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Doctors and Engineers Pool Their Knowledge to Advance Medicine
Physicians' needs fuel the creative process for an informal band of inventive faculty and students.
by Wendy Y. Lawton
When the number of red blood cells drops, the body gets less
oxygen. Anemia results. If unchecked, anemia can lead to kidney failure or a heart
attack. It is also a sign of serious illness, often accompanying cancer,
diabetes, or HIV. In the developing world, the condition is associated with
malnutrition and malaria. An estimated 3.5 million Americans are anemic;
worldwide, the number is about 2 billion.
To diagnose anemia, doctors typically draw blood and send it
to a lab for a complete cell count. Results can take hours or days. But Brown
doctors and engineers have created a device that can diagnose anemia in seconds
- reliably and without a needle.
Doctoral candidate Leslie Shelton, left, and Greg Jay, associate professor of
emergency medicine, are working on a project to create simulation skin for medical
training mannequins that would change color and texture to mimic bruising,
jaundice, rashes or pox - even mimic goose bumps.
The collaboration that led to the development and testing of
the device, dubbed AnemiCAM, is textbook Brown: Faculty and students in one
academic discipline reach out to faculty and students in another, and fresh
ideas fly. AnemiCAM is just one result of a burgeoning bioengineering
partnership on campus that now counts more than a dozen doctors, engineers and
graduate students on its R&D roster.
Spearheaded
by Greg Crawford, associate professor of engineering, and Greg Jay, associate
professor of emergency medicine, the informal band of inventors is turning the
trajectory of translational research on its head. Instead of the
standard bench-to-bedside route, the biomedical devices the group is exploring
spring from bedside to bench: Doctors hatch an idea; students make it happen.
Crawford is convinced this model represents the future of
biomedical engineering.
"Who better to come up with an idea for a medical device
than a doctor?" Crawford said. "They know what they need, so there's a
guaranteed market, and they know how the device should operate. Under the
system, you get good ideas practically executed. Translation is built in."
Selim Suner, a Medical School professor and Rhode Island
Hospital emergency room physician, is also sold. "This is the future of
medicine," Suner said. "We're still operating in a pretty primitive system -
paper and pencil, stethoscopes. But technology, from PDAs to electronic
prescribing, is starting to infiltrate. With its culture of collaboration,
Brown can excel in the medical device arena."
Students and doctors are at work on a handful of promising
projects, from nanolasers to destroy cancer cells to simulation skin for
medical school training mannequins. (See details below.)
AnemiCAM, however, is the most developed idea on the drawing
board.
The device was tested successfully on Rhode Island Hospital
patients last spring and proof-of-concept results were published in a recent Journal
of Biomedical Optics. Patents
have been filed, and a prototype is in the works. The AnemiCAM team - which
includes Crawford, Jay, and Suner along with bioengineering graduate student
John McMurdy - is fielding calls from potential investors. The hope: Start a
spin-off company and get AnemiCAM in doctors' hands in two to three years.
The concept sprang from a 2002 engineering entrepreneurship
course Crawford taught. Jay, who directs Rhode Island Hospital emergency
medicine, agreed to speak with students and offer project ideas.
One was already in hand. To do a quick anemia check, doctors
pull down a patient's lower eyelid and check the conjunctiva, the tissue that
covers the front of the eye and lines the inside of the lid. If the tissue is
pale, not pink, hemoglobin levels in red blood cells may be low. When
hemoglobin is low, anemia results.
But this check is not definitive. A diagnosis still requires
a blood test. Jay and Suner - who both earned engineering degrees - had tried
using a digital camera to diagnose the problem. Take a picture of the tissue
and the camera instantly separates the image into red, blue and green light. A
deficiency of spectral red and green, they found, is a strong predictor of
anemia.
The AnemiCAM was tested on patients at Rhode Island Hospital
Could Crawford and his students do something with the idea?
Of course, Crawford said, but why not use a spectometer - an optical instrument that
measures light across the entire electromagnetic
spectrum - for more accurate readings?
Enter McMurdy, a doctoral candidate in biomedical
engineering and an optics ace who created the spectrometer-based system that
was tested at Rhode Island Hospital last spring. Now McMurdy splits his time in
the lab, refining and miniaturizing the device, and in conference rooms and
restaurants, where he and other members of the team make pitches to potential
investors.
Like all of the graduate engineering students involved in
Brown's budding collaborative, McMurdy is enthralled with medicine.
"When you get into the hospital, you see your ideas in
action," he said. "You're learning about biology, disease, how doctors work.
And you have contact with people - people you hope to help. In that way,
working with doctors is incredibly satisfying."
Maureen McCamley, another doctoral student, agrees. "The
difference between the hospital and the lab is like the Moon versus Earth. One
place is technical. The other is practical."
Doctors benefit from the partnership, too. They still get to
solve problems, but in a new way. "I went to medical school," Jay jokes, "to
become a better engineer."
The bioengineering partnership is blossoming. Last year, the
Office of the Vice President for Research awarded the group an $82,638 seed grant
to get off the ground. Doctors, engineers and students have applied for three
joint research grants, and hope to secure shared laboratory space, making the
bench-bedside merger complete.
Medical Need/High-Tech Devices
Student: Maureen McCamley, doctoral candidate,
biomedical engineering
Physicians: Andrew Artenstein, associate professor
of medicine, Memorial Hospital; Steven Opal, professor of medicine, Memorial Hospital
Project: Create liquid crystal sensors that
identify the presence of gram-negative bacteria, which cause meningitis and
other serious infections. The sensors, in the form of small patches, would
detect the bacteria in minutes rather than hours.
Student: Leslie Shelton, doctoral candidate,
physics
Physicians: Greg Jay, associate professor of
emergency medicine, Rhode Island Hospital; Selim Suner, assistant professor of emergency medicine, Rhode Island Hospital; Leo Kobayashi, assistant professor of emergency medicine, Rhode Island Hospital; Frank Overly, assistant professor of emergency medicine, Rhode Island Hospital
Create simulation skin for medical
training mannequins that would change color and texture to mimic bruising,
jaundice, rashes or pox - even mimic goose bumps. The skin would be created
using liquid crystal flat panel display technology.
Student: Elejdis Kulla, doctoral candidate,
biomedical engineering
Physician: Greg Jay, associate professor of
emergency medicine, Rhode Island Hospital
Project: Create nanolasers for cancer treatment
that can be injected in the body, along with photosensitive drugs, to seek and
destroy tumor cells.
Students: John McMurdy, doctoral candidate,
biomedical engineering; Zara Matthews,
undergraduate neuroscience concentrator
Physicians: Greg Jay, associate professor of
emergency medicine, Rhode Island Hospital; Susan Duffy,
assistant professor of emergency medicine, Rhode Island Hospital
Project: Create a spectroscope-based imaging
system that can "age" a bruise - important information for detecting child
abuse.
Photos by Frank Mullen
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