users would test the value of the software compared to a standard reading. This could include measuring the reporting time and accuracy, confidence in diagnosis, as well as gathering feedback around the usability and acceptability of the software.
  • We will integrate the software tool into the Oxford Brain Health Clinic to assess the impact of the software in the clinical workflow and test the software on data from real-world clinical populations in a research setting, while building evidence for further adoption.
  • Finally, a health economic evaluation will be required to determine the cost-effectiveness as well as gathering further clinical evidence.

What are your top tips for other researchers planning innovation projects?

  • Working with Health Innovation Oxford is a great way of getting access to NHS stakeholders for early barrier to adoption study. 
  • Utilise the contacts that are available to you such as Oxford University Innovation, Translation Research Office and the Business Partnerships Office. Additionally, the WIN Impact and Engagement team can offer support. 
  • Take small and achievable steps – the pathway to impact through innovation is complex. The steps to impact might be smaller than you think.