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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Sep 11, 2020
Date Accepted: Dec 14, 2020
Date Submitted to PubMed: Jan 27, 2021

The final, peer-reviewed published version of this preprint can be found here:

Digital Pathology During the COVID-19 Outbreak in Italy: Survey Study

Giaretto S, Renne SL, Rahal D, Bossi P, Colombo P, Spaggiari P, Manara S, Sollai M, Fiamengo B, Brambilla T, Fernandes B, Rao S, Elamin A, Valeri M, De Carlo C, Belsito V, Lancellotti C, Cieri M, Cagini A, Terracciano L, Roncalli M, Di Tommaso L

Digital Pathology During the COVID-19 Outbreak in Italy: Survey Study

J Med Internet Res 2021;23(2):e24266

DOI: 10.2196/24266

PMID: 33503002

PMCID: 7901595

Digital Pathology During The Epidemic Of Covid 19 In Milan, Italy

  • Simone Giaretto; 
  • Salvatore Lorenzo Renne; 
  • Daoud Rahal; 
  • Paola Bossi; 
  • Piergiuseppe Colombo; 
  • Paola Spaggiari; 
  • Sofia Manara; 
  • Mauro Sollai; 
  • Barbara Fiamengo; 
  • Tatiana Brambilla; 
  • Bethania Fernandes; 
  • Stefania Rao; 
  • Abu Elamin; 
  • Marina Valeri; 
  • Camilla De Carlo; 
  • Vincenzo Belsito; 
  • Cesare Lancellotti; 
  • Miriam Cieri; 
  • Angelo Cagini; 
  • Luigi Terracciano; 
  • Massimo Roncalli; 
  • Luca Di Tommaso

ABSTRACT

Background:

Transition to digital pathology (DP) usually takes months or years to be completed. We were familiarizing with DP solutions, when COVID19 epidemic forced us to embark in an abrupt transition.

Objective:

The aim of this paper is to report and analyze this exceptional experience.

Methods:

Pathologists involved received 25 additional test cases from the archive and a final survey. These cases were addressed as follows: neoplastic Vs non-neoplastic disease; malignant Vs benign tumor; histopathological diagnosis; histotype and grade of lesion. Answers were compared to the original diagnosis. We performed a Bayesian data analysis with probabilistic modeling.

Results:

Seventeen pathologists (2 seniors, 5 experts, 6 young, 4 residents) were involved. The overall analysis, 1345 different items, showed a 9% error rate with digital slides. About 3% (42/1345) were in the category “neoplastic Vs non-neoplastic disease” and less than 1% (11/1345) in the category “benign Vs malignant tumor”. Senior pathologists generated the majorities of discrepancies, likely due to a digital gap. Mistakes were common for tumor grading (23%; 27/117) and in biopsy (25%; 29/117). Breast specimens showed the highest level of discrepancies (11.6%) followed by GI-tract (8.0%) and urogenital tract (4.3%) specimens.

Conclusions:

Our diagnostic performance is in line with literature, emphasizing that the duration of transition (lengthy or abrupt) does not influence it. Moreover, we highlight that digital gap negatively affects the performance with DP and that satisfaction with DP is not related to the diagnostic performance but to the use of adequate instruments and/or robust formation. These notes can be of help during the process of digital transition.


 Citation

Please cite as:

Giaretto S, Renne SL, Rahal D, Bossi P, Colombo P, Spaggiari P, Manara S, Sollai M, Fiamengo B, Brambilla T, Fernandes B, Rao S, Elamin A, Valeri M, De Carlo C, Belsito V, Lancellotti C, Cieri M, Cagini A, Terracciano L, Roncalli M, Di Tommaso L

Digital Pathology During the COVID-19 Outbreak in Italy: Survey Study

J Med Internet Res 2021;23(2):e24266

DOI: 10.2196/24266

PMID: 33503002

PMCID: 7901595

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