A Systematic Analysis of Discordant Diagnoses in Digital Pathology Compared With Light Microscopy
- 1 December 2017
- journal article
- research article
- Published by Archives of Pathology and Laboratory Medicine in Archives Of Pathology & Laboratory Medicine
- Vol. 141 (12), 1712-1718
- https://doi.org/10.5858/arpa.2016-0494-oa
Abstract
Context.—: Relatively little is known about the significance and potential impact of glass-digital discordances, and this is likely to be of importance when considering digital pathology adoption.Objective.—: To apply evidence-based medicine to collect and analyze reported instances of glass-digital discordance from the whole slide imaging validation literature.Design.—: We used our prior systematic review protocol to identify studies assessing the concordance of light microscopy and whole slide imaging between 1999 and 2015. Data were extracted and analyzed by a team of histopathologists to classify the type, significance, and potential root cause of discordances.Results.—: Twenty-three studies were included, yielding 8069 instances of a glass diagnosis being compared with a digital diagnosis. From these 8069 comparisons, 335 instances of discordance (4%) were reported, in which glass was the preferred diagnostic medium in 286 (85%), and digital in 44 (13%), with no consensus in 5 (2%). Twenty-eight discordances had the potential to cause moderate/severe patient harm. Of these, glass was the preferred diagnostic medium for 26 (93%). Of the 335 discordances, 109 (32%) involved the diagnosis or grading of dysplasia. For these cases, glass was the preferred diagnostic medium in 101 cases (93%), suggesting that diagnosis and grading of dysplasia may be a potential pitfall of digital diagnosis. In 32 of 335 cases (10%), discordance on digital was attributed to the inability to find a small diagnostic/prognostic object.Conclusions.—: Systematic analysis of concordance studies reveals specific areas that may be problematic on whole slide imaging. It is important that pathologists are aware of these areas to ensure patient safety.Keywords
This publication has 31 references indexed in Scilit:
- Validation of Whole Slide Imaging for Primary Diagnosis in Surgical PathologyArchives Of Pathology & Laboratory Medicine, 2013
- Digital Pathology Consultations—a New Era in Digital Imaging, Challenges and Practical ApplicationsJournal of Digital Imaging, 2013
- Going fully digital: Perspective of a Dutch academic pathology labJournal of Pathology Informatics, 2013
- Whole slide images for primary diagnostics of paediatric pathology specimens: a feasibility studyJournal of Clinical Pathology, 2012
- Validation of diagnostic accuracy using digital slides in routine histopathologyDiagnostic Pathology, 2012
- Virtual microscopy using whole-slide imaging as an enabler for teledermatopathology: A paired consultant validation studyJournal of Pathology Informatics, 2012
- Whole slide imaging for educational purposesJournal of Pathology Informatics, 2012
- Diagnosis of dysplasia in upper gastro-intestinal tract biopsies through digital microscopyJournal of Pathology Informatics, 2012
- Whole slide images for primary diagnostics in dermatopathology: a feasibility studyJournal of Clinical Pathology, 2011
- Routine Surgical Telepathology in the Department of Veterans Affairs: Experience-Related Improvements in Pathologist Performance in 2200 CasesTelemedicine Journal, 1999