Clinical Engineering

Clinical Engineering: A Handbook for Clinical and Biomedical Engineers

Azzam F.G. Taktak, Paul Ganney, David Long, and Paul White, Eds., Academic Press, 2014. ISBN: 978–0– 12–396961–3, xvii + 443 pages, US$125.

To me, the title of this book implied that it might be useful as a textbook or as a reference handbook in survey courses on clinical engineering. I was unable to find a reviewer who was active in the field as a clinical engineer; thus, I decided to review it myself.

It consists of four sections, with a total of 26 chapters written by 35 contributors. As might be expected from these numbers, the writing style, content, and quality are (very) uneven.

The first seven chapters (Part 1) are simply titled “General.”

  • Chapter 1, “Anatomy and Physiology,” is a 20-page crash course on that topic.
  • “Research Methodology” is covered briefly in Chapter 2.
  • “Good Clinical Practice” is reasonably covered in Chapter 3.
  • “Health Technology Management” is nicely overviewed and well referenced in Chapter 4.
  • Chapter 5 is a unique and nice discussion of leadership in a generic sense (independent of clinical engineering).
  • Chapter 6 summarizes “Risk Management“ and briefly covers the relevant topic of “risk appetite.”
  • Chapter 7, “The Role of Clinical Engineers in Hospitals” should have been the introductory chapter to this textbook but is only a ten-page overview of the generic roles of a clinical engineer. It is of interest here that the authors, all from the United Kingdom, consider clinical engineering to be “applied biomedical engineering.” A reasonable overview of European and U.S. standards and protocols is also provided in this section.

Part 2, “Information Technology and Software Engineering,” is a brief overview in the three chapters:

  • Chapter 8—“Information Communications Technology”
  • Chapter 9—“Software Engineering”
  • Chapter 10—“Web Development.”

Software as a medical device is covered in Chapter 8. A brief listing of languages used and some generic topics are introduced in Chapter 9 along with a few application examples. Much more detail would need to be presented to term this section part of a handbook.

Part 3 of the text, “Clinical Instrumentation and Measurement,“ consists of six chapters.

  • Chapter 11 covers “Medical Electronics” from electronic components through filters in 17 pages.
  • Chapter 12, “Clinical Measurement,” discusses accuracy and precision, uncertainty, sensitivity, and type I and type II errors—all in seven pages and with only three references.
  • “Cardiology” is lightly covered in the nine pages of Chapter 13.
  • “Pressure and Flow” (including blood pressure measurement) is covered in six pages in Chapter 14.
  • Neurological measurements are overviewed (electromyography and electroencephalography) in seven pages in Chapter 15. No references are given.
  • Chapter 16, “Respiratory,” covers some basic lung function measurements in 12 pages. This section is very light in coverage and details virtually none of the instrumentation and instrumentation maintenance matters that are common in these areas.

The final section of the text, “Rehabilitation Engineering and Assistive Technology,” includes ten chapters.

  • Chapter 17, “Introduction: Medical Engineering Design, Regulations, and Risk Management,” is 18 pages long, of which seven are under the subheading “Introduction” and five are repeats of earlier discussions of regulations and risk analysis—for a net total of about four pages on the topic of the section.
  • Chapters 18–26 cover (briefly and without brand or maintenance information) functional electrical stimulation, posture management, pressure ulcerations, wheelchair assessment and prescription and controls, electrical assistive technology, clinical gait analysis, and mechanical and electromechanical systems used in implants, prosthetics, and orthotics.

This textbook is primarily an overview of different topics relating to clinical engineering as seen and reported by the 35 contributors. It fails as a handbook in that none of the chapters are sufficiently in depth on their subjects to be a reference for clinical (or biomedical) engineers. With its uneven coverage of topics, the textbook does not fulfill the needs of those looking for assistance on the topics involved, which might qualify this text as a handbook covering the vocabulary and profession of clinical engineering. The textbook Clinical Engineering Handbook by Joseph Dyro better fills this role.