Feasibility and diagnostic accuracy of Internet-based dynamic telepathology between Uganda and Germany
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Date
2011
Authors
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Journal ISSN
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Publisher
Journal of telemedicine and telecare
Abstract
We assessed the feasibility and diagnostic accuracy of Internet-based telepathology compared with conventional microscopic
examination. A total of 96 cases from the routine workload of the Department of Pathology at the Mulago Hospital in
Uganda were examined by robotic telemicroscopy via the Internet at the Fuerth Hospital in Germany. The telepathology
diagnoses were compared with those of conventional microscopy. Email and Skype telephony were used to exchange clinical
and diagnostic information. The reference diagnosis (gold standard) was established by consensus between two or more
experienced pathologists using both conventional microscopy and telemicroscopy; immunohistochemistry was used
whenever it was necessary. It took approximately 30 min for a pathologist to learn to use the telepathology system and
4–25 min to read a case remotely. Internet speed was the main limiting factor. The images were of good quality and the
pathologist at the remote site was able to navigate through the slide and change the magnification as necessary. In 92 of the
specimens (97%), the pathologists at the two hospitals agreed exactly about the diagnosis. Agreement overall was moderate
(kappa ¼ 0.39). The discordant diagnoses were attributed to factors related to diseases morphologically difficult to diagnose,
such as soft tissue sarcomas and primitive tumours. Internet-based conferencing systems offer an inexpensive method of
obtaining a primary diagnosis by telepathology and consulting on cases that require subspecialty expertise.
Description
Keywords
Feasibility, Accuracy, Telepathology
Citation
Wamala, D., Katamba, A., & Dworak, O. (2011). Feasibility and diagnostic accuracy of Internet-based dynamic telepathology between Uganda and Germany. Journal of telemedicine and telecare, 17(5), 222-225. DOI: 10.1258/jtt.2010.100609