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Digital Pathology and access to slides

Discussion in 'Pathology' started by UKPathLab, Mar 29, 2017.

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  1. UKPathLab

    UKPathLab

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    Mar 29, 2017
    Hi All,

    I've stumbled across your website whilst research bone tumour pathologists.

    My company is a UK based laboratory that reports annually 50,000 cases for both the private and public sector.

    We have invested in 2 digital scanners with capacities of 500 slides per run and thus report around 65% of our cases through digital pathology.

    I understand that in the US, digital pathology is not FDA approved for primary diagnosis - however given that we've accumulated, reported and archived around 30,000 cases - would there be a benefit of gaining permission, anonymising and hosting these cases for educational purposes - or are digital libraries available throughout the States?

    Thank You,

    S.
     
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  3. coroner

    coroner Peace Sells...but who's buying? 10+ Year Member

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    Aug 3, 2007
    22 Acacia Avenue
    Physician
    We do have numerous digital libraries here in the US for educational purposes, usually created by universities that are available to anyone worldwide who visits that institutions' website. If your company hosted their 30,000 cases on an independent platform, no permission is necessary as it's equivalent to starting up a website and putting whatever information you like. If your company doesn't have a website/publicly available digital library and doesn't want to create one, then you could offer these cases to a US based digital library and contact them to see if they would be interested in adding it to their collection.
     
  4. Tamahawk

    Tamahawk 7+ Year Member

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    Dec 14, 2009
    Can you tell me a few of these institutional websites that offer free digital slides to review?
     
    Adityatech likes this.
  5. coroner

    coroner Peace Sells...but who's buying? 10+ Year Member

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    Aug 3, 2007
    22 Acacia Avenue
    Physician
  6. path_spouse

    path_spouse

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    Apr 1, 2016
    Something you might want to consider is that the regulatory status of whole slide imaging for primary diagnosis could change.

    Several years ago, the FDA had put whole slide imaging for primary diagnosis in Class III, meaning that approval would probably require extensive clinical trial data.

    Based on a statement last year from the Digital Pathology Association, though,

    DPA Recommends Whole Slide Imaging Manufacturers Submit De Novo Applications to the FDA for Primary Diagnosis in the United States

    the FDA now appears willing to consider less burdensome regulatory pathways.
     
  7. path_spouse

    path_spouse

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    Apr 1, 2016
  8. Dro133

    Dro133 2+ Year Member

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    Mar 7, 2013
    Naive MS1 here. What implications, if any, could this have on the practice of pathology? Could pathologists sit at home and do remote reads while technicians prepare and image the slides?
     
  9. jkdoctor

    jkdoctor 2+ Year Member

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    Apr 29, 2013
    Major implications.
    It actually means a pathologist could be at Quest Diagnostics in India and read the slides.
    Quest Diagnostics Locations – Reach Quest Diagnostics
     
  10. AcutelyObtuse

    AcutelyObtuse 2+ Year Member

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    Dec 31, 2012
    Is this really going to be a threat in the near future? A similar scenario has already been played out in radiology and nothing ever happened because most hospitals/medical groups are not willing to take on the additional liability. I think at best (or worst depending on how you look at things), people in other countries will do preliminary signouts and a US MD will finalize them. This kind of setup is pretty rare in radiology and has had little if any effect on the job market.
     
    Last edited: Apr 13, 2017
  11. jkdoctor

    jkdoctor 2+ Year Member

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    Apr 29, 2013
    Cannot compare with radiology. Most pathology residents are FMGs and most radiology residents are not FMGs. There is a large pool of pathologists who might be willing to work at Quest in India or similar operations after completing a US residency, especially considering the crappy US job market in pathology.
     
  12. jupiterianvibe

    jupiterianvibe

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    Mar 3, 2016
    this right here.
    the fmgs would probably be happy in going back overseas to live while signing out digital slides for a cut rate. our cut rate is still good money in most other developing countries.
     
  13. yaah

    yaah Boring SDN Administrator 10+ Year Member

    Radiology is a very big field, which has had its own "too many graduates for available jobs" crisis in the past few years. And it's still not happening. It's really hard to square the arguments if you think it's going to affect path but not radiology.
     
  14. path_spouse

    path_spouse

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    Apr 1, 2016
    One other issue with digital pathology, as compared to radiology, is the volume of data. Image file sizes in pathology are very large relative to radiology. Because you don't know ahead of time what parts of a slide a pathologist will want to zoom in on, you need to store the entire slide at high magnification. That the images are color images, unlike in radiology, probably doesn't help either. I think it will take a while before IT infrastructure catches up to what would be needed for wide-scale use of digital pathology.
     
    Last edited: Apr 17, 2017
  15. jupiterianvibe

    jupiterianvibe

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    Mar 3, 2016
    Radiology doesn't have nearly as many FMGs as pathology.
     
  16. Deucedano

    Deucedano 10+ Year Member

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    Aug 16, 2006
    I agree 100%. The IT infrastructure needs to be drastically beefed up in order to handle this sort of workflow. A vast majority of the IT people at my institution don't seem to understand how much network bandwidth is actually needed to simulate practice. Your standard home computer and most workplace computers don't have enough graphics processing power for everyday practice. My worry would be the lack of understanding by IT people and hospital administration in putting the proper infrastructure in place to optimize its use. A half a**ed implementation would mean a step backwards in efficiency and workflow for the pathologist.
     
    path_spouse likes this.

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