Original contributionDiagnostic accuracy of second-opinion diagnoses based on still images
Section snippets
Case material
The study group comprised 100 cases of histological specimens, originally referred for extramural second opinion by the Department of Pathology, County Hospital of Nordland, consecutively retrieved from the archives.
Still image capture
Two different types of still images were captured at the sender site at the county hospital. One or two birds’ eye images (Figure 1) of the glass slides from each case were selected using a Polaroid SprintScan 35 Film Scanner (maximum resolution, 2700 dpi; Polaroid Corp.,
Case material
Of the 100 cases studied, 10 had not been referred for second opinion. Eight of these 10 cases had been requested by pathology departments at other hospitals because the patients were undergoing further treatment. Thus, 90 cases remained for analysis. Most of these 90 cases had originally been referred to one of three hospitals in Norway (29 cases to University Hospital of Northern Norway, 27 to Norwegian Radium Hospital, and 22 to Ullevål University Hospital).
The cases represented tissues from
Discussion
The importance of second opinion in diagnostic pathology has received much attention recently.14, 15, 16, 17 Access to extramural second opinion through still image communication is a valuable approach if an acceptable degree of diagnostic accuracy can be attained. Despite the existence of limited studies addressing diagnostic accuracy, the use of still images to render second opinions has grown gradually and today is offered by, for example, the Armed Forces Institute of Pathology and the
Acknowledgements
The authors thank The Research Council of Norway for a grant to the project NorTelemed, of which this study has been a part. They also thank Yngve Nyheim and Pål Reidar Fredriksen for technical support, Tormod Brenn for advice on design, and Anna Bofin for linguistically reading the manuscript.
References (41)
- et al.
Telepathology diagnosis by means of digital still imagesAn international validation study
Hum Pathol
(1996) - et al.
Transcontinental consults in surgical pathology via the internet
Hum Pathol
(1997) - et al.
Diagnostic accuracy of an international static-imaging telepathology consultation service
Hum Pathol
(1997) - et al.
Telepathology diagnosis of prostate needle biopsies
Hum Pathol
(1997) - et al.
Clinical evaluation of an international static image-based telepathology service
Hum Pathol
(2001) - et al.
Referrals for second opinion in surgical pathologyImplications for management of cancer patients in the UK
Eur J Surg Oncol
(2001) - et al.
Remote frozen section serviceA telepathology prosject in northern Norway
Hum Pathol
(1991) - et al.
Interobserver variability in the interpretation of epithelial ovarian cancer
Gynecol Oncol
(1984) - et al.
Histological grading of breast cancer. Interobserver, reproducibility and prognostic significance
Pathol Res Pract
(1990) - et al.
An analysis of interobserver recognition of the histopathologic features of dysplastic nevi from a mixed group of nevomelanocytic lesions
J Am Acad Dermatol
(1992)
Second opinion pathology in liver biopsy interpretation
Am J Gastroenterol
Telepathology and the networking of pathology diagnostic services
Arch Pathol Lab Med
Long distance image transferFirst results of its use in histopathological diagnosis
Acta Pathol Microbiol Immunol Scand
Second opinion in surgical pathology
Am J Clin Pathol
Telepathology using Internet multimedia electronic mailremote consultation on gastrointestinal pathology
J Telemed Telecare
Expert pathology consultation through the internetMelanoma versus benign melanocytic tumours
J Telemed Telecare
Telepathology reviewUtility, diagnostic accuracy, and interobserver variability on a difficult case consultation service
Mod Pathol
Concordance between telepathologic diagnosis and conventional histopathologic diagnosis
Arch Dermatol
Offline telepathology diagnosis of colorectal polypsA study of interobserver agreement and comparison with glass slide diagnoses
J Clin Pathol
Mandatory second opinion surgical pathology at a large referral hospital
Cancer
Cited by (16)
Diagnostic accuracy of second-opinion diagnoses based on still images [2]
2004, Human PathologyHistological Assessment of Gonads in DSD: Relevance for Clinical Management
2018, Sexual DevelopmentInterobserver agreement in salivary gland neoplasms by telepathology an analysis of 47 cases
2013, Analytical and Quantitative Cytology and HistologyPatient safety strategies targeted at diagnostic errors: A systematic review
2013, Annals of Internal Medicine