Telecytology in East Africa: a feasibility study of forty cases using a static imaging system

Author:

Kumar Neeta1,Busarla Satya Vara Prasad2,Sayed Shahin1,Kirimi Jesca Muthoni3,Okiro Patricia4,Gakinya Samuel Mukono1,Moloo Zahir1,Sohani Aliyah R5

Affiliation:

1. Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya

2. Department of Pathology, Aga Khan Hospital, Kisumu, Kenya

3. Department of Pathology, Aga Khan Hospital, Dar es Salaam, Tanzania

4. Department of Pathology, Aga Khan Hospital, Mombasa, Kenya

5. Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, USA

Abstract

We conducted a pilot study to assess the feasibility of telecytology as a diagnostic tool in difficult cases originating from a hospital in East Africa. Forty cytology cases considered difficult by a referring pathologist were posted on a telepathology website. Six pathologists independently assessed the static images. Telecytology diagnoses were compared with the consensus diagnoses made on glass slides and also with the histogical diagnoses when available. The diagnostic agreement of the six pathologists was 71–93% and tended to be higher for pathologists with more experience. Reasons for discordance included poor image quality, presence of diagnostic cells in thick areas of smears, sampling bias and screening errors. The consensus diagnoses agreed with histological diagnoses in all 17 cases in which a biopsy was performed. Diagnostic accuracy rates (i.e. telecytology diagnosis vs. histological diagnosis) for individual pathologists were 65–88%. To ensure diagnostic accuracy both referring and consulting pathologists must have adequate training in cytology, image acquisition and image-based diagnosis and the diagnostic questions of importance must be clearly communicated by the referring pathologist when posting a case.

Publisher

SAGE Publications

Subject

Health Informatics

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