Document Detail


Telepathologic review: utility, diagnostic accuracy, and interobserver variability on a difficult case consultation service.
MedLine Citation:
PMID:  9195582     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The diagnostic accuracy of telepathologic analysis has not been compared to that of conventional light microscopic review on a difficult case consultation service. The anatomic pathology consultation files of the University of Iowa were retrospectively examined, and 105 difficult cases from a variety of organs were chosen for real-time telepathologic and light microscopic review. The telepathologic and light microscopic crude agreement of five pathologists were compared, with use of the original consultation diagnosis as the "gold standard." Cases were scored as correct, partially correct, or incorrect. After making a video diagnosis, the pathologists reported whether they wanted to review the case with use of a light microscope. The pathologists performed significantly better with the light microscope, even after excluding cases in areas of inexpertise (P = .005). The mean percentage of cases that the pathologists wanted to review with the light microscope was 64%, and the major reason for review was diagnostic uncertainty. Cases incorrectly diagnosed with use of the video monitor were almost always requested for review. We conclude that, on a difficult case consultation service, pathologists perform significantly better with use of light microscopic than with telepathologic analysis; rarely make an incorrect diagnosis and do not request that case for light microscopic review; and exhibit high telepathologic diagnostic accuracy in areas of expertise.
Authors:
S S Raab; R A Robinson; T E Snider; H L McDaniel; J D Sigman; C J Leigh; P A Thomas
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc     Volume:  10     ISSN:  0893-3952     ISO Abbreviation:  Mod. Pathol.     Publication Date:  1997 Jun 
Date Detail:
Created Date:  1997-08-21     Completed Date:  1997-08-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8806605     Medline TA:  Mod Pathol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  630-5     Citation Subset:  IM    
Affiliation:
Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City 52242-1009, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Humans
Male
Microscopy*
Middle Aged
Observer Variation*
Predictive Value of Tests
Remote Consultation / methods*
Retrospective Studies
Telepathology*
Video Recording

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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