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Asiedu MN, Agudogo JS, Dotson ME, Skerrett E, Krieger MS, Lam CT, Agyei D, Amewu J, Asah-Opoku K, Huchko M, Schmitt JW, Samba A, Srofenyoh E, Ramanujam N. A novel speculum-free imaging strategy for visualization of the internal female lower reproductive system. Sci Rep 2020; 10:16570. [PMID: 33024146 PMCID: PMC7538883 DOI: 10.1038/s41598-020-72219-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 08/25/2020] [Indexed: 12/16/2022] Open
Abstract
Fear of the speculum and feelings of vulnerability during the gynecologic exams are two of the biggest barriers to cervical cancer screening for women. To address these barriers, we have developed a novel, low-cost tool called the Callascope to reimagine the gynecological exam, enabling clinician and self-imaging of the cervix without the need for a speculum. The Callascope contains a 2 megapixel camera and contrast agent spray mechanism housed within a form factor designed to eliminate the need for a speculum during contrast agent administration and image capture. Preliminary bench testing for comparison of the Callascope camera to a $20,000 high-end colposcope demonstrated that the Callascope camera meets visual requirements for cervical imaging. Bench testing of the spray mechanism demonstrates that the contrast agent delivery enables satisfactory administration and cervix coverage. Clinical studies performed at Duke University Medical Center, Durham, USA and in Greater Accra Regional Hospital, Accra, Ghana assessed (1) the Callascope's ability to visualize the cervix compared to the standard-of-care speculum exam, (2) the feasibility and willingness of women to use the Callascope for self-exams, and (3) the feasibility and willingness of clinicians and their patients to use the Callascope for clinician-based examinations. Cervix visualization was comparable between the Callascope and speculum (83% or 44/53 women vs. 100%) when performed by a clinician. Visualization was achieved in 95% (21/22) of women who used the Callascope for self-imaging. Post-exam surveys indicated that participants preferred the Callascope to a speculum-based exam. Our results indicate the Callascope is a viable option for clinician-based and self-exam speculum-free cervical imaging.Clinical study registration ClinicalTrials.gov https://clinicaltrials.gov/ct2/show/record/ NCT00900575, Pan African Clinical Trial Registry (PACTR) https://www.pactr.org/ PACTR201905806116817.
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Affiliation(s)
- Mercy N. Asiedu
- grid.26009.3d0000 0004 1936 7961Department of Biomedical Engineering, Duke University, Gross Hall Rm 370, Durham, NC 27713 USA ,grid.26009.3d0000 0004 1936 7961Center for Global Women’s Health Technologies, Duke University, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Duke Global Health Institute, Duke University, Durham, NC USA
| | - Júlia S. Agudogo
- grid.26009.3d0000 0004 1936 7961Department of Biomedical Engineering, Duke University, Gross Hall Rm 370, Durham, NC 27713 USA ,grid.26009.3d0000 0004 1936 7961Center for Global Women’s Health Technologies, Duke University, Durham, NC USA
| | - Mary E. Dotson
- grid.26009.3d0000 0004 1936 7961Center for Global Women’s Health Technologies, Duke University, Durham, NC USA
| | - Erica Skerrett
- grid.26009.3d0000 0004 1936 7961Department of Biomedical Engineering, Duke University, Gross Hall Rm 370, Durham, NC 27713 USA ,grid.26009.3d0000 0004 1936 7961Center for Global Women’s Health Technologies, Duke University, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Duke Global Health Institute, Duke University, Durham, NC USA
| | - Marlee S. Krieger
- grid.26009.3d0000 0004 1936 7961Department of Biomedical Engineering, Duke University, Gross Hall Rm 370, Durham, NC 27713 USA ,grid.26009.3d0000 0004 1936 7961Center for Global Women’s Health Technologies, Duke University, Durham, NC USA
| | - Christopher T. Lam
- grid.26009.3d0000 0004 1936 7961Department of Biomedical Engineering, Duke University, Gross Hall Rm 370, Durham, NC 27713 USA ,grid.26009.3d0000 0004 1936 7961Center for Global Women’s Health Technologies, Duke University, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Duke Global Health Institute, Duke University, Durham, NC USA
| | - Doris Agyei
- Family Planning and Reproductive Health Unit, Greater Accra Regional Hospital, Accra, Ghana
| | - Juliet Amewu
- Family Planning and Reproductive Health Unit, Greater Accra Regional Hospital, Accra, Ghana
| | - Kwaku Asah-Opoku
- grid.415489.50000 0004 0546 3805Department of Obstetrics and Gynecology, Korle Bu Teaching Hospital, Accra, Ghana ,grid.8652.90000 0004 1937 1485The University of Ghana Medical School, Accra, Ghana
| | - Megan Huchko
- grid.26009.3d0000 0004 1936 7961Duke Global Health Institute, Duke University, Durham, NC USA ,grid.414179.e0000 0001 2232 0951Department of Obstetrics and Gynecology, Duke Medical Center, Durham, NC USA
| | - John W. Schmitt
- grid.26009.3d0000 0004 1936 7961Duke Global Health Institute, Duke University, Durham, NC USA ,grid.414179.e0000 0001 2232 0951Department of Obstetrics and Gynecology, Duke Medical Center, Durham, NC USA
| | - Ali Samba
- grid.415489.50000 0004 0546 3805Department of Obstetrics and Gynecology, Korle Bu Teaching Hospital, Accra, Ghana ,grid.8652.90000 0004 1937 1485The University of Ghana Medical School, Accra, Ghana
| | - Emmanuel Srofenyoh
- Family Planning and Reproductive Health Unit, Greater Accra Regional Hospital, Accra, Ghana
| | - Nirmala Ramanujam
- grid.26009.3d0000 0004 1936 7961Department of Biomedical Engineering, Duke University, Gross Hall Rm 370, Durham, NC 27713 USA ,grid.26009.3d0000 0004 1936 7961Center for Global Women’s Health Technologies, Duke University, Durham, NC USA ,grid.26009.3d0000 0004 1936 7961Duke Global Health Institute, Duke University, Durham, NC USA
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