Ss. Raab et al., TELEPATHOLOGIC REVIEW - UTILITY, DIAGNOSTIC-ACCURACY, AND INTEROBSERVER VARIABILITY ON A DIFFICULT CASE CONSULTATION SERVICE, Modern pathology, 10(6), 1997, pp. 630-635
The diagnostic accuracy of telepathologic analysis has not been compar
ed to that of conventional light microscopic review on a difficult cas
e consultation service, The anatomic pathology consultation files of t
he University of Iowa were retrospectively examined, and 105 difficult
cases from a variety of organs were chosen for real-time telepatholog
ic and light microscopic review. The telepathologic and light microsco
pic crude agreement of five pathologists were compared, with use of th
e original consultation diagnosis as the ''gold standard.'' Cases were
scored as correct, partially correct, or incorrect. After making a vi
deo diagnosis, the pathologists reported whether they wanted to review
the case with use of a light microscope, The pathologists performed s
ignificantly better with the light microscope, even after excluding ca
ses in areas of inexpertise (P = .005), The mean percentage of cases t
hat the pathologists wanted to review with the light microscope was 64
%, and the major reason for review was diagnostic uncertainty, Cases i
ncorrectly diagnosed with use of the video monitor were almost always
requested for review. We conclude that, on a difficult case consultati
on service, pathologists perform significantly better with use of ligh
t microscopic than with telepathologic analysis; rarely make an incorr
ect diagnosis and do not request that case for light microscopic revie
w; and exhibit high telepathologic diagnostic accuracy in areas of exp
ertise.