Telepathology for Frozen Section Analysis: A Validation of Remote Meeting Technologies (RMT)™ Software
Samuel Barasch, Zhanhai Li, Jimmie Stewart III. University of Wisconsin, Madison, WI
Background: The University of Wisconsin Hospital and Clinics is supporting frozen section(FS) capability at a partner institution over 40 miles away. The Department of Pathology was tasked with finding the most cost effective, accurate, and efficient solution to providing this service. After review of many techniques, including virtual scanning, real time imaging was chosen. To prove this method was just as effective as direct microscopy, a validation/correlation study was performed. This also functioned as a training/competency assessment for participating pathologists allowing them to become familiar with making diagnoses from digital images.
Design: Six pathologists were given a set of 20 FS slides and asked to interpret them via our chosen telepathology system, Remote Meeting Technologies (RMT)™. The slides were chosen after a review of common FS slides seen in the partner institution. The more difficult cases were favored to show that the RMT system could accurately display diagnostic features in a digitized image. After 3 months or more of lag time, the slides were reordered and presented to the same pathologists for direct microscopy examination. The answers from each exam were then correlated to determine if any difference existed between the two methods of diagnosis.
Results: The Cochran-Mantel-Haenszel (CMH) test found outstanding correlation between telepathology and direct microscopy with a p value of <0.0001. The null hypothesis in this analysis was that there was no correlation between the two methods. The exceedingly low p value gives extremely strong evidence against that null hypothesis.
|Pathologist||P value from McNemar's test||Comment|
|D||1||Telepathology and microscopy agree|
|F||.083||Telepathology and microscopy agree|
|G||.083||Telepathology and microscopy agree|
|H||1||Telepathology and microscopy agree|
|I||.083||Telepathology and microscopy agree|
|J||.16||Telepathology and microscopy agree|