The Empirical Foundations of Telepathology: Evidence of Feasibility and Intermediate Effects

Abstract

The evidence regarding feasibility/acceptance of telepathology and related information technology applications has been well documented for several decades. The majority of evidentiary studies focused on intermediate outcomes, as indicated by comparability between telepathology and conventional light microscopy. A consistent trend of concordance between the two modalities was observed in terms of diagnostic accuracy and reliability. Additional benefits include use of telepathology and whole slide imaging for teaching, research, and outreach to resource-limited countries. Challenges still exist, however, in terms of use of telepathology as an effective diagnostic modality in clinical practice.

Pathology and Telepathology Methods in the Child Health and Mortality Prevention Surveillance Network

“…Telepathology is an emerging field utilizing digital communication technology and whole slide imaging (WSI) to transmit digital versions of glass slides for long-distance, real-time discussions and consultations for diagnosis, second opinion, or educational purposes [25][26][27]. WSI, captured on slide scanners, can be stored, organized, annotated, and transmitted digitally, even to remote areas.…”

“…The contribution of telepathology is especially relevant in remote locations that lack specialists and/or access to advanced testing methods (eg, special stains, IHC) [28], and provides opportunities for pathologists to participate in collaborative review of cases and research over distances. While several studies have demonstrated the utility of telepathology using WSI as an effective diagnostic modality in surgical pathology, mostly for neoplastic diseases, only rare studies have evaluated its utility for infectious disease diagnoses [27,[29][30][31][32]. CHAMPS is unique in that it is the largest prospective multicenter surveillance study utilizing MITS, and the first to implement telepathology primarily for identification of infectious causes of death.…”

Telemedizin in der Onkologie: Qualität verbessern – aber wie?

“…Dies gilt insbesondere für die Diagnose von kolorektalen Karzinomen und Mammakarzinomen. Schwierigkeiten kann allerdings die Begutachtung nukleärer oder zellulärer Details bereiten, die sich beim Grading oder in der Zytopathologie bemerkbar machen können (Bashshur et al 2017 (Bashshur et al 2017;Romero Lauro et al 2013). Dies gilt insbesondere für interne Konsile, die innerhalb einer Institution eingeholt werden, die auf verschiedene Standorte verteilt ist.…”

Artificial intelligence can augment global pathology initiatives

“…AI in telepathology will only be implemented in LMICs if it has first been implemented in high-income countries (HICs), where its role in dayto-day patient care remains to be seen. 4 Second, although telepathology could be used within integrated, tiered laboratory networks in LMICs, with slides prepared and scanned in lower levels and transferred to higher levels within the network for interpretation and consultation, telepathology relies on access to technology that is neither affordable nor practical in these countries. Most LMICs lack the capacity to generate the histopathology slides needed as a prerequisite for telepathology, and do not have access to these integrated networks.…”