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Improving the histopathologic diagnosis of pediatric malignancies in a low‐resource setting by combining focused training and telepathology strategies
Author(s) -
Santiago Teresa C.,
Jenkins Jesse J.,
Pedrosa Francisco,
Billups Catherine,
Quintana Yuri,
Ribeiro Raul C.,
Qaddoumi Ibrahim
Publication year - 2012
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.24071
Subject(s) - telepathology , medicine , medical diagnosis , concordance , pediatric oncology , medical physics , pediatric cancer , pathology , cancer , telemedicine , health care , economics , economic growth
Background Accurate diagnosis is critical for optimal management of pediatric cancer. Pathologists with experience in pediatric oncology are in short supply in the developing world. Telepathology is increasingly used for consultations but its overall contribution to diagnostic accuracy is unknown. Procedure We developed a strategy to provide a focused training in pediatric cancer and telepathology support to pathologists in the developing world. After the training period, we compared trainee's diagnoses with those of an experienced pathologist. We next compared the effectiveness of static versus dynamic telepathology review in 127 cases. Results were compared by Fisher's exact test. Results The diagnoses of the trainee and the expert pathologist differed in only 6.5% of cases (95% CI, 1.2–20.0%). The overall concordance between the telepathology and original diagnoses was 90.6% (115/127; 95% CI, 84.1–94.6%). Conclusions Brief, focused training in pediatric cancer histopathology can improve diagnostic accuracy. Dynamic and static telepathology analyses are equally effective for diagnostic review. Pediatr Blood Cancer 2012;59:221–225. © 2012 Wiley Periodicals, Inc.