Additive-manufacture for Design-led Efficient Patient Treatment - ADEPT

The research team created for this project would seek to inform the development of intelligent software systems that
capture the tacit knowledge of designers, engineers and medical specialists into vastly improved laser melting driven
production chain. The academic partner's role in this project is aligned to enabling the design freedoms and IP frameworks
of AM to create successful business transformation. The purpose of research within this project is to improve the
applicability and acceptance of a new service, where the aim is to create a commercially viable output that is significantly
more efficient than competitors. In order to achieve this, structured research based on a Design Research Methodology
(DRM) framework (Blessing and Chakrabarti, 2009) would first seek to define research goals, establish the criteria of
success and identify influences and how they interact.
This first research phase is linked to project work package 1. This is fundamentally about understanding end user (the
medical specialists who would use the new service) requirements in terms of implant design intention and software
interface requirements. The research team would work with the Maxillofacial Unit at Morriston Hospital and other end
users to employ the principles of a User-Centred Design (UCD) approach. UCD is multidisciplinary approach that requires
experts from various disciplines to examine, analyse, interpret and synthesise user needs and behaviours and translate
these to end products, often in an iterative process. It is value-adding both in terms of improved design output (leading to
greater commercial success) and in considering the overall experience of product/service interaction for the user. Crucial to this approach is the involvement of product/service users, in this case medical professionals, in the very early stages of
insight generation, through to the development and evaluation of concepts. This is contrary to more commonly used
approaches that first establish concepts and prototypes before engaging with the end users. The approach significantly
reduces the risk of developing services that do not meet the market needs.
A combination of observational techniques and structured reviews would be used during work package 1 to capture user
requirement at the points of potential application. Stakeholder interaction mapping would be used to define and quantify
how new services developed as part of this project would impact implant production. The data generated would be used to
define an optimum workflow, measures of project impact and a product specification, against which new approaches can
be developed. This information would be used to develop a testable software-based platform based on low-fidelity, 'throw
away' prototyping for evaluation by end users. Low-fidelity prototypes are not constrained by current technical knowledge
and by nature contain no coding that could be used in the final solution; they are, however, an important mechanism that
will be used to assess the user requirements that may make the product successful in the market, without committing the
significant resources required to build a final system. User feedback will be used to filter more viable options into highfidelity,
evolutionary prototypes, with increased function. These prototypes would be evaluated in theoretical clinical case
studies that can be evaluated against the specification developed in work package 2.
User-insight generated research developed during work packages 1-3 would then be used to inform the software
engineering team for final, functional product development.
Benchmark data and the concluded impact measures defined during work package 1 will be used to evaluate the
demonstrator platform created in work package 7. This would determine the effectiveness of the project and research
outcomes.

The research combines Renishaw's Laser Melting AM technology with patient-specific medical device expertise at PDR
and the supply chain and material expertise of LPW, and evaluates the resulting implant concepts in a challenging clinical
environment. This would have direct impact to the project consortium and indirect benefits to the wider research
community, through which findings can be translated to new areas. The research would have the methodology to create
realistic benchmarks that will enable changes in surgical procedures using AM-enabled services to be measured. Direct
beneficiaries are envisaged to be healthcare service users, patients of the service providers, project industrial partners and
the design and engineering research communities. Appropriate methods for dissemination would ensure that each of these
potential beneficiaries are targeted appropriately:
- Healthcare service users (UK NHS and worldwide)
The project seeks to develop a vastly improve service which healthcare providers will be able to access. By reducing the
barriers of engagement and improving the efficiency of patient specific implant production, healthcare providers would be
become more competitive and agile in planning surgical intervention, reduce cost associated with stock inventory and
access services that offer an improved product quality over those currently available. Based on the service being used for
the calculated addressable market potential of 22,500 worldwide cases per year, an estimated 1,845,000 man hours could
be saved. Impact to this primary, service user group would be ensured through disseminating research in relevant journals
(such as the British J. Oral Maxfac Surg, J. Eng. In Medicine and open access journals such as the Open Neurosurgery J.)
and conferences (such as Advanced Digital Technologies in Head and Neck Reconstruction and the annual British
Association of Oral & Maxfac Surgeons). Professional network events and hospital research group meetings would also be
used to ensure interdisciplinary dissemination.
- Patients
AM production is proven to offer improved product performance in terms of fit. This project would enable these anatomical,
aesthetic advantages to be delivered to more patients, dramatically more efficiently. This would result in a reduced number
of bed days (waiting for surgery), more predictable surgical outcomes (more advanced ability to preview and verify the
optimal surgical outcome) and reduced numbers of invasive procedures (improved communication should result in the ability to achieve an optimal result first time). Information on the project would be made available to patients via the project
website. Further dissemination would be offered via the application of the newly created service.
- Industry lead and partner
Research undertaken as part of this project would enable the lead partner and the industry partner to enter new markets
worth a calculated £18m/yr. The capability enabled through this project would also create a platform to launch into further,
emerging markets where the benefits of an AM approach are constrained due to process inefficiencies and lack of design
user insight. Impact would be ensured throughout the interdisciplinary research during the project with trade events (such
as TCT Live) and a strategic marketing strategy developed towards the latter project phases used to increase market
awareness.
- The Research Community
The design research community would directly benefit from case studies that demonstrate the potential of employing a
structured, user-centric approach to generate a positive economic and social impact. The interdisciplinary nature of the
work would create opportunity for academic dissemination through broadly appealing journals for: the AM/Rapid
Prototyping sector (the Rapid Prototyping J.), the design research sector (Design Management J.) and biomedical design
engineers (J. of Eng. in Med.).