Diagnostic concordance and discordance in digital pathology: a systematic review and meta-analysis.
Diagnostic concordance and discordance in digital pathology: a systematic review and meta-analysis.
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DOI：
10.1136/jclinpath-2020-206764
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发表时间：
2021-07
影响因子：
3.4
通讯作者：
Snead DRJ
中科院分区：
文献类型：
--
作者：
Azam AS;Miligy IM;Kimani PK;Maqbool H;Hewitt K;Rajpoot NM;Snead DRJ
数字病理学（DP）有可能从根本上改变组织病理学的实践方式，简化工作流程，提高效率，提高诊断准确性，并促进基于人工智能的计算机辅助诊断平台的实施。虽然更广泛地采用DP的障碍是多因素的，但可靠性的证据有限是一个重要因素。文献中仍然缺乏证明DP的综合准确性和可靠性的荟萃分析。我们的目的是审查已发表的关于DP诊断用途的文献，并在验证过程中综合DP用于常规诊断（主要和次要）的安全性和可靠性的统计学汇总证据。通过PubMed、Medline、EMBASE、科克伦图书馆和Google Scholar对2013年至2019年8月期间发表的研究进行了全面的文献检索。检索方案确定了所有比较DP与光学显微镜（LM）报告用于诊断目的的研究，主要包括H& E染色载玻片。随机效应荟萃分析用于汇总研究证据。25项研究被认为有资格纳入审查，共检查了10410份组织学样本（平均样本量176）。对于总体一致性（临床一致性），24项研究的一致率为98.3%（95% CI 97.4 - 98.9）。25项研究共报告了546项重大不一致。其中一半以上（57%）与核异常的评估、异型增生和恶性程度有关。其次是具有挑战性的诊断（26%）和识别小物体（16%）。该荟萃分析的结果表明，在常规诊断方面，DP与LM的性能相当。此外，结果提供了有价值的信息，有关领域的诊断差异，可能需要特别注意的过渡到DP。
Digital pathology (DP) has the potential to fundamentally change the way that histopathology is practised, by streamlining the workflow, increasing efficiency, improving diagnostic accuracy and facilitating the platform for implementation of artificial intelligence–based computer-assisted diagnostics. Although the barriers to wider adoption of DP have been multifactorial, limited evidence of reliability has been a significant contributor. A meta-analysis to demonstrate the combined accuracy and reliability of DP is still lacking in the literature. We aimed to review the published literature on the diagnostic use of DP and to synthesise a statistically pooled evidence on safety and reliability of DP for routine diagnosis (primary and secondary) in the context of validation process. A comprehensive literature search was conducted through PubMed, Medline, EMBASE, Cochrane Library and Google Scholar for studies published between 2013 and August 2019. The search protocol identified all studies comparing DP with light microscopy (LM) reporting for diagnostic purposes, predominantly including H&E-stained slides. Random-effects meta-analysis was used to pool evidence from the studies. Twenty-five studies were deemed eligible to be included in the review which examined a total of 10 410 histology samples (average sample size 176). For overall concordance (clinical concordance), the agreement percentage was 98.3% (95% CI 97.4 to 98.9) across 24 studies. A total of 546 major discordances were reported across 25 studies. Over half (57%) of these were related to assessment of nuclear atypia, grading of dysplasia and malignancy. These were followed by challenging diagnoses (26%) and identification of small objects (16%). The results of this meta-analysis indicate equivalent performance of DP in comparison with LM for routine diagnosis. Furthermore, the results provide valuable information concerning the areas of diagnostic discrepancy which may warrant particular attention in the transition to DP.
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影响因子：
3.4
作者：
Ordi, Jaume;Castillo, Paola;Ramirez, Jose
通讯作者：
Ramirez, Jose
DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
--
作者：
Buck, Thomas P;Dilorio, Rebecca;O'Neill, Dennis G
通讯作者：
O'Neill, Dennis G
影响因子：
2.6
作者：
Brunelli M;Beccari S;Colombari R;Gobbo S;Giobelli L;Pellegrini A;Chilosi M;Lunardi M;Martignoni G;Scarpa A;Eccher A
通讯作者：
Eccher A
影响因子：
3.4
作者：
McCluggage, WG;Bharucha, H;Walsh, MY
通讯作者：
Walsh, MY