Presented at the 1999 APIII Conference Return to 1999 Abstract Index
AN INFORMATION SYSTEM FOR QUALITY ASSESSMENT IN PATHOLOGY
Institute
of Molecular Pathology and Immunology
University of Porto
Porto, PORTUGAL
Domingos Cruz, MS
Aims: Development an image information
system to organize and document pathological diagnosis activities.
Test the adequacy of the image information systems for Quality
Assessment (QA) in pathology and its capacity to perform
Quality Control
Design: The application was implemented with Microsoft Visual Tools and uses a relational database running under Windows® operating systems in our network environment. The system was designed to manage a large set of images (millions) stored in multipage TIFF. All the images are tagged with case number and included in a single file.
The pathologists made the documentation of each case with images that support the diagnosis. Using digital cameras the images are acquired compressed and stored along with the complete case data.
To determine the suitability of the program to perform QC tasks, each month, following the ADASP recommendations, cases are randomly selected and reviewed by one or more pathologists, using digital images. To perform QC the level of agreement is registered.
Results: We documented 1013 cases using 2809 images (2.7 images per case) occupying 863 MB of disk space. The mean time spent by the pathologist responsible by the acquisition (n=104) searching a field and acquiring the respective image was 1.2 minute/field.
The images were acquired randomly in different resolutions 1600x1200 (n=1357) and 800x600 (n=1452) with and without JPEG compression, and no problems related with these parameters were reported in the revisions.
A total of 112 cases were selected for review based upon the related images (n=298), clinical and final diagnoses. The pathologists considered 92% of the images acceptable. In 11% of the cases due to incomplete image documentation the agreement with the original diagnoses was not possible.
Conclusion: Our results showed that using this system is possible to select and review cases for assess the quality of diagnoses. The main advantages of the system is simplicity, reduction of time spent for QA activities and possibility of integrate the laboratory in a network of QC by Internet, using externals reviewers. Ours results support that our system is able to handle images without compromise the QA.
