Optical fibre sensors (OFS), as a result of their unique properties such as small size, no interference with electromagnetic radiation, high sensitivity and the ability to design multiplexed or distributed sensing systems, have found applications ranging from structural health monitoring to biomedical and point of care instrumentation. While the former represents the main commercial application for OFS, there is body of literature concerning the deployment of this versatile sensing platform in healthcare. This paper reviews the different types of OFS and their most recent applications in healthcare. It aims to help clinicians to better understand OFS technology and also provides an overview of the challenges involved in the deployment of developed technology in healthcare. Examples of the application of OFS in healthcare are discussed with particular emphasis on recently (2015–2017) published works to avoid replicating recent review papers. The majority of the work on the development of biomedical OFS stops at the laboratory stage and, with a few exceptions, is not explored in healthcare settings. OFSs have yet to fulfil their great potential in healthcare and methods of increasing the adoption of medical devices based on optical fibres are discussed. It is important to consider these factors early in the device development process for successful translation of the developed sensors to healthcare practice.

The healthcare industry is dependent upon the provision of well designed medical devices. To achieve this it is recommended that user-centred design should begin early, and continue throughout device development. This is a challenge, particularly for smaller companies who may lack the necessary expertise and knowledge. The aim of this study was to conduct a rigorous yet focused investigation into the user requirements for a new medical imaging device. Open-ended semi-structured interviews were conducted with potential clinical users of the device to investigate the clinical need for the device and the potential benefits for patients and clinical users. The study identified a number of new and significant clinical needs that suggested that the concept of the device should be fundamentally changed. The clinical and organisational priorities of the clinical users were identified, as well as a number of factors that would act as barriers to the safe and effective adoption of the device. The developers reported that this focused approach to early requirements elicitation would result in an improved product, reduce the time to market, and save the time and cost of producing and evaluating an inappropriate prototype.

BackgroundThe rigorous elicitation of user needs is a crucial step for both medical device design and purchasing. However, user needs elicitation is often based on qualitative methods whose findings can be difficult to integrate into medical decision-making. This paper describes the application of AHP to elicit user needs for a new CT scanner for use in a public hospital.MethodsAHP was used to design a hierarchy of 12 needs for a new CT scanner, grouped into 4 homogenous categories, and to prepare a paper questionnaire to investigate the relative priorities of these. The questionnaire was completed by 5 senior clinicians working in a variety of clinical specialisations and departments in the same Italian public hospital.ResultsAlthough safety and performance were considered the most important issues, user needs changed according to clinical scenario. For elective surgery, the five most important needs were: spatial resolution, processing software, radiation dose, patient monitoring, and contrast medium. For emergency, the top five most important needs were: patient monitoring, radiation dose, contrast medium control, speed run, spatial resolution.ConclusionsAHP effectively supported user need elicitation, helping to develop an analytic and intelligible framework of decision-making. User needs varied according to working scenario (elective versus emergency medicine) more than clinical specialization. This method should be considered by practitioners involved in decisions about new medical technology, whether that be during device design or before deciding whether to allocate budgets for new medical devices according to clinical functions or according to hospital department.

A major drawback in polarization gating of light backscattered from tissue is that surface reflections dominate the image. An optically flat plate and matching fluid applied to the tissue surface, combined with off-axis detection, were previously used to address this problem. This approach is often inappropriate or inconvenient for practical use and more importantly can affect the tissue's optical properties. A method is demonstrated that combines images obtained with linearly and circularly polarized light to produce a polarization-gated image that is free from surface reflections and does not require optically flat plates or matching fluid.

The imaging resolution in turbid media is severely degraded by light scattering. Resolution can be improved if the unscattered or weakly scattered light is extracted. Here the state of polarization of the emerging light is used to discriminate photon path length, with the more weakly scattered photons maintaining their original polarization state. It is experimentally demonstrated that over a wide range of scatterer concentrations there exist three distinct imaging regimes. It is also shown that within the intermediate regime one of two distinct imaging techniques is appropriate, depending on the particle size.

The polarization properties of light backscattered from a two layer scattering medium are investigated. Linear, circular and elliptical polarization states are considered and it is demonstrated that the degree of polarization of the backscattered light is sensitive to the optical properties of both layers and to layer thickness. Furthermore, it is shown that the polarization memory of circularly polarized light enables deeper layers to be probed whereas linearly polarized light is more sensitive to surface layers. This has applications for characterizing burns and melanoma.

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