Informatics, digital & computational pathology

• Digital transfer of image rich dermatopathology data using telecommunication technology
• Classified into real time, store and forward or hybrid

• Goal is to provide the highest quality of dermatologic care by moving patient information efficiently (Semin Cutan Med Surg 2002;21:179)
• Composed of telecommunication lines, a virtual slide system and a public web server (Diagn Pathol 2012;7:177)
• Implementation requires adequate infrastructure, internet connectivity and healthcare provider basic training related to imaging and storage (BMC Res Notes 2014;7:588)

• The College of American Pathologists in collaboration with the Association for Pathology Informatics and the American Society for Clinical Pathology have updated the guidelines for validating whole slide imaging systems for pathology diagnosis (Arch Pathol Lab Med 2022;146:440)
  • 3 major recommendations and 9 good practice statements
  • Good practice statements are statements that are not evidence based but they are likely to do more good than harm (Arch Pathol Lab Med 2022;146:440)
• 3 major recommendations are
  • At least 60 cases for 1 use case or 1 application in validation set
    • Must cover the entire spectrum of cases likely to be encountered in the routine practice
    • Another 20 cases for additional applications like immunohistochemistry or special stains if not included in validation set
  • Only intraobserver concordance considered for validation, if < 95%, appropriate remedial steps taken
  • Minimum wash out period of 2 weeks to avoid recall bias for the validation study (Arch Pathol Lab Med 2022;146:440)

Contributed by Jasmine Saleh, M.D.

Contributed by Nadeem Tanveer, M.D., D.N.B.

Which of the following is true about teledermatopathology?

1. Does not increase access to specialists
2. Facilitates international collaboration and widens global access to specialists
3. Has a poor diagnostic concordance
4. Increases interpretive errors

B. Facilitates international collaboration and widens global access to specialists. Teledermatopathology helps pathologists to discuss cases with specialists from other states or countries. Answer A is incorrect because teledermatopathology improves access to specialists. Answer C is incorrect because teledermatopathology has a good diagnostic concordance. Answer D is incorrect because teledermatopathology reduces interpretive errors by facilitating a second opinion.

Comment Here

Reference: Teledermatopathology

Which of the following is the most commonly used modality in teledermatopathology?

1. Hybrid
2. In person consultation
3. Real time
4. Store and forward

D. Store and forward. Store and forward is widely used due to its ease of application. Answer A and C are incorrect because they are used less often. Answer B is incorrect since it is not a modality for teledermatopathology.

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Reference: Teledermatopathology

A dermatologist sends the patient’s clinical history and microscopic images of her dermatologic condition to a pathologist, who subsequently views them and provides diagnosis and recommendations. Which of the following modalities did these physicians use?

1. Hybrid
2. In person consultation
3. Real time
4. Store and forward

D. Store and forward. The images are first stored on the dermatologists computer or mobile phone and then forwarded to the pathologist for opinion. Answer A is incorrect because only one modality is being used to share the static images. Answer B is incorrect because the consultation is online and not in person. Answer C is incorrect because the live images are not being sent in real time.

Comment Here

Reference: Teledermatopathology

A dermatologist emails a pathologist with the patient’s clinical history and microscopic images of her dermatologic condition. The pathologist reviews the information and responds to the email with diagnosis and recommendations. He also sets up a video consultation with the dermatologist. Which of the following modalities best describes the method used by the physicians in this scenario?

1. Hybrid
2. In person consultation
3. Real time
4. Store and forward

A. Hybrid. 2 modalities are being used to discuss the case, static images (store and forward) and video consultation (real time). Answer B is incorrect answer because the meeting is taking place online and not in person. Answer C is incorrect because both static images and videoconferencing are being used to discuss the case. Answer D is incorrect because store and forward technique is being used in conjunction with videoconferencing.

Comment Here

Reference: Teledermatopathology