Diagnostic Accuracy, Feasibility and Time Study of Telepathology in China
Haixia Xu MD; Haikou Renmin Hospital; Ting Li MD; Peking University; Jiang Gu PhD; Peking University; Michael McNutt MD; Peking University; Feng Li MD; Shihezi University; Encong Gong ; Peking University; Xinxia Li MDS; Peking University; Virginia M. Anderson MA; SUNY Downstate; Jianying Liu MD; Peking University;
Content:
Context: Chinas huge geographic expanse, dense population plus uneven urban and economic development results in a shortage of experienced pathologists. Virtual slides e-mailed to experts permit accurate diagnosis in rural and urban settings.
Technology:
Motic Virtual Slide Technology http://www.motic.pathology.com
Design:
Design:Study1) 400 virtual slides prepared from a wide range of surgical pathology cases were reviewed on a computer monitor and diagnoses recorded. At a later date, glass slides from the same cases were randomized and cases diagnosed in the usual manner using the light microscope. Study,2) 600 cases were reviewed using dynamic telepathology, followed 2 months later by a glass slide review of the same cases by 4 observers. The medical history and macroscopic description of the samples were uploaded. (http://www.motic.pathology.com.)
Results:
Results: Study 1) Diagnostic accuracy was statistically similar for glass and virtual slides, (97.25%-96.25%, glass v. 95.5%-94.75% virtual slides). Time spent viewing virtual slides were 3.41-5.24 minutes as compared to 1.16-3.35 minutes for glass slides. Study 2) Concordance between dynamic telepathology and glass slides ranged from 94.2-99.26%. The length of time increased 3-4 times using dynamic telepathology v light microscopy for an average of 17 minutes per diagnosis.
Conclusion:
Conclusion: This diagnostic accuracy and feasibility study highlights the value and bright future for telepathology in China and other underserved populations. The slight time increase using virtual slides is acceptable and will likely be reduced as pathologists become accustomed to the system. Robotic telepathology is acceptable for diagnostic surgical pathology and second opinions. End user experience and advances in technology promise to improve the turn around time for a busy pathology practice.
