Elmore Joann G, Shucard Hannah, Lee Annie C, Wang Pin-Chieh, Kerr Kathleen F, Carney Patricia A, Drew Trafton, Brunyé Tad T, Weaver Donald L
Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Department of Biostatistics, University of Washington, Seattle, WA, USA.
Acad Pathol. 2020 Sep 30;7:2374289520951922. doi: 10.1177/2374289520951922. eCollection 2020 Jan-Dec.
Digital whole slide images are Food and Drug Administration approved for clinical diagnostic use in pathology; however, integration is nascent. Trainees from 9 pathology training programs completed an online survey to ascertain attitudes toward and experiences with whole slide images for pathological interpretations. Respondents (n = 76) reported attending 63 unique medical schools (45 United States, 18 international). While 63% reported medical school exposure to whole slide images, most reported ≤ 5 hours. Those who began training more recently were more likely to report at least some exposure to digital whole slide image training in medical school compared to those who began training earlier: 75% of respondents beginning training in 2017 or 2018 reported exposure to whole slide images compared to 54% for trainees beginning earlier. Trainees exposed to whole slide images in medical school were more likely to agree they were comfortable using whole slide images for interpretation compared to those not exposed (29% vs 12%; = .06). Most trainees agreed that accurate diagnoses can be made using whole slide images for primary diagnosis (92%; 95% CI: 86-98) and that whole slide images are useful for obtaining second opinions (93%; 95% CI: 88-99). Trainees reporting whole slide image experience during training, compared to those with no experience, were more likely to agree they would use whole slide images in 5 years for primary diagnosis (64% vs 50%; = .3) and second opinions (86% vs 76%; = .4). In conclusion, although exposure to whole slide images in medical school has increased, overall exposure is limited. Positive attitudes toward future whole slide image diagnostic use were associated with exposure to this technology during medical training. Curricular integration may promote adoption.
数字全切片图像已获得美国食品药品监督管理局批准，可用于病理学临床诊断；然而，其整合尚处于初期阶段。来自9个病理学培训项目的学员完成了一项在线调查，以确定对全切片图像进行病理诊断的态度和经验。受访者（n = 76）报告称就读于63所不同的医学院（45所美国医学院，18所国际医学院）。虽然63%的人报告称在医学院接触过全切片图像，但大多数人接触时间≤5小时。与较早开始培训的人相比，较近期开始培训的人更有可能报告在医学院至少接受过一些数字全切片图像培训：2017年或2018年开始培训的受访者中有75%报告接触过全切片图像，而较早开始培训的学员这一比例为54%。与未接触过全切片图像的学员相比，在医学院接触过全切片图像的学员更有可能认同自己在使用全切片图像进行诊断时感到自在（29%对12%；P = 0.06）。大多数学员认同使用全切片图像进行初步诊断可以做出准确诊断（92%；95%置信区间：86 - 98），并且全切片图像有助于获得二次诊断意见（93%；95%置信区间：88 - 99）。与没有全切片图像经验的学员相比，在培训期间有全切片图像经验的学员更有可能认同自己在5年后会使用全切片图像进行初步诊断（64%对50%；P = 0.3）和二次诊断意见（86%对76%；P = 0.4）。总之，虽然医学院对全切片图像的接触有所增加，但总体接触仍然有限。对未来全切片图像诊断应用的积极态度与医学培训期间接触该技术有关。课程整合可能会促进其应用。
