全载玻片成像允许以模拟显微镜的方式查看整个载玻片;因此,它被广泛用于心灵感应学。然而,管理整个幻灯片成像所需的大型数字文件是困难的。为了解决这个问题,我们建立了中国国家基于云的心灵感应系统(CNCTPS)。CNCTPS已经运行了4年多,积累了大量的数据。
这项研究的主要目的是基于大样本综合评估CNCTPS的有效性。评价指标包括服务量、周转时间,诊断准确性,和经济效益。
收集了2016年1月至2019年12月提交给CNCTPS的23,167个案例的详细信息,以分析服务量,周转时间,和经济效益。对在郑州大学第一附属医院就诊并获得最终诊断的564例患者进行随访,分析CNCTPS的诊断准确性。
从2016年到2019年,CNCTPS的服务量从2335家增加到9240家,参与的医院数量从60家增加到74家。县级医院的咨询请求占86.57%(20,287/23,167)。23,167例中,共确诊17,495例(75.52%),包括12,088个良性病变,5217个恶性病变,和190个临界病变。在这些案件中,3.85%(893/23,167)由于切片质量差和采样不完整等原因未能诊断。中位周转时间为16.93小时,每年缩短(2018年至2019年:调整后P=0.01;其他组:调整后P<.001);82.88%的病例在48小时内诊断。11例诊断与最终诊断存在差异,其中假阳性4例,假阴性7例。敏感性和特异性分别为97.66%和98.49%,分别。系统的诊断准确率为98.05%,与医院的最终诊断无统计学差异(P=0.55)。通过使用这个系统,每年为患者节省了30万美元。
基于云的新型远程病理学系统有可能缓解基层医院病理学家的短缺。它还可以同时降低中国患者的医疗费用。它应该,因此,进一步提高效率,数量,和心灵感应诊断的质量。
Whole-slide imaging allows the entire slide to be viewed in a manner that simulates microscopy; therefore, it is widely used in
telepathology. However, managing the large digital files needed for whole-slide imaging is difficult. To solve this problem, we set up the Chinese National Cloud-Based
Telepathology System (CNCTPS). CNCTPS has been running for more than 4 years and has accumulated a large amount of data.
The main purpose of this study was to comprehensively evaluate the effectiveness of the CNCTPS based on a large sample. The evaluation indicators included service volume, turnaround time, diagnosis accuracy, and economic benefits.
Details of 23,167 cases submitted to the CNCTPS from January 2016 to December 2019 were collected to analyze the service volume, turnaround time, and economic benefits. A total of 564 patients who visited the First Affiliated Hospital of Zhengzhou University and obtained final diagnoses were followed up to analyze the diagnostic accuracy of the CNCTPS.
From 2016 to 2019, the service volume of the CNCTPS increased from 2335 to 9240, and the number of participating hospitals increased from 60 to 74. Consultation requests from county-level hospitals accounted for 86.57% (20,287/23,167). A total of 17,495 of 23,167 cases (75.52%) were confirmed, including 12,088 benign lesions, 5217 malignant lesions, and 190 borderline lesions. Of the cases, 3.85% (893/23,167) failed to be diagnosed for reasons such as poor slice quality and incomplete sampling. The median turnaround time was 16.93 hours and was shortened yearly (between 2018 and 2019: adjusted P=.01; other groups: adjusted P<.001); 82.88% cases were diagnosed in 48 hours. There was a discrepancy between the diagnosis and final diagnosis for 11 cases, including 4 false-positive cases and 7 false-negative cases. The sensitivity and specificity were 97.66% and 98.49%, respectively. The diagnostic accuracy of the system was 98.05%, with no statistical difference from the final diagnosis in the hospital (P=.55). By using this system, a total of US $300,000 was saved for patients every year.
The novel cloud-based
telepathology system has the potential to relieve the shortage of pathologists in primary hospitals. It can also simultaneously reduce medical costs for patients in
China. It should, therefore, be further promoted to enhance the efficiency, quantity, and quality of
telepathology diagnoses.