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Concept to Care Delivery of the Pocket Colposcope: A Unique Ph.D. Experience

May 31, 2018

In 2010, Chris entered the Masters of Science program in Global Health at the Duke Global Health Institute (DGHI). As a visiting fellow at the George Institute for Chronic Diseases in China, Chris characterized the burden of hypertension and the effectiveness of a dietary salt substitute intervention in reducing hypertension in an elderly pastoralist rural Tibetan population. This fieldwork experience, demonstrated that there is a prodigious need for the translation of technological and scientific advances to settings where populations that have the greatest challenge accessing modern health care.

 

In 2012, Chris began his doctoral dissertation research towards the design and development of a low-cost technology for cervical cancer screening at the Center for Global Women’s Health Technologies ().  His first attempt utilized a spectroscopy based approach to characterize vascular changes in the pre-cancerous cervix in the Blanchard Clinic (Fig. 1). However, the complexity and fragility of the detectors and fiber optics simply did not hold up in a pilot study in post-earthquake Haiti. For example, the blazing heat impacted the stability of the device and the lack of access to sterilization techniques made it very challenging to actually conduct clinical studies. Importantly, the providers wanted a colposcope (the standard device used for the magnified visualization of cervical abnormalities), not a new, yet unproven gadget! That led to the genesis of the Pocket Colposcope.  (Fig. 2).

 

Fig 1: Chris performs calibration measurements with the fiber optic based spectroscopy system before a busy day at the Blanchard Clinic in Port-au-Prince, Haiti. 

What started from a hastily sketched concept drawing on the back of a napkin, has transformed into a tangible robust low-cost diagnostic tool that could help abrogate the dramatic burden of cervical cancer resource-limited settings through early screening. The Pocket Colposcope has been developed into a fully validated product over the course of Chris’s tenure at Duke and now being used in clinical trials in four continents across the globe. 

Fig 2: Chris demonstrates the operation of the latest generation Pocket Colposcope on a training mannequin when interfaced with a mobile phone.

Recently, Chris along with staff specialist Rachel Barrera had a unique opportunity to help begin an implementation study led by PATH (Seattle, Washington) to determine the feasibility of a “see and treat” paradigm with primary care providers in Tegucigalpa, Honduras (Fig. 3).  Their week-long journey supported by a DGHI Doctoral Scholar dissertation and travel grant gave Chris and Rachel the opportunity to deliver, train, and visit four Ministry of Health clinics and connect with their local NGO partner ASHONPLAFA and the Honduran Ministry of Health. The clinical trial utilizing the Pocket Colposcope is now underway and is expected to finish at the end of the year.

Fig 3: (Left) Rachel and Chris review the Pocket Colposcope with the San Miguel clinical team, Dr. Alfonso Auerbach (in the red t-shirt) practicing with the device. (Right) Representative exam space measuring 8 ft. x 8 ft., with the incandescent light stand which is typically the illumination source used when performing naked eye visual inspection with acetic acid. 

Outside of research, Chris was on the Duke Global Health Institute’s Student Council for four years and was a co-executive lead on the Triangle Global Health Case Competition for two years.  Chris also served on the Duke Global Health Institute’s Masters of Global Health Curriculum Review Committee in 2011.  Chris was an officer in the local optics and spectroscopy student group, OSA/SPIE, and has helped organize education outreach programs that included high school research summer rotations and demonstrations at local schools.

 

Chris’s future plans after graduation, are to pursue a entrepreneurship post-doctoral fellowship that will enable him to develop the necessary business acumen to create lasting impact on the health of others through commercialization of the Pocket Colposcope.