Johnston Dan J, Costello Sean P, Dervan Peter A, O'Shea Daniel G
Medical Informatics Group, School of Biotechnology, Dublin City University, Dublin, Ireland.
BMC Med Inform Decis Mak. 2005 Apr 21;5:10. doi: 10.1186/1472-6947-5-10.
Advances in computing and telecommunications have resulted in the availability of a range of online tools for use in pathology training and quality assurance. The majority focus on either enabling pathologists to examine and diagnose cases, or providing image archives that serve as reference material. Limited emphasis has been placed on analysing the diagnostic process used by pathologists to reach a diagnosis and using this as a resource for improving diagnostic performance.
The ReplaySuite is an online pathology software tool that presents archived virtual slide examinations to pathologists in an accessible video-like format, similar to observing examinations with a double-headed microscope. Delivered through a customized web browser, it utilises PHP (Hypertext PreProcessor) to interact with a remote database and retrieve data describing virtual slide examinations, performed using the Virtual Pathology Slide (VPS). To demonstrate the technology and conduct a preliminary evaluation of pathologists opinions on its potential application in pathology training and quality assurance, 70 pathologists were invited to use the application to review their own and other pathologists examinations of 10 needle-core breast biopsies and complete an electronic survey. 9 pathologists participated, and all subsequently completed an exit survey.
Of those who replayed an examination by another pathologist, 83.3% (5/6) agreed that replays provided an insight into the examining pathologists diagnosis and 33.3% (2/6) reconsidered their own diagnosis for at least one case. Of those who reconsidered their original diagnosis, all re-classified either concordant with group consensus or original glass slide diagnosis. 77.7% (7/9) of all participants, and all 3 participants who replayed more than 10 examinations stated the ReplaySuite to be of some or great benefit in pathology training and quality assurance.
Participants conclude the ReplaySuite to be of some or of great potential benefit to pathology training and quality assurance and consider the ReplaySuite to be beneficial in evaluating the diagnostic trace of an examination. The ReplaySuite removes temporal and spatial issues that surround the use of double-headed microscopes by allowing examinations to be reviewed at different times and in different locations to the original examination. While the evaluation set was limited and potentially subject to bias, the response of participants was favourable. Further work is planned to determine whether use of the ReplaySuite can result in improved diagnostic ability.
计算和电信技术的进步带来了一系列可用于病理学培训和质量保证的在线工具。大多数工具要么侧重于使病理学家能够检查和诊断病例，要么提供作为参考资料的图像存档。对于分析病理学家用于做出诊断的诊断过程并将其用作提高诊断性能的资源，所给予的关注有限。
ReplaySuite是一款在线病理学软件工具，它以类似视频的可访问格式向病理学家呈现存档的虚拟切片检查，类似于使用双头显微镜观察检查。通过定制的网络浏览器提供，它利用PHP（超文本预处理器）与远程数据库交互，并检索描述使用虚拟病理切片（VPS）进行的虚拟切片检查的数据。为了展示该技术并对病理学家对其在病理学培训和质量保证中的潜在应用的意见进行初步评估，邀请了70位病理学家使用该应用程序来回顾他们自己以及其他病理学家对10例针芯乳腺活检的检查，并完成一项电子调查。9位病理学家参与了，随后他们都完成了一份退出调查。
在那些重放另一位病理学家检查的人中，83.3%（5/6）同意重放能让人深入了解检查病理学家的诊断，33.3%（2/6）至少对一个病例重新考虑了自己的诊断。在那些重新考虑其原始诊断的人中，所有人都重新分类为与小组共识或原始玻片诊断一致。所有参与者中的77.7%（7/9），以及所有重放超过10次检查的3位参与者都表示ReplaySuite在病理学培训和质量保证方面有一定或很大的益处。
参与者得出结论，ReplaySuite对病理学培训和质量保证有一定或很大的潜在益处，并认为ReplaySuite在评估检查的诊断过程方面是有益的。ReplaySuite通过允许在与原始检查不同的时间和地点回顾检查，消除了围绕使用双头显微镜的时间和空间问题。虽然评估集有限且可能存在偏差，但参与者的反应是积极的。计划进一步开展工作以确定使用ReplaySuite是否能提高诊断能力。
