@article {941, title = {Computational Pathology and Telepathology: SY05-1 TELECYTOLOGY TC AND TELEPATHOLOGY TP IN UNDERSERVED COUNTRIES TOY OR TOOL?}, journal = {Pathology}, volume = {46 Suppl 2}, year = {2014}, month = {2014 Oct}, pages = {S7}, abstract = {

BACKGROUND: Pathologic anatomic practice is an essential part of medical practice even in low-income countries. It is an extraordinarily helpful tool in finding therapeutic decisions, monitoring therapeutic processes and in academic teaching students and residents in understanding aetiology and morphology of infectious and neoplastic diseases. However, all countries worldwide are suffering from a shortage of experienced surgical pathologists providing an adequate service to the clinics. Training pathologists is a time-consuming procedure and it takes more than one decade. Therefore new techniques have to be utilized to overcome the gap of human resources in medical fields in these countries. Telepathology and telecytology may be effective tools to transfer both knowledge and experience to any place in the world with simple technical equipment using the Internet. We evaluate the benefit of TP and TC on three projects, with different educational levels of the local pathologists.

MATERIAL AND APPROACH: In 2002 Cambodian pathologists started off with telepathology using iPath Network as an open-source system. Up to now more than 5600 cases have been submitted to experts. In 2007 a Tanzanian hospital started telepathology and solved more than 3600 cases. In 2010 an Afghan group of medical experts started using TP and submitted more than 1600 cases. The latest 100 cases of each group were analysed with respect to (1) the organs concerned; (2) the diagnostic techniques used such as histology vs cytology; (3) complexity of the diagnostic question; (4) information quality and quantity; (5) diagnostic concordance between primary diagnosis and the experts opinion; and (6) diagnostic accuracy of the experts diagnoses in order to evaluate the benefit of the projects.

RESULTS AND CONCLUSION: Telepathology services are ranging from a triage of diagnostic assessment of benign vs malignant to academic-scientific services including teaching and research facilities. Breast pathology is predominant in Afghanistan, whereas cervix pathology is the leading issue in Tanzania, and in Cambodia soft tissue/bone pathology plays the major role. In more than 50\% cytology was applied in Afghanistan and only 10\% and 5\% in Cambodia and Tanzania respectively. The complexity of diagnostic questions differs from Cambodia using TP for confirmation in most cases, to Tanzania and Afghanistan using TP mostly for primary diagnosis. Diagnostic concordance depending on both the experience of local pathologists and the technical facilities of the laboratory was high in Cambodia, followed by Tanzania and Afghanistan. Diagnostic accuracy corresponding with the quantity and quality of information followed the same pattern. The success of TP projects can be measured by the number of TP sessions and by the sustainability of projects. Our TP/TC projects in those countries with limited resources are effective tools in improving medical health care.

}, keywords = {iPath, open source software, telepathology}, issn = {1465-3931}, doi = {10.1097/01.PAT.0000454068.32934.09}, author = {Stauch, Gerhard and Miringa, Angelica and Raoufi, Rokai and Vathana, Cchut Serey and Hetzmann, Sophia and Hinsch, Nora and Dalquen, Peter and Voelker, Ullrich and Kunze, Dietmar} } @article {1035, title = {A hybrid approach to telepathology in Cambodia.}, journal = {J Telemed Telecare}, volume = {19}, year = {2013}, month = {2013 Dec}, pages = {475-8}, abstract = {

We established a hybrid telepathology network at the Children{\textquoteright}s Surgical Centre (CSC) in Cambodia, based on store-and-forward communication using iPATH and videoconferencing using Skype. We retrospectively analysed all data from the CSC stored on the iPATH server and reviewed the patient notes over an 8-month period. Of 115 patients for histopathology diagnosis during the study period, 38 cases were uploaded onto iPATH for further telemedicine discussion. The median number of days it took a specialist, other than the local one, to comment on the case on iPATH was 5 days (range 0-15). In three cases (8\%) there was no reply from a specialist on iPATH. During the study period, seven clinical conferences were held, with an average of 6 cases (range 4-7) discussed at each conference. All 38 cases discussed had a final agreed diagnosis and firm management plans were made. Of the 24 cases where proactive management was advised, 17 patients followed through with the recommendations. Although the combination of video consultations and store-and-forward communication has not been used much before in the developing world, it has benefited patient care and outcomes at the CSC.

}, keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Cambodia, Child, Child, Preschool, Female, Humans, Internet, Male, Middle Aged, Remote Consultation, Retrospective Studies, Surgical Procedures, Operative, telepathology, Videoconferencing, Young Adult}, issn = {1758-1109}, doi = {10.1177/1357633X13512071}, author = {Kadaba, Varsha and Ly, Tho and Noor, Saqib and Chhut, Serey V and Hinsch, Nora and Stauch, Gerhard and Gollogly, James} }