Impact of photographer experience and number of images on telecytology accuracy

Abstract

| INTRODUC TI ONAs technology continues to be incorporated into numerous facets of personal and professional life, it is not surprising that veterinary medicine is facing the same fate. Veterinarians are increasingly using telemedicine (the use of technology to practice medicine remotely) to facilitate more rapid connections to specialists, clients, and pharmacists. 1 Telecytology, which involves converting a microscopic image into a digital image that can be shared electronically, has its origins in human gynecologic studies but has been evolving for over a decade. 2,3 While different variations of telecytology exist, this study has focused on the accuracy of the "store-and-forward" or "static" method, which requires a sender to take still images of a slide and submit them to someone else for interpretation. 4 This form of transmission is simple and economical for practices with low volume and limited Abstract Background: Studies evaluating the potential impact of photographer experience or the number of images evaluated using the "store-and-forward" method of telecytology are not reported. Objectives:This study aimed to determine the diagnostic sensitivity (Se) and specificity (Sp) of static telecytology when images were taken by experienced and inexperienced cytologists and when the number of images taken varied. Clinical agreement between the diagnoses was compared. Methods: Fifty archived cytology cases were randomly chosen. A board-certified clinical pathologist and a recent veterinary graduate took five images of each case. A third pathologist made a preliminary diagnosis after reviewing two images, and a final diagnosis after reviewing all images. The gold standard for comparison was the glass slide cytologic diagnosis.Results: Se and Sp were higher for the experienced cytologist and the evaluation of more images, but differences were not statistically significant. Clinical agreement between the image and glass slide diagnoses was significantly higher when images were taken by an experienced rather than inexperienced cytologist after the evaluation of two (P = .007) and five images (P = .008). The telecytology diagnoses agreed with the gold standard diagnoses more frequently after evaluation of five images rather than two when images were captured by both the experienced (P < .001) and inexperienced cytologist (P < .001). Conclusions:There is more clinical agreement when the photographer has more cytology experience and when more images are provided for interpretation. K E Y W O R D Scytology, diagnostic test, digital cytology, telemedicine, veterinary S U PP O RTI N G I N FO R M ATI O NAdditional supporting information may be found online in the Supporting Information section at the end of the article.How to cite this article: Brooker AJ, Krimer PM, Meichner K, Garner BC. Impact of photographer experience and number of images on telecytology accuracy. Vet Clin Pathol.

The use of telepathology in veterinary medicine: a scoping review

“…Following de-duplication, we screened 86 pieces of literature and included 17 articles 1 – 3 , 5 , 6 , 8 – 11 , 15 , 17 , 19 , 20 , 24 , 27 , 29 , 31 after the full-text review ( Fig. 1 ).…”

“… 5 , 10 , 31 However, with the ease of processing and staining of cytology and hematology slides in-clinic combined with more reliable and affordable equipment and telecommunication platforms, a unique feature of telecytology is its ability to connect the community practitioner to the clinical pathologist. 11 , 19 , 27 , 29 Telecytology in community practice ranges from the use of static images to the use of in-clinic digital slide scanners to send images or scanned slides to a remote clinical pathologist. 11 , 19 , 27 – 29 Thereby, telecytology accelerates the diagnostic process by eliminating the complexities and delays associated with shipping glass slides to the laboratory, resulting in rapid analysis and results.…”

“… 11 , 19 , 27 , 29 Telecytology in community practice ranges from the use of static images to the use of in-clinic digital slide scanners to send images or scanned slides to a remote clinical pathologist. 11 , 19 , 27 – 29 Thereby, telecytology accelerates the diagnostic process by eliminating the complexities and delays associated with shipping glass slides to the laboratory, resulting in rapid analysis and results. It is particularly suited to facilitating intra-operative diagnosis and decision-making.…”

Remote Evaluation of Short Videos Captured by Static Telecytological Applications for Obtaining Expert Opinions

“…The slides collected for the production of the digital material from the Cytology Department'sregistrywerecomingfromalreadyhistologicallyconfirmedcases.The histologicalexaminationconsistsofthegoldenstandardforcytologyslidesvalidation (Brooker et al, 2019;Chantziantoniou et al, 2017;Pantanowitz et al, 2009). Inadequatevalidationoftestslidescouldleadtoindiscriminatefailureofqualified, competentpersonnelparticipatinginteleconsultationprograms(Chantziantoniouet al,2017;Pantanowitzetal.,2009;Sirintrapunetal.,2017).…”

“…Telecytology by means of short pre-captured videos, when integrated into the dailyworkflow,canprovidespecialconsultationopportunitiestodistantlaboratories (Brooker et al, 2019;Chantziantoniou et al, 2017;Pantanowitz et al, 2009). We suggest that static telecytology systems are preferred because of their low cost by laboratories that cannot afford the high cost of buying and maintaining dynamic systems.Besides,thetelecommunicationcostsfortheoperationofstaticsystemsis lower,astheusualstandardADSLInternetconnectionisadequatetooperateastatic method.…”