A Systematic Analysis of Discordant Diagnoses in Digital Pathology Compared With Light Microscopy
A Systematic Analysis of Discordant Diagnoses in Digital Pathology Compared With Light Microscopy
复制标题
数字病理学与光学显微镜诊断不一致的系统分析
DOI：
10.5858/arpa.2016-0494-oa
复制
发表时间：
2017-12-01
影响因子：
4.6
通讯作者：
Treanor, Darren
中科院分区：
文献类型：
--
作者：
Williams, Bethany J.;DaCosta, Philip;Treanor, Darren
上下文。-对玻璃-数字不一致的重要性和潜在影响的了解相对较少，这在考虑数字病理学采用时可能很重要。-应用循证医学收集和分析整个幻灯片成像验证文献中玻璃数字不一致的报告实例。-我们使用之前的系统评价方案来识别1999年至2015年间评估光学显微镜和全切片成像一致性的研究。数据由一组组织病理学家提取和分析，以分类不一致的类型、意义和潜在的根本原因。-包括23项研究，产生8069例玻璃诊断与数字诊断的比较。在这8069例比较中，报告了335例不一致（4%），其中玻璃是首选诊断介质286例（85%），数码44例（13%），5例（2%）不一致。28项不一致可能对患者造成中度/重度伤害。其中，玻璃是26例（93%）首选的诊断介质。在335例不一致中，109例（32%）涉及不典型增生的诊断或分级。在这些病例中，玻璃是101例（93%）首选的诊断介质，这表明对不典型增生的诊断和分级可能是数字诊断的潜在缺陷。在335例病例中，32例（10%）的数字不一致归因于无法找到一个小的诊断/预后对象。-对一致性研究的系统分析揭示了在整个幻灯片成像中可能存在问题的特定区域。病理学家了解这些领域以确保患者安全是很重要的。
Context.-Relatively little is known about the significance and potential impact of glass-digital discordances, and this is likely to be of importance when considering digital pathology adoption.Objective.-To apply evidence-based medicine to collect and analyze reported instances of glass-digital discordance from the whole slide imaging validation literature.Design.-We used our prior systematic review protocol to identify studies assessing the concordance of light microscopy and whole slide imaging between 1999 and 2015. Data were extracted and analyzed by a team of histopathologists to classify the type, significance, and potential root cause of discordances.Results.-Twenty-three studies were included, yielding 8069 instances of a glass diagnosis being compared with a digital diagnosis. From these 8069 comparisons, 335 instances of discordance (4%) were reported, in which glass was the preferred diagnostic medium in 286 (85%), and digital in 44 (13%), with no consensus in 5 (2%). Twenty-eight discordances had the potential to cause moderate/severe patient harm. Of these, glass was the preferred diagnostic medium for 26 (93%). Of the 335 discordances, 109 (32%) involved the diagnosis or grading of dysplasia. For these cases, glass was the preferred diagnostic medium in 101 cases (93%), suggesting that diagnosis and grading of dysplasia may be a potential pitfall of digital diagnosis. In 32 of 335 cases (10%), discordance on digital was attributed to the inability to find a small diagnostic/prognostic object.Conclusions.-Systematic analysis of concordance studies reveals specific areas that may be problematic on whole slide imaging. It is important that pathologists are aware of these areas to ensure patient safety.