Experience with telepathology in combination with diagnostic assistance systems in countries with restricted resources

Author:

Fritz Peter1ORCID,Kleinhans Andreas2,Hubler Monika3,Rokai Raoufi4,Firooz Haroon5,Sediqi Atiq6,Khachatryan Anna7,Sotoudeh Kambiz8,Mamunts David9,Desai Munaf10,Omer Mohamed11,Kunze Dietmar12,Hinsch Nora13,Jundt Gernot14,Dalquen Peter14,Ott German1,Aboud Al Alaboud15,Alscher Mark-Dominik2,Stauch Gerhard3

Affiliation:

1. Department of Pathology, Robert Bosch Hospital, Stuttgart, Germany

2. Department of Internal Medicine and Nephrology, Robert Bosch Hospital, Stuttgart, Germany

3. IPath Telemedicine Network gemeinnützige GmbH, Aurich, Germany

4. Abu Ali Sina Hospital, Mazari al Sharif, Afghanistan

5. Firooz Medical Laboratory, Herat, Afghanistan

6. Mili-Medical Service, Mazari-Al-Sharif, Afghanistan

7. Department of Pathology, Yerevan State Medical University, Yerevan, Armenia

8. Department of Pathology, Jam General Hospital, Teheran, Iran

9. Department of Pathology, Central Clinical Military Hospital, Yerevan, Armenia

10. Hospital SGH Dubai, United Arab Emirates

11. Kabul Pathology Laboratory, Kabul, Afghanistan

12. Institute of Pathology, University Hospital, TU Dresden, Germany

13. MVZ Fachbereich Pathologie Lukaskrankenhaus, Neuss, Germany

14. Department of Dermatopathology, King Faisal Hospital, Makkah, Saudi Arabia

15. Institute of Pathology, University Basel, Basel, Switzerland

Abstract

IntroductionWe describe the use of telepathology in countries with restricted resources using two diagnosis assistance systems (Isabel and Memem7) in addition to the diagnoses made by experts in pathology via the iPath-Network.MethodsA total of 156 cases, largely from Afghanistan, were analysed; 18 cases had to be excluded because of poor image quality.ResultsOf the remaining 138 cases (100%), a responsible physician provided a tentative diagnosis for 61.6% of them. With a diagnosis from a consultant pathologist, it was then possible to make a definite diagnosis in 84.8% of cases on the basis of images taken from hematoxylin and eosin staining sections alone. The use of the diagnosis assistance systems resulted in an ordered list of differential diagnoses in 82.6% (IsabelHealth) and in 74.6% (Memem7) of cases, respectively. Adding morphological terminology reduced the list of possible diagnoses to 52.2% (72 cases, Memem7), but improved their quality.DiscussionIn summary, diagnosis assistance systems are promising approaches to provide physicians in countries with restricted resources with lists of probable differential diagnoses, thus increasing the plausibility of the diagnosis of the consultant pathologist.

Publisher

SAGE Publications

Subject

Health Informatics

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