Effectiveness of a Cloud-Based Telepathology System in China: Large-Sample Observational Study

Abstract

Background 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. Objective 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. Methods 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. Results 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. Conclusions 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.

Key Factors Influencing the Operationalization and Effectiveness of Telemedicine Services in Henan Province, China: Cross-Sectional Analysis

“…Therefore, they prefer to request a tele-ECG service with upper-tier hospitals for a better diagnosis of patient conditions. Similar reasons are applied to telediagnosis and telepathology [29]. Other service types such as remote emergency care and remote surgery have low volumes currently, and their supporting devices have a low deployment rate at the respective hospitals.…”

“…To the best of our knowledge, prior research articles have examined the effectiveness of telemedicine services delivered through regional collaborative platforms with regard to their service delivery processes [27,28]. In addition, some studies have focused on specific service types such as telepathology [29] and teleconsultation [23,26]. However, limited information is available concerning the operational factors crucial to ensuring the effective delivery of telemedicine services.…”

Infiltrating characteristics and prognostic value of tertiary lymphoid structures in resected gastric neuroendocrine neoplasm patients

“…After the staining procedure, the pathological sections from each patient were scanned for WSIs, which comprised tissues from both the tumor and adjacent surrounding normal tissues. Scanning control software (K‐Scanner 1.6.0.14, Konfoong Biotech International Co. Ltd, Ningbo, China) and image browsing and management software (K‐Viewer 1.5.3.1, Konfoong Biotech International Co. Ltd) were utilised for control scanning and viewing in WSIs 42 …”

“…Scanning control software (K-Scanner 1.6.0.14, Konfoong Biotech International Co. Ltd, Ningbo, China) and image browsing and management software (K-Viewer 1.5.3.1, Konfoong Biotech International Co. Ltd) were utilised for control scanning and viewing in WSIs. 42 To examine the localisation and abundance of multiple immune cells of TLS in the same slide of GNEN tissue, fluorescent mIHC 13,43,44 was performed on serial sections of FFPE tumor tissue using a Six Colour mIHC Fluorescence kit (Recordbio Biological Technology, Shanghai, China) based on the tyramide signal amplification (TSA) technology following the manufacturer's instructions. Immune cells were stained with CD4 + T cells, CD8 + T cells, CD20 + B cells, CD15 + TANs and FOXP3 + Treg antibodies.…”

Digital twin concept: Healthcare, education, research

“…In medicine, though, despite the wide use of digital technologies and artificial intelligence, 7 , 8 , 9 the application of the digital twins’ concept is still in its infancy, not only in education but also in healthcare and research. This can be explained by the utmost complexity of biological systems, which should be represented at multiple levels, including molecular, cellular, and tissular ones, 8 to be fully mimicked. While still a challenge, elaboration of digital twins in medicine starts with the first steps, such as consolidation of data between biobanks and creation of databases.…”