Institute for Pathology, Leopoldina Krankenhaus Schweinfurt, Schweinfurt, Germany.
Retired Pathologist, Consultant in Telepathology, Aurich, Germany.
J Telemed Telecare. 2020 Jun;26(5):261-270. doi: 10.1177/1357633X18818745. Epub 2018 Dec 30.
Static telepathology (TP) was used to support a hospital in Tanzania that cannot employ a resident pathologist but has a basic laboratory. Histological slides were prepared by the local technical staff and digital images were uploaded into an Internet-based system; consultant pathologists in Germany could give their opinion. The aim of the study was to examine the diagnostic validity of this project without local pathologists.
The set-up period for special training of local technical assistants was 10 weeks. Diagnoses of the first 545 cases that were processed via TP were compared with the results of a second opinion on the basis of routine slides created from the corresponding paraffin blocks, which were sent to Germany.
Of all cases, 384 (70%) TP diagnoses were completely confirmed by the second opinion. Minor deviations (e.g. divergent subtypes of tumours or other aetiology of non-specific reactive processes) were documented in 76 cases (14%), so that overall, 84% of diagnoses were useful in the setting of the available therapeutic possibilities. The results were better in some subgroups of diseases (90-100% useful diagnoses) and suboptimal (minimum 63%) in a few subgroups with rare diseases. Thirty (5%) malignant diseases were primarily misinterpreted as being benign and 12 (2%) benign diseases as malignant. Forty-three (8%) cases were insufficient for diagnosis using TP and could not be provided with a primary assessment.
Static TP can help support medical services in low-income countries in the absence of local pathologists with a potentially high diagnostic validity, especially for selected groups of diseases. The procedure can significantly improve the diagnostic procedures before commencement of therapy - a substantial contribution within a globalised world.
静态远程病理学（TP）被用于支持坦桑尼亚的一家医院，该医院无法雇用常驻病理学家，但拥有基本的实验室。当地技术人员准备组织学切片，并将数字图像上传到基于互联网的系统；德国的顾问病理学家可以发表意见。本研究的目的是在没有当地病理学家的情况下检查该项目的诊断准确性。
对当地技术助理进行特殊培训的设置期为 10 周。通过 TP 处理的前 545 例病例的诊断结果与根据相应石蜡块创建的常规切片的第二次意见结果进行了比较，这些石蜡块被送到德国。
在所有病例中，384 例（70%）TP 诊断完全得到第二次意见的证实。记录了 76 例（14%）较小的偏差（例如肿瘤的不同亚型或非特异性反应性过程的其他病因），因此，在可利用的治疗可能性范围内，84%的诊断是有用的。在某些疾病亚组（90-100%有用的诊断）中结果更好，而在少数罕见疾病亚组中结果较差（最低 63%）。30 例（5%）恶性疾病最初被误诊为良性，12 例（2%）良性疾病被误诊为恶性。43 例（8%）病例不足以通过 TP 进行诊断，无法提供初步评估。
静态 TP 可以在没有当地病理学家的情况下帮助支持低收入国家的医疗服务，具有潜在的高诊断准确性，特别是对于某些疾病组。该程序可以显著改善治疗前的诊断程序-在全球化的世界中是一项重要贡献。
