A team from Duke University has developed a portable colposcope that brings primary care setting for a broad range of healthcare providers with different levels of training to use.

Nimmi Ramanujam, professor of biomedical engineering and global health and the director of the Centre for Global Women’s Health Technologies, led a team comprised of Duke faculty, staff, postdoctoral researchers and students, including several current and former Master of Science in Global Health students and a few undergraduate global health majors.

 
Duke Pocket Colposcope Fig1 (cr) Figure 1: Some of the members of the Pocket Colposcope team. From left: Rachel Barrera, Marlee Krieger, Jenna Mueller, Mercy Asiedu and Nimmi Ramanujam. (Source: Duke)  

Since 2012, Ramanujam and her research team have been developing and testing a portable colposcope, called the “Pocket Colposcope,” to increase access to cervical cancer screening in primary care settings. Last month, 20 of these devices were produced for distribution to international partners.

Ease of access paves early detection

According to the World Health Organization (WHO), more than 85% of the more than 270,000 annual deaths from cervical cancer occur in low- and middle-income countries. A clinical colposcope is typically not available in a primary care setting, and in many low- and middle-income countries, often the alternative is to visualise the cervix with only the naked eye—a method that often results in misdiagnoses. The disease is easily treatable if identified early and if easy access to effective screening is available.

The pocket colposcope is designed to address these barriers. It brings that secondary test—traditionally performed using a clinical colposcope by physicians at referral centres—to the primary care setting. In addition, it’s easy for a broad range of health care providers with different levels of training to use.

Developmental collaborations

After four generations of development, the team has created a beta prototype of the pocket colposcope in collaboration with 3rd Stone Design.

 
Duke Pocket Colposcope prototype Fig2 (cr) Figure 2: A beta prototype of the Pocket Colposcope, a portable cervical cancer screening and triage device. (Source: 3rd Stone Design)  

The pocket colposcope is less expensive, smaller and lighter than a traditional clinical colposcope. Weighing less than 0.91kg, it fits inside a pocket (hence the name). The device enables healthcare providers to zoom and capture images by pressing a button with their thumb. Images taken with the pocket colposcope are transmitted instantly to a smartphone, tablet or laptop. Afterwards, the device can be sterilised by immersion in bleach or hydrogen peroxide.

“What’s unique about this design compared to traditional and redesigned, low-cost colposcopes on the market is that it reimagines the way a gynecological exam is performed,” said Ramanujam.

Rivaling clinical colposcopes

Traditional colposcopes have a camera and light source and a binocular viewing system to examine the cervix. Thus, the colposcope is external to the cervix. The pocket colposcope does not have a viewing system, but rather has a consumer grade light source and camera at the tip, that when inserted can provide a live video or image of the cervix on a laptop or tablet. The ability to insert the colposcope through a speculum enables a close-up view of the cervix (3cm rather than 30cm away from the cervix), alleviating the need for high-end optics and high-resolution cameras, which make traditional colposcopes expensive.

 
Duke Pocket Colposcope sync to phone Fig3 (cr) Figure 3: The tablet displays an image of a plastic cervix model.  

The pocket colposcope provides image quality that rivals other colposcopes on the market. Side-by-side images read by an expert shows that the images obtained with the Pocket Colposcope result in the same diagnosis as a high-end clinical colposcope.

 
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