Zilico Ltd present ZedScan Introduction Yorkshire and Humber AHSN, - - PowerPoint PPT Presentation

Digital North Accelerator Programme

Zilico Ltd present ZedScan

Yorkshire and Humber AHSN, Health Innovation Manchester, Innovation Agency North West Coast and North East and North Cumbria AHSN are working together to help innovative digital SMEs within their regions to increase their adoption across the whole of the north of England. To achieve this the Digital North Accelerator Programme has been established to deliver a range of supporting activity to facilitate adoption and spread. It will also form a funnel for the Innovation Exchange where those best suited for national adoption will be identified

Introduction

AHSNs exist to encourage innovation in health and care and to stimulate growth in industry and the life sciences. Our vision is to improve the health and prosperity of our regions by unlocking the potential of new ideas. Across the country AHSNs act as a bridge between healthcare providers, commissioners, academia and industry. By connecting these sectors, we help to build a pipeline of solutions for the NHS from research and product development through to implementation and commercialisation. Locally, we work in partnership with our regional health and care community and develop projects, programmes and initiatives that reflect the diversity and meet the needs of our local populations and healthcare challenges. Together, we breathe life into innovations that improve care, effectiveness and efficiency in the NHS and social care. In the year ahead we will continue to accelerate the spread and adoption of innovations with proven impact and value so that the healthcare system in our regions gains the maximum benefits more quickly

• Company overview
• Clinical challenge
• Electrical Impedance Spectroscopy and ZedScan -a diagnostic tool
• Value - health economics and patient outcomes – Bradley Quinn
• User testimonial – Bradford Royal Infirmary experience
• Real world of innovation adoption in the NHS – ELHT experience
• Q and A

Agenda

• 1. Adjunctive colposcopy technologies for assessing suspected cervical abnormalities: the DYSIS colposcope with DYSISmap and

the ZedScan I Diagnostics guidance [DG32] Published date: April 2018 https://www.nice.org.uk/guidance/dg32

1

ZedScan Clinical Testimonial – Bradford Royal Infirmary experience

Mr Nicholas Myerson, Clinical Lead for Obstetrics and Gynaecology Suzanne Taylor, Lead Nurse Colposcopist and Cervical Screening Programme Lead Bradford Royal Infirmary

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Bradley Quinn Insight and Intelligence Lead, Health Innovation Manchester

Real World of innovation adoption within the NHS – Burnley Hospital

Ms Uma Krishnamoorthy MBBS, MRCOG, MBA Associate Medical Director (A&R), Consultant Gynaecologist and Lead for Colposcopy, East Lancashire Hospitals NHS Trust

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Training Manager – Alison Roberts RGN, MA - alison.roberts@zilico.co.uk Chief Executive – Sameer Kothari - sameer.kothari@zilico.co.uk VP Sales – Darren Neill – Darren.neill@zilico.co.uk

Q&A

Appendix of published data - This is not an exhaustive list ZedScan-related publications 1.B H Brown, J Tidy, K Boston, A D Blackett, R H Smallwood and F Sharp, (2000), The relationship between tissue structure and imposed electrical current flow in cervical neoplasia, The Lancet, 355: 892-95. 2.Abdul S, Brown BH, Milnes P and Tidy J, (2006) The use of Electrical Impedance Spectroscopy in the detection of Cervical Intraepithelial Neoplasia, Int. J Gynaecological Cancer, 16, 1823-1832. 3.Abdul S, Brown BH, Milnes P and Tidy JA, (2005) A clinical study of the use of impedance spectroscopy in the detection of Cervical Intraepithelial Neoplasia (CIN), Gynecol. Oncol. 99,3, S64-S66 4.Brown BH, Milnes P, Abdul S and Tidy JA. (2005) Detection of cervical intraepithelial neoplasia using impedance spectroscopy: a prospective study, Br J Obstet Gynae: 112, 802-806. 5.Balasubramani L, Brown BH, Healey J, Tidy JA. (2009) The detection of cervical intraepithelial neoplasia by electrical impedance spectroscopy: The effects of acetic acid and tissue homogeneity Gynecol Oncol 115(2):267-71. 6.JA Tidy, BH Brown, TJ Healey, S Daayana, M Martin, W Prendiville, HC Kitchener. (2013) Accuracy of detection of high-grade cervical intraepithelial neoplasia using electrical impedance spectroscopy with colposcopy Br J Obstet Gynae 120; 400-411 7.Brown, B., Tidy, J., Healey, J., Highfield, P.,(2013) Supplementary Information relating to EIS performance: Personal Communication 8.National Institute for Health and Care Excellence, Medical Innovation Briefing. 2015, "The ZedScan as an adjunct to colposcopy in women with suspected cervical intra-epithelial neoplasia". 12th February, 2015 9.MacDonald, M.C., Lyon, R., Palmer, J.E., Tidy, J.A. (2015), "The routine use of ZedScan within one colposcopy service in England", unpublished presentation at the BSCCP Annual Meeting, 15-17th April, 2015, Nottingham, UK.

• 10. C. MuszynskiE. DupontB. VaysseS. LantaJ. TidyF. SergentJ. Gondry (2017), The impact of using electrical impedance

spectroscopy (ZedScan) on the performance of colposcopy in diagnosing high grade squamous lesions of the cervix http://dx.doi.org/10.1016/j.jogoh.2017.08.007 11.MacDonald M.C. et al. (2017), Influence of high risk HPV genotype on colposcopic performance: A large prospective study demonstrates improved detection of disease with ZedScan 1, particularly in non-HPV 16 patients. European Journal of Obstetrics & Gynecology and Reproductive Biology 211 pp.194–198

• 12. Macdonald M, Crossley J, Ellis K, et al. (2018) Prevalence of high-grade cervical intraepithelial neoplasia in women with persistent

high-risk HPV genotypes and negative cytology. Cytopathology; 00:1–10. https://doi.org/10.1111/cyt.12516

• 13. J. Tidy, B. Brown, J Healey, J. Palmer(2018) Increased detection of high grade glandular intraepithelial neoplasia (HG-CGIN) by

electrical impedance spectroscopy (ZedScan); presented at BSCCP

EIS-related references

1.B H Brown, J Tidy, K Boston, A DBlackett and F Sharp. (1998) Tetrapolar Measurement of Cervical Tissue structure using Impedance Spectroscopy. IEEE/EMBS International Conference, Hong Kong, 2886-2889. 2.C A Gonzalez-Correa, B H Brown, R H Smallwood, N Kalia, C J Stoddard, T J Stephenson, S J Haggie, D N Slater and K D Bardhan (1999) Virtual Biopsies in Barret’s Esophagus Using an Impedance Probe, Annals of the New York Academy of Sciences, 873, 313-321. 3.S Nebuya, B H Brown, R H Smallwood, P Milnes, A R Waterworth and M Noshiro, (1999), Synchronisation of demodulation in an optically Isolated Tetra-Polar Impedance Measurement System, Proc. EMBEC, 37,2, 84-5, Vienna. 4.S Nebuya, B H Brown, R H Smallwood, P Milnes, A R Waterworth and M Noshiro, (1999), Measurement of high frequency electrical transfer impedances from biological tissues, Electronics Letters, 35: (23) 1985-1987. 5.A R Waterworth, R H Smallwood, P Milnes and B H Brown, (2000), Cole equation modelling to measurements made using an impulse driven transfer impedance system, Phys.Meas.21,1, 137- 144. 6.M P O’Connell, J Tidy, S J Wisher, N J Avis, B H Brown and S W Lindow, (2000), An in vivo comparative study of the pregnant and nonpregnant cervix using electrical impedance measurements, British Journal of Obstetrics and Gynaecology, 107, 1040-1041. 7.D C Walker, B H Brown, D R Hose and R H Smallwood, (2000), Modelling the electrical impedivity of normal and premalignant cervical tissue. Electronics Letters, 1603-1604. 8.Gonzalez-Correa CA. Brown BH. Smallwood RH. Kalia N. Stoddard CJ. Stephenson TJ. Haggie SJ. Slater DN. Bardhan KD. (2000) Assessing the conditions for in vivo electrical virtual biopsies in Barrett's oesophagus. Medical & Biological Engineering & Computing. 38(4):373-6. 9.B H Brown, A J Wilson and P Bertemes-Filho (2000), Bipolar and tetrapolar transfer impedance measurements from a volume conductor, Electronics Letters 36(25), 2060-2062. 10.Jones DM, Smallwood RH, Hose DR and Brown BH (2001), Constraints on tetrapolar tissue impedance measurements, Electronics Letters, 37, 25, 1515-1517. 11.Brown BH, (2001), Measurement of the Electrical Properties of Tissue – New developments in Impedance Imaging and Spectroscopy, IEICE Trans. On Information Systems, E85-D, 2-5. 12.Nebuya S, Noshiro M, Brown BH, Smallwood RH and Milnes P. (2002), Accuracy of an optically isolated tetra-polar impedance measurement system. Med. Biol. Eng. Comput. 40(6), 647-9. 13.Walker DC, Brown BH, Smallwood RH, Hose DR and Jones DM. (2002), Modelled current distribution in cervical squamous tissue. Physiol. Meas. 23(1), 159-68. 14.Gonzalez-Correa CA, Brown BH , Smallwood RH, Stephenson TJ, Stoddard CJ and Bardhan KD, (2003) Low frequency electrical bioimpedance for the detection of inflammation and dysplasia in Barrett’s oesophagus, Physiol. Meas. 24(2). 291-296. 15.Jones DM, Smallwood RH, Hose DR, Brown BH , Walker DC, (2003) Modelling of epithelial tissue impedance measured using three different designs of probe, Physiol. Meas. 24(2), 605- 624. 16.Walker DC, Brown BH, Blackett AD, Tidy J and Smallwood RH, (2003) A study of the morphological parameters of cervical squamous epithelium, Phys. Meas. 24(1), 121-136. 17.Bertemes –Filho P, Brown BH, Smallwood RH and Wilson AJ, (2003) Stand off electrode (SOE) a new method for improving the sensitivity of tetrapolar impedance measurements, Phys.

• Meas. 24(2), 517-526.

18.Brown BH, Milnes P, Abdul S and Tidy JA, (2004) Detection of cervical intra-epithelial neoplasia using impedance spectroscopy, Proc. of 12th Int. Conf. on Electrical Bioimpedance, Gdansk, Poland. 19.Gonzalez-Correa CA, Brown BH, Smallwood RH, Walker DC and Bardhan KD. (2005) Electrical bioimpedance readings increase with higher pressure applied to the measuring probe, Phys.

• Meas. 26, 2, S39-47.

20.UK Patent application 0511323.8 3rd June 2005 Cervical Probe – Sheath. 21.UK Patent application 0511290.9 3rd June 2005 Cervical Probe – Wireless connection. 22.UK Patent application 0511289.1 3rd June 2005 Cervical Probe Boundary Detection. 23.Gandhi SV, Walker D, Milnes P, Mukherjee S, Brown BH and Anumba DOC. (2006) Electrical Impedance Spectroscopy of the Cervix in non-pregnant and pregnant women, European Journal

• f Obstetrics and Gynaecology, 129, 145-149.

24.Lundin, P., Karpefors. M., Carllson, K., Hansen, M.B., Ruth, M. (2011) Bioimpedance spectroscopy: a new tool to assess early esophageal changes linked to gastroesophageal reflux disease? Diseases of the Esophagus, 24 462-469 25.Antakia, R., Brown, B.H., Highfield, P.E., Stephenson, T.J., Brown, N.J., Balasubramanian, S.P. (2014) Electrical impedance spectroscopy of rabbit thyroid and parathyroid glands. European Journal of Surgical Oncology, 40 (S1), S9 26.Tidy, J. (2015) Utilisation of electrical impedance spectroscopy (EIS) in the detection of dysplasia. Oncology News, Mar/April, 2015 27.Antakia, R., Brown, B.H., Highfield, P.E., Stephenson, T.J., Brown, N., Balasubramanian, S.P. (2015) Electrical Impedance Spectroscopy to Aid Parathyroid Identification and Preservation in Central Compartment Neck Surgery. A Proof of Concept in a Rabbit Model. Surgical Innovation, Sept, 2015