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The American Journal of Surgical... Aug 2022Direct pathologist-patient encounters are infrequent, but there has been a modest movement toward such interactions in the past 2 decades. The present article places...
Direct pathologist-patient encounters are infrequent, but there has been a modest movement toward such interactions in the past 2 decades. The present article places that movement in perspective. It includes a discussion of diverse factors-including congressional laws, the views of department chairs, and progress in artificial intelligence-that could promote pathologist-patient interactions and also reviews factors that might deter such encounters.
Topics: Artificial Intelligence; Humans; Pathologists
PubMed: 35220353
DOI: 10.1097/PAS.0000000000001877 -
Archives of Pathology & Laboratory... Jan 2023
Topics: Humans; Pathologists
PubMed: 36577091
DOI: 10.5858/arpa.2022-0226-ED -
American Journal of Clinical Pathology Jan 2021
Topics: Humans; Minority Groups; Pathologists
PubMed: 33106844
DOI: 10.1093/ajcp/aqaa192 -
Archives of Pathology & Laboratory... Apr 2020
Topics: Career Choice; Career Mobility; Humans; Pathologists; Pathology, Clinical
PubMed: 31971465
DOI: 10.5858/arpa.2019-0680-ED -
International Journal of Laboratory... Jun 2023An increasing number of machine learning applications are being developed and applied to digital pathology, including hematopathology. The goal of these modern... (Review)
Review
An increasing number of machine learning applications are being developed and applied to digital pathology, including hematopathology. The goal of these modern computerized tools is often to support diagnostic workflows by extracting and summarizing information from multiple data sources, including digital images of human tissue. Hematopathology is inherently multimodal and can serve as an ideal case study for machine learning applications. However, hematopathology also poses unique challenges compared to other pathology subspecialities when applying machine learning approaches. By modeling the pathologist workflow and thinking process, machine learning algorithms may be designed to address practical and tangible problems in hematopathology. In this article, we discuss the current trends in machine learning in hematopathology. We review currently available machine learning enabled medical devices supporting hematopathology workflows. We then explore current machine learning research trends of the field with a focus on bone marrow cytology and histopathology, and how adoption of new machine learning tools may be enabled through the transition to digital pathology.
Topics: Humans; Machine Learning; Algorithms; Pathologists; Workflow
PubMed: 37257440
DOI: 10.1111/ijlh.14110 -
American Journal of Clinical Pathology Sep 2021The pathology report serves as a crucial communication tool among a number of stakeholders. It can sometimes be challenging to understand. A communication barrier exists... (Review)
Review
OBJECTIVES
The pathology report serves as a crucial communication tool among a number of stakeholders. It can sometimes be challenging to understand. A communication barrier exists among pathologists, other clinicians, and patients when interpreting the pathology report, leaving both clinicians and patients less empowered when making treatment decisions. Miscommunication can lead to delays in treatment or other costly medical interventions.
METHODS
In this review, we highlight miscommunication in pathology reporting and provide potential solutions to improve communication.
RESULTS
Up to one-third of clinicians do not always understand pathology reports. Several causes of report misinterpretation include the use of pathology-specific jargon, different versions of staging or grading systems, and expressions indicative of uncertainty in the pathologist's report. Active communication has proven to be crucial between the clinician and the pathologist to clarify different aspects of the pathology report. Direct communication between pathologists and patients is evolving, with promising success in proof-of-principle studies. Special attention needs to be paid to avoiding inaccuracy while trying to simplify the pathology report.
CONCLUSIONS
There is a need for active and adequate communication among pathologists, other clinicians, and patients. Clarity and consistency in reporting, quantifying the level of confidence in diagnosis, and avoiding misnomers are key steps toward improving communications.
Topics: Communication; Humans; Pathologists; Pathology, Clinical; Patients; Physicians; Research Report; Translational Research, Biomedical; Uncertainty
PubMed: 33907793
DOI: 10.1093/ajcp/aqab014 -
Liver International : Official Journal... Feb 2018When a patient with suspected drug-induced liver injury (DILI) undergoes liver biopsy, the pathologist is confronted with two major challenges. The first and most... (Review)
Review
When a patient with suspected drug-induced liver injury (DILI) undergoes liver biopsy, the pathologist is confronted with two major challenges. The first and most important is to establish the pattern(s) of injury which are present. Patterns of injury represent stereotypical responses of an organ to injury and relate to specific aetiologies of liver damage. The pattern of injury and the histological details of that injury can then be analysed with respect to the patient's intercurrent diseases and medication history. The specific expertise of the pathologist can be used to weigh the prospect of DILI against the likelihood of other explanations of injury. The second challenge is to characterize specific types of injury and the severity of injury, both of which may have importance for clinical decision-making and prognosis. The pathologist's report should convey both an accurate description of the pathology as well its interpretation.
Topics: Biopsy; Chemical and Drug Induced Liver Injury; Clinical Competence; Clinical Decision-Making; Diagnosis, Differential; Humans; Liver; Pathologists; Predictive Value of Tests; Prognosis; Risk Factors; Severity of Illness Index
PubMed: 28865179
DOI: 10.1111/liv.13584 -
Critical Reviews in Oncology/hematology Oct 2022Anatomic pathology has changed dramatically in recent years. Although the microscopic assessment of tissues and cells is and will remain the mainstay of cancer diagnosis... (Review)
Review
Anatomic pathology has changed dramatically in recent years. Although the microscopic assessment of tissues and cells is and will remain the mainstay of cancer diagnosis molecular profiling has become equally relevant. Thus, to stay abreast of the evolving landscape of today's anatomic pathology, modern pathologists must be able to master the intricate world of predictive molecular pathology. To this aim, pathologists have had to acquire additional knowledge to bridge the gap between clinicians and molecular biologists. This new role is particularly important, as cases are now collegially discussed in molecular tumor boards (MTBs). Moreover, as opposed to traditional pathologists, modern pathologists have also adamantly embraced innovation while keeping a constant eye on tradition. In this article, we depict the highlights and shadows of the upcoming "Anatomic Pathology 2.0" by placing particular emphasis on the pathologist's growing role in the management of cancer patients.
Topics: Humans; Neoplasms; Pathologists
PubMed: 35934262
DOI: 10.1016/j.critrevonc.2022.103776 -
Endocrine Pathology Mar 2023The effects of many pharmacological agents on thyroid function are well known. Direct influences on measurements of thyroid function tests are also described. However,... (Review)
Review
The effects of many pharmacological agents on thyroid function are well known. Direct influences on measurements of thyroid function tests are also described. However, certain classes of drugs produce morphological changes in the gland. This review focuses on the significance of the following drug classes for the thyroid pathologist: iodine, antithyroid drugs, psychotropic drugs, antibiotics, cardiotropic drugs, antidiabetic drugs, and immunomodulatory agents. Radioactive iodine initially induces mild histologic changes; however, the long-term effects include marked follicular atrophy, fibrosis, and nuclear atypia-changes that vary depending on the pre-therapy condition of the gland. Some psychotropic drugs have been associated with a spectrum of inflammatory changes throughout the gland. The tetracycline class of antibiotics, namely minocycline, can lead to a grossly black thyroid gland with pigment seen in both colloid and follicular epithelial cells while variably present within thyroid nodules. The surgical pathologist most commonly sees an amiodarone-affected gland removed for hyperthyroidism, and the histologic findings again depend on the pre-therapy condition of the gland. While GLP-1 receptor agonists carry an FDA black box warning for patients with a personal or family history of multiple endocrine neoplasia or medullary thyroid carcinoma, the C cell hyperplasia originally noted in rats has not borne out in human studies. Finally, thyroiditis and hypothyroidism are well known complications of checkpoint inhibitor therapy, and rare cases of severe thyroiditis requiring urgent thyroidectomy have been reported with unique histologic findings. In this review, we describe the histologic findings for these drugs and more, in many cases including their functional consequences.
Topics: Humans; Animals; Rats; Iodine Radioisotopes; Pathologists; Thyroid Neoplasms; Thyroiditis; Anti-Bacterial Agents; Iodine
PubMed: 36723855
DOI: 10.1007/s12022-023-09749-1 -
Science (New York, N.Y.) May 2022Itiel Dror is determined to reveal the role of bias in forensics, even if it sparks outrage.
Itiel Dror is determined to reveal the role of bias in forensics, even if it sparks outrage.
Topics: Autopsy; Bias; Dermatoglyphics; Forensic Pathology; Humans; Pathologists
PubMed: 35549426
DOI: 10.1126/science.adc8720