Telepathology

心电病理学
  • 文章类型: Journal Article
    通过适当的辅助测试对死亡的生产动物进行验尸是确定发病和死亡原因的基础。做出明确的诊断对于保障动物健康和福利的循证牧群管理和治疗决策至关重要。食品安全,和人类健康。然而,由于一系列原因,有时无法在兽医诊断实验室检查尸体。因此,养殖动物的验尸,包括牛,通常由转诊兽医(rVet)在农场进行,并将组织样本提交给兽医诊断实验室进行辅助测试。由于各种原因,现场验尸可能与较低的诊断率有关。我们调查了实时病理学家辅助的现场验尸(rtPAP)对肉牛rVets的帮助,以评估在实现最终诊断方面的任何改进。我们发现,与无辅助的现场验尸相比,rtPAP提高了最终诊断的成功率。参与的牛rVets和病理学家都看到了rtPAP的好处,牛rVets表示,如果有的话,他们将来会使用这项服务。我们的概念验证研究证明了rtPAP在诊断肉牛疾病中的积极作用,并说明了对支持食用动物rVets和生产者的心灵感应服务的需求。
    Postmortem examination of deceased production animals with appropriate ancillary testing is fundamental to determining causes of morbidity and mortality. Reaching a definitive diagnosis is crucial to evidence-based herd management and treatment decisions that safeguard animal health and welfare, food safety, and human health. However, for a range of reasons, carcasses sometimes cannot be examined in a veterinary diagnostic laboratory. As a result, postmortem examinations of farmed animals, including cattle, are often performed on-farm by the referring veterinarian (rVet) with tissue samples submitted to a veterinary diagnostic laboratory for ancillary testing. For various reasons, field postmortems can be associated with lower diagnostic rates. We investigated real-time pathologist-assisted field postmortem examination (rtPAP) assistance to beef cattle rVets to gauge any improvement in attaining a final diagnosis. We found that rtPAPs improved the success of reaching a final diagnosis compared to unassisted field postmortem examinations. Both the participating bovine rVets and the pathologists saw benefits to the rtPAPs, with bovine rVets indicating that they would utilize this service in the future if available. Our proof-of-concept study demonstrated the positive role of rtPAPs in diagnosing beef cattle disease and speaks to the need for telepathology services supporting food animal rVets and producers.
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  • 文章类型: Journal Article
    心电病理学作为一个重要的工具,为加强非洲的病理学服务提供了巨大的希望,一个历史上受到医疗保健准入和资源限制挑战的地区。这篇综述探讨了发展,收养,通过全面的文献计量分析和文献综述,以及非洲心灵感应的影响。在PubMed中对截至2024年的出版物进行了有条不紊的搜索,发现了119项相关研究,其中47项符合纳入标准,对心传病理学在非洲医疗机构中的作用进行了重点审查。这项研究描绘了人们对心灵感应学日益增长的兴趣的明确轨迹,相关出版物的逐年增加和强有力的国际合作证明了这一点。它强调了心灵感应病理学在诊断中不断扩大的效用,教育,以及在非洲的研究,特别是在皮肤病理学等领域,神经病理学,and,特别是,肿瘤学.将人工智能集成到远程病理学中提出了提高诊断准确性和效率的新领域。然而,审查还确定了持续存在的挑战,例如基础设施不足,缺乏熟练的专业人员,和监管障碍。该研究强调了国际伙伴关系在该地区推进心灵感应学方面不可或缺的作用。这篇评论提出了朝着“跨越式发展”的战略支点,“这种方法允许非洲通过直接采用尖端技术和实践来跳过传统的发展障碍。
    Telepathology emerges as a vital tool, offering significant promise for enhancing pathology services in Africa, a region historically challenged by healthcare access and resource limitations. This review explores the development, adoption, and impacts of telepathology in Africa through a comprehensive bibliometric analysis and literature review. A methodical search in PubMed for publications up to 2024 revealed 119 pertinent studies, out of which 47 met the inclusion criteria for a focused review on telepathology\'s role in African healthcare settings. This research has charted a clear trajectory of growing interest in telepathology, as evidenced by the annual increase in related publications and robust international collaboration. It underscores the expanding utility of telepathology in diagnostics, education, and research within Africa, particularly in domains like dermatopathology, neuropathology, and, notably, oncology. The integration of artificial intelligence into telepathology presents new frontiers for enhancing diagnostic accuracy and efficiency. However, the review also identifies persistent challenges such as infrastructural inadequacies, a shortage of skilled professionals, and regulatory hurdles. The study highlights the indispensable role of international partnerships in advancing telepathology in the region. This review proposes a strategic pivot toward \"leapfrogging,\" an approach that allows Africa to skip traditional developmental hurdles by directly adopting cutting-edge technologies and practices.
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  • 文章类型: Journal Article
    COVID-19大流行加速了兽医教育的技术变革,特别是在从传统方法过渡到数字病理学(DP)的临床病理学和解剖病理学课程中。这项研究评估了个人的效能和满意度,以及优点和缺点,DP,特别是数字细胞学(DC),作为欧洲兽医学生的教学方法,在本科和研究生阶段,在大流行期间和之前参加了数字病理学课程。另一个目的是讨论两个学生群体之间的差异。由11个多项选择题组成的GoogleForm调查已通过电子邮件发送给病理老师并分发给他们的学生。结果表明,本科生展示了更多的数字病理学培训,偏爱DC作为最有效的学习方式。相比之下,研究生报告数字幻灯片培训较少,他们对学习细胞学的偏好分为单独的DC和与传统显微镜结合的DC。所有学生都经历了整个幻灯片成像学习细胞学幻灯片普遍,他们表示DC增强了他们的学习经验。虽然DC展示了个人有效性和满意度作为一种教学方法,重要的是不要用光学显微镜完全取代病理训练,几乎三分之一的学生表示。
    The COVID-19 pandemic accelerated technological changes in veterinary education, particularly in clinical pathology and anatomic pathology courses transitioning from traditional methods to digital pathology (DP). This study evaluates the personal effectiveness and satisfaction, as well as the advantages and disadvantages, of DP, in particular digital cytology (DC), as a teaching method among European veterinary students, both at the undergraduate and postgraduate level, who attended digital pathology courses during and before the pandemic. A further aim is to discuss the differences between the two student groups. A Google Form survey consisting of 11 multiple-choice questions was emailed to pathology teachers and distributed to their students. Results indicated that undergraduate students showed greater digital pathology training, favouring DC as the most effective learning modality. In contrast, postgraduate students reported less digital slide training, and their preference for learning cytology was split between DC alone and DC integrated with traditional microscopy. All students experienced whole slide imaging for learning cytology slides prevalently, and they stated that DC enhanced their learning experience. While DC demonstrates personal effectiveness and satisfaction as a teaching method, it is important to not replace pathology training with light microscopy completely, as almost a third of the students indicated.
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  • 文章类型: Journal Article
    组织病理学在临床诊断中起着举足轻重的作用,研究,和医学教育。近年来,全载玻片成像(wsi)已成为替代传统显微镜进行病理检查的潜在方法.本研究旨在提供wsi和传统显微镜(tm)在组织病理学实践的各个方面的综合比较。
    在这项研究中,从研究所的档案中考虑了总共30例具有诊断挑战性的口腔癌前和恶性肿瘤病例进行验证。用载玻片扫描仪扫描载玻片并由组织病理学家评估。注意到的比较参数是诊断不一致,观察到的达到诊断的字段数量和花费的时间。
    在整个载玻片成像技术中,病理学家达到诊断所需的平均时间明显较少。与tm相比,使用wsi在较短的时间内观察到的场的平均数量更高,结果具有统计学意义,p=0.001.然而,对于wsi和tm的疣状病变,诊断差异最大。
    wsi以更有效和更少错误的方式促进了快速诊断模式的专业。它还帮助了银行和研究的可能性。因此,随着心灵感应病理学的出现,非常有必要尽早接受wsi培训,以便专业人员能够做出正确的诊断。
    UNASSIGNED: histopathology plays a pivotal role in clinical diagnosis, research, and medical education. In recent years, whole slide imaging (wsi) has emerged as a potential alternative to traditional microscopy for pathological examination. This study aims to provide a comprehensive comparison of wsi and traditional microscopy(tm) in various aspects of histopathology practice.
    UNASSIGNED: In this study, total of 30 cases comprising of oral premalignant and malignant cases which were diagnostically challenging was considered from the archives of the institute for validation. The slides were scanned with slide scanner and were evaluated by histopathologists. The comparative parameters which were noted were diagnostic discordances, number of fields observed to reach the diagnosis and time taken.
    UNASSIGNED: The mean time taken by the pathologists to reach the diagnosis was significantly less in whole slide imaging technique. The average number of fields observed was higher by using wsi that too in a lesser time compared to tm, the results were found to be statistically significant with p=0.001.however the diagnostic disparity were seen to be maximum for verrucous lesions both in wsi and tm.
    UNASSIGNED: wsi has facilitated the specialty with rapid mode of diagnosis in a more efficient and error less manner. It has also aided in case banking as well as research possibilities. Hence with the advent of telepathology it is very much necessary to get trained with wsi as early as possible so that the professionals can render correct diagnosis.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    背景:技术不仅彻底改变了直接患者护理,而且彻底改变了诊断护理流程。这项研究评估了在多站点学术机构中从载玻片显微镜到数字病理学(DP)的转变,使用混合方法来了解用户对数字化的看法和实践变化的关键生产力指标。
    方法:参与者包括皮肤病理学家,病理报告专家,和临床医生。电子调查和个人或团体访谈包括与技术舒适度相关的问题,对DP的信任,以及采用DP的理由。病例量和周转时间从2020年第4季度至2023年第1季度(含)的电子健康记录中提取。数据进行了描述性分析,而访谈采用内容分析法进行分析。
    结果:34名工作人员完成了调查,22人参加了面试。在实施时间表期间或之后,整个机构的病例量和诊断周转时间没有差异(分别为p=0.084;p=0.133)。82.5%(28/34)的员工认为DP改善了签出体验,具有可达性,人体工程学,和注释功能被描述为关键因素。临床医生报告了DP对患者安全和跨学科合作的积极影响。
    结论:我们的研究表明,DP具有很高的接受率,不会对生产力产生不利影响,并可以改善患者安全和护理合作。
    BACKGROUND: Technology has revolutionized not only direct patient care but also diagnostic care processes. This study evaluates the transition from glass-slide microscopy to digital pathology (DP) at a multisite academic institution, using mixed methods to understand user perceptions of digitization and key productivity metrics of practice change.
    METHODS: Participants included dermatopathologists, pathology reporting specialists, and clinicians. Electronic surveys and individual or group interviews included questions related to technology comfort, trust in DP, and rationale for DP adoption. Case volumes and turnaround times were abstracted from the electronic health record from Qtr 4 2020 to Qtr 1 2023 (inclusive). Data were analyzed descriptively, while interviews were analyzed using methods of content analysis.
    RESULTS: Thirty-four staff completed surveys and 22 participated in an interview. Case volumes and diagnostic turnaround time did not differ across the institution during or after implementation timelines (p = 0.084; p = 0.133, respectively). 82.5% (28/34) of staff agreed that DP improved the sign-out experience, with accessibility, ergonomics, and annotation features described as key factors. Clinicians reported positive perspectives of DP impact on patient safety and interdisciplinary collaboration.
    CONCLUSIONS: Our study demonstrates that DP has a high acceptance rate, does not adversely impact productivity, and may improve patient safety and care collaboration.
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  • 文章类型: Journal Article
    心电病理学,作为远程咨询的一个子集,是远处进行的病理学解释。心电病理学不是一个新现象,但自2015年以来,信息技术和电信的显著进步加上大流行导致了前所未有的复杂性,可访问性,以及心灵感应病理学在人类和兽医学中的应用。此外,远程病理学可以将兽医实践与遥远的实验室联系起来,并为服务不足的动物和社区提供支持。通过我们的范围审查,我们概述了如何在兽医学中使用心灵感应病理学,找出文献中的空白,并强调未来的研究和服务发展领域。我们搜索了MEDLINE,CAB文摘,和灰色文学,包括所有相关文献。尽管在大型兽医诊断实验室中广泛使用数字显微镜,我们发现,描述心灵感应在兽医学中使用的文献很少,在验证全载玻片成像用于主要诊断的研究中存在显著差距。还确定了未充分利用心灵感应病理学来支持在该领域进行的尸检,这表明了服务发展的潜在领域。在兽医学中,心灵感应的使用越来越多,病理学家必须跟上不断变化的技术,确保创新技术的验证,并确定新颖的用途来推进职业发展。
    Telepathology, as a subset of teleconsulting, is pathology interpretation performed at a distance. Telepathology is not a new phenomenon, but since ~2015, significant advances in information technology and telecommunications coupled with the pandemic have led to unprecedented sophistication, accessibility, and use of telepathology in human and veterinary medicine. Furthermore, telepathology can connect veterinary practices to distant laboratories and provide support for underserved animals and communities. Through our scoping review, we provide an overview of how telepathology is being used in veterinary medicine, identify gaps in the literature, and highlight future areas of research and service development. We searched MEDLINE, CAB Abstracts, and the gray literature, and included all relevant literature. Despite the widespread use of digital microscopy in large veterinary diagnostic laboratories, we identified a paucity of literature describing the use of telepathology in veterinary medicine, with a significant gap in studies addressing the validation of whole-slide imaging for primary diagnosis. Underutilization of telepathology to support postmortem examinations conducted in the field was also identified, which indicates a potential area for service development. The use of telepathology is increasing in veterinary medicine, and pathologists must keep pace with the changing technology, ensure the validation of innovative technologies, and identify novel uses to advance the profession.
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  • 文章类型: Journal Article
    远程诊断使用信息和通信技术来支持诊断,缩短地理距离。它有助于对各种口腔病变做出决定。这项范围审查的目的是绘制有关数字策略的现有文献,以协助诊断口腔鳞状细胞癌。这篇综述是基于Arksey和O\'Malley提出的5阶段方法构建的,JoannaBriggs研究所的证据综合手册,并遵循系统审查和Meta分析扩展的首选报告项目进行范围审查。这些方法已在开放科学框架上注册。研究问题是:在口腔鳞状细胞癌的诊断中使用了哪些数字策略?在PubMed/MEDLINE上进行了搜索,Scopus,WebofScience,Embase,和科学直接。纳入标准包括远程诊断研究,由专业人员和英语专业人员调解的远程会诊或远程会诊,没有日期限制。2023年6月进行的搜索产生了1,798篇文章,其中包括16项研究。九项研究报告了远程诊断,涉及通过应用程序进行数据筛选,来自数码相机的临床图像,手机或人工智能。在四项研究中报告了组织病理学图像。两者,远程诊断和远程会诊,在七项研究中提到,利用图像和信息提交服务到平台,WhatsApp或应用程序。一项研究介绍了涉及幻灯片的远程会诊,另一项研究介绍了由专业人员介导的远程会诊。数字策略远程诊断和远程咨询可以通过临床或组织病理学图像对口腔癌进行组织病理学诊断。观察到的诊断一致性越高,策略的性能越好。
    Telediagnosis uses information and communication technologies to support diagnosis, shortening geographical distances. It helps make decisions about various oral lesions. The objective of this scoping review was to map the existing literature on digital strategies to assist in the diagnosis of oral squamous cell carcinoma. this review was structured based on the 5-stage methodology proposed by Arksey and O\'Malley, the Joanna Briggs Institute Manual for Evidence Synthesis and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. The methods were registered on the Open Science Framework. The research question was: What digital strategies have been used to assist in the diagnosis of oral squamous cell carcinoma? The search was conducted on PubMed/MEDLINE, Scopus, Web of Science, Embase, and ScienceDirect. Inclusion criteria comprised studies on telediagnosis, teleconsultation or teleconsultation mediated by a professional and studies in English, without date restrictions. The search conducted in June 2023 yielded 1,798 articles, from which 16 studies were included. Telediagnosis was reported in nine studies, involving data screening through applications, clinical images from digital cameras, mobile phones or artificial intelligence. Histopathological images were reported in four studies. Both, telediagnosis and teleconsultation, were mentioned in seven studies, utilizing images and information submission services to platforms, WhatsApp or applications. One study presented teleconsultations involving slides and another study introduced teleconsultation mediated by a professional. Digital strategies telediagnosis and teleconsultations enable the histopathological diagnosis of oral cancer through clinical or histopathological images. The higher the observed diagnostic agreement, the better the performance of the strategy.
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  • 文章类型: Journal Article
    头颈部的外科病理学是所有诊断病理学中更具挑战性的领域之一。其无与伦比的多样性和复杂性使其极易受到诊断错误的影响,迫使其不受约束地获得专业诊断专业知识。数字病理学(DP)是一种最先进的工具,可以促进获得专业知识,但在病理学咨询的背景下,它是相对未经测试的。在LabcorpDianon和一家拥有亚专科外科病理学的大型学术医院之间的合作中,实施DP是为了向病理学界提供头颈部病理学专业知识。从这种合作经验中,之前使用DP诊断的连续会诊病例的载玻片在延长洗脱期后,由专家顾问以盲法进行审查.记录观察者内部差异率。重大差异被定义为对临床管理和/或预后产生重大影响的差异。而较小的差异是对护理或预后无影响的差异.57例病例的幻灯片可供审查。平均冲洗期为19个月。记录了5个差异(观察者内部一致率为91%)。所有差异都很小(主要差异率,0%;微小差异率,9%)。关于对不一致案件的鉴定,不一致的诊断归因于解释方面的主观差异,而非与DP自卑相关的客观差异.DP使中位周转时间减少了97%(从70小时26分钟减少到2小时25分钟)。DP提供高效和快速的专家顾问访问。案例交付的速度不会影响诊断精度。差异并不常见,未成年人,并反映了头颈部疑难杂症和模棱两可的主观解释差异,而不是DP作为诊断平台的劣势。即使对于那些集中在协商实践中的困难和复杂的案件,也可以实现高度一致。这一观察结果对获得专业诊断专业知识的全民医疗保健具有深远的影响。
    Surgical pathology of the head and neck is one of the more challenging areas in all of diagnostic pathology. Its unparalleled diversity and complexity renders it highly vulnerable to diagnostic error compelling unconstrained access to specialized diagnostic expertise. Digital pathology (DP) is a state-of-the-art tool that could facilitate access to specialized expertise, but it is relatively untested in the context of pathology consultations. In a collaboration between Labcorp Dianon and a large academic hospital with subspecialized surgical pathology, DP was implemented to provide the pathology community access to head and neck pathology expertise. From this collaborative experience, glass slides from consecutive consult cases that had been previously diagnosed using DP were reviewed by an expert consultant in a blinded manner following an extended wash-out period. The intraobserver discrepancy rate was recorded. Major discrepancies were defined as those resulting in significant impact on clinical management and/or prognosis, whereas minor discrepancies were those with no impact on care or prognosis. Slides from 57 cases were available for review. The average wash-out period was 19 months. Five discrepancies were recorded (intraobserver concordance rate of 91%). All discrepancies were minor (major discrepancy rate, 0%; minor discrepancy rate, 9%). On appraisal of the discrepant cases, discordant diagnoses were attributed to subjective differences in interpretation rather than objective differences related to the inferiority of DP. DP decreased the median turnaround time by 97% (from 70 h 26 min to 2 h 25 min). DP provides efficient and fast access to expert consultants. The speed of case delivery does not compromise diagnostic precision. Discrepancies are uncommon, minor, and reflect subjective interpretative differences inherent to difficult and ambiguous head and neck cases, and not the inferiority of DP as a diagnostic platform. High concordance can be achieved even for those difficult and complex cases that are concentrated in the consultation practice. This observation carries profound implications regarding universal health care access to specialized diagnostic expertise.
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  • 文章类型: Journal Article
    背景:2020年的COVID-19大流行带来了重大的沟通挑战,尤其是在医疗保健领域。远程病理学为医疗保健提供者提供了一种有价值的沟通手段。本研究通过对这一时期进行的相关研究的系统回顾,调查了心灵感应在教育中的主要挑战和益处。
    方法:本系统综述于2022年进行。我们利用数据库,包括PubMed,谷歌学者和科学直接。我们的搜索时间为2022年2月7日至2022年2月13日。我们根据纳入标准选择文章,并使用关键评估技能计划检查表来评估研究的优势和局限性。我们使用检查表提取数据,并对结果进行叙述合成。
    结果:我们最初确定了125篇文章,经过筛选,15人被纳入研究。这些研究报告了各种挑战,包括成本,技术,沟通问题,教育困难,浪费时间,法律问题和家庭分心问题。相反,研究提到了好处,比如护理改善,更好的教育,时间效率,适当的沟通,成本和技术进步。
    结论:这项研究的结果将有助于未来的努力和调查,以实施和建立心灵感应病理学。根据我们的评论,尽管面临挑战,心灵感应在教育中的好处大于这些障碍,表明其未来使用的潜力。
    BACKGROUND: The COVID-19 pandemic in 2020 posed significant communication challenges, especially in the healthcare sector. Telepathology provides a valuable means for healthcare providers to communicate. This study investigated the key challenges and benefits of telepathology in education through a systematic review of relevant studies conducted during this period.
    METHODS: This systematic review was conducted in 2022. We utilized databases, including PubMed, Google Scholar and ScienceDirect. Our search was performed from 7 February 2022 to 13 February 2022. We selected articles based on inclusion criteria and used the Critical Appraisal Skills Program checklist to assess study strengths and limitations. We extracted data using a checklist and synthesized the results narratively.
    RESULTS: We initially identified 125 articles, and after screening, 15 were included in the study. These studies reported various challenges, including cost, technology, communication problems, educational difficulties, time wasting, legal issues and family distraction problems. Conversely, studies mentioned benefits, such as care improvement, better education, time efficiency, proper communication, cost and technology advancement.
    CONCLUSIONS: The results of this study will help future efforts and investigations to implement and set up telepathology. Based on our review, despite the challenges, the benefits of telepathology in education are greater than these obstacles, indicating its potential for future use.
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