@Article{info:doi/10.2196/jmir.5.2.e11,
author="Costello, Sean SP
and Johnston, Daniel J
and Dervan, Peter A
and O'Shea, Daniel G",
title="Development and Evaluation of the Virtual Pathology Slide: A New Tool in Telepathology",
journal="J Med Internet Res",
year="2003",
month="Jun",
day="13",
volume="5",
number="2",
pages="e11",
keywords="Telepathology; Internet; telemicroscopy; remote diagnosis; virtual slide; pathology; imaging",
abstract="Background: The Virtual Pathology Slide is an interactive microscope emulator that presents, via the Internet or CD-ROM, a complete 15.53 mm x 11.61 mm digitalized tissue section. The Virtual Pathology Slide mimics the use of a microscope in both the stepwise increase in magnification (from 16x up to 2000x) and in lateral motion in the X and Y Cartesian directions. This permits a pathologist to navigate to any area on a slide, at any magnification, similar to a conventional microscope. Objective: The aim of this study was to assess the diagnostic accuracy and acceptability of the Virtual Pathology Slide. Methods: Ten breast needle core biopsies were randomly selected and presented to 17 pathologists or trainee pathologists with at least 2 years experience in pathology practice. Participants were required to examine each case online and provide a diagnostic classification using online feedback forms. The recorded data permitted examination of interobserver variability and user satisfaction. Results: Agreement between original glass-slide diagnosis and consensus diagnosis using the Virtual Pathology Slide was reached in 9 out of 10 slides. Percentage concordance for slides lay in the range of 35.3{\%} to 100{\%} with an average percentage concordance between slides of 66.5{\%}. The average Kappa statistics for interobserver agreement was 0.75 while average percentage concordance amongst participants was 66.5{\%}. Participants looked at an average of 22 fields of view while examining each slide. Confidence: 81.25{\%} of the participants indicated confidence using the Virtual Pathology Slide to make a diagnostic decision, with 56.25{\%} describing themselves as ``reasonably confident,'' 18.75{\%} as ``confident,'' and 6.25{\%} as ``very confident.'' Ease of use: 68.75{\%} reported the system as ``easy'' or ``very easy'' to use. Satisfaction: 87.5{\%} of participants expressed satisfaction with image quality, with 43.75{\%} describing the image quality as ``adequate,'' 25{\%} describing it as ``good,'' and 18.75{\%} describing the image quality as ``excellent.'' Pathologists with a working bandwidth greater than 20 kilobits per second found the download speed of the Virtual Pathology Slide ``adequate'' or better. Conclusions: Results from this study show that the Virtual Pathology Slide can be used to make a correct diagnostic decision, and that the system is a realistic alternative to dynamic telepathology. ",
issn="1438-8871",
doi="10.2196/jmir.5.2.e11",
url="http://www.jmir.org/2003/2/e11/",
url="https://doi.org/10.2196/jmir.5.2.e11",
url="http://www.ncbi.nlm.nih.gov/pubmed/12857667"
}