An Analysis of the Effect of the COVID-19 Pandemic on Case Volumes in an Academic Subspecialty-Based Anatomic Pathology Practice

Sinard, John H.

doi:10.1177/2374289520959788

Cited by 13 publications

(11 citation statements)

References 13 publications

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“…Early, and very early, neonatal mortality was not changed during these periods (Table 1). Consequently, despite the strain COVID-19 is expected to place on health care resources, 32 the observed reduction of xPTB is unlikely to be driven by a change in obstetric policies, formal or otherwise.…”

Section: )mentioning

confidence: 99%

Preterm birth, stillbirth, and early neonatal mortality during the Danish COVID-19 lockdown

Hedley

Hedermann

Hagen

et al. 2021

Preprint

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Importance: Using provisional or opportunistic data, three nationwide studies (The Netherlands, USA, and Denmark) have identified a reduction in preterm or extremely preterm births during periods of COVID-19 restrictions. However, these findings have been challenged as none of the studies accounted for perinatal deaths. Objective: To determine whether the reduction in extremely preterm births, observed in Denmark during the COVID-19 lockdown, could be a result of an increase in number of perinatal deaths; and to assess the impact of extended COVID-19 restrictions on the prevalence of preterm birth and perinatal death. Design: The study is a nationwide Danish register-based prevalence proportion study using detailed data to capture all births (induced abortions were excluded) throughout Denmark. We assessed the prevalence of stillbirth, preterm birth, and early neonatal death. Setting: Population-based study Participants: All singleton pregnancies delivered in Denmark, between February 27, and September 30, 2015-2020. COVID-19 lockdown was studied in 31,164 births and the extended period of COVID-19 restrictions in 214,862 births. Exposure: COVID-19 restrictions broadly (February 27, to September 30, 2020) or COVID-19 lockdown specifically (March 12, to April 14, 2020). Main Outcome: Prevalence of preterm births, stillbirths and early neonatal deaths across the periods under study. Results: The extremely preterm birth rate was reduced (OR 0.27, 95% CI 0.07 to 0.86) during the strict lockdown period, while perinatal mortality was not significantly different. During the extended period of restrictions, the extremely preterm birth rate was marginally reduced, and a significant reduction in the stillbirth rate (OR 0.69, 0.50 to 0.95) was observed. No changes in early neonatal mortality rates were found. Conclusion and Relevance: Stillbirth and extremely preterm birth rates were reduced in Denmark during the period of COVID-19 restrictions and lockdown, respectively, suggesting that aspects of these containment and control measures confer an element of protection. The present observational study does not allow for causal inference; however, the results support design of studies to ascertain whether behavioural or social changes for pregnant women may improve pregnancy outcomes.

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Section: )mentioning

confidence: 99%

Preterm birth, stillbirth, and early neonatal mortality during the Danish COVID-19 lockdown

Hedley

Hedermann

Hagen

et al. 2021

Preprint

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“…Cancer hospitals have seen a marked decrease in patient visits and in treatment volume during the height of the pandemic 5,6 with most nonurgent surgeries temporary suspended. 7 At MSKCC, SARS-CoV-2 was detected in 946 patients from March 10 to April 7, 2020.…”

Section: Operationsmentioning

confidence: 99%

Digital Pathology Operations at an NYC Tertiary Cancer Center During the First 4 Months of COVID-19 Pandemic Response

et al. 2021

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Implementation of an infrastructure to support digital pathology began in 2006 at Memorial Sloan Kettering Cancer Center. The public health emergency and COVID-19 pandemic regulations in New York City required a novel workflow to sustain existing operations. While regulatory enforcement discretions offered faculty workspace flexibility, a substantial portion of laboratory and digital pathology workflows require on-site presence of staff. Maintaining social distancing and offering staggered work schedules. Due to a decrease in patients seeking health care at the onset of the pandemic, a temporary decrease in patient specimens was observed. Hospital and travel regulations impacted onsite vendor technical support. Digital glass slide scanning activities onsite proceeded without interruption throughout the pandemic, with challenges including staff who required quarantine due to virus exposure, unrelated illness, family support, or lack of public transportation. During the public health emergency, we validated digital pathology systems for a remote pathology operation. Since March 2020, the departmental digital pathology staff were able to maintain scanning volumes of over 100 000 slides per month. The digital scanning team reprioritized archival slide scanning and participated in a remote sign-out validation and successful submission of New York State approval for a laboratory developed test. Digital pathology offers a health care delivery model where pathologists can perform their sign out duties at remote location and prevent disruptions to critical pathology services for patients seeking care at our institution during emergencies. Development of standard operating procedures to support digital workflows will maintain turnaround times and enable clinical operations during emergency or otherwise unanticipated events.

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“…Technology is being increasingly integrated into the training and practice of laboratory medicine in many new and innovative ways. [1][2][3] While pathology resident education has been following suit, pathology examinations have been slow to adopt new technology. With the spread of the COVID-19 pandemic, anatomical pathology residency programs across the world have increasingly incorporated digital technology into their training programs to allow continuity in the residency curriculum without compromising trainee safety.…”

Section: Introductionmentioning

confidence: 99%

Pathology Resident Evaluation During the Pandemic: Testing and Implementation of a Comprehensive Online Pathology Exam

2021

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Despite global digitization, evaluating pathology trainees by paper exams remains the norm. As new social distancing practices require new ways of administering exams, we assessed the viability of an online format for in-house exams from the resident and examiner perspectives. First, pathology residents participated in a practice exam, while staff who were experienced in creating exams were given an online exam-creation demonstration. Subsequently, residents completed a formal 3-hour online exam comprised of multiple-choice, matching, short answer, and whole slide images in place of the paper exam regularly used to evaluate trainees. The experience of the participants was evaluated by surveys. Eighteen residents completed the practice exam; 67% were receptive to the new format and 94% were in favor of moving to digital exams. Seven staff evaluated the digital format and 6 were in favor of it. For the formal online in-house exam, 20 residents participated and 14 completed the survey. Feedback was generally positive with the most common issue being slow-loading digital slides. Exam scores stratified by postgraduate training years in a statistically significant manner, showing positive correlation with resident training level. The online exam format was preferred over paper exams by trainees, with support from both staff and trainees for a permanent transition. Online exams have clear advantages, but technical issues should be addressed before widespread implementation. Our study demonstrates that online exams are a feasible alternative for trainee assessment, especially in socially distanced environments.

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An Analysis of the Effect of the COVID-19 Pandemic on Case Volumes in an Academic Subspecialty-Based Anatomic Pathology Practice

Cited by 13 publications

References 13 publications

Preterm birth, stillbirth, and early neonatal mortality during the Danish COVID-19 lockdown

Preterm birth, stillbirth, and early neonatal mortality during the Danish COVID-19 lockdown

Digital Pathology Operations at an NYC Tertiary Cancer Center During the First 4 Months of COVID-19 Pandemic Response

Pathology Resident Evaluation During the Pandemic: Testing and Implementation of a Comprehensive Online Pathology Exam

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