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American Journal of Clinical Pathology Sep 2022The aim of this study was to assess expectations of performance that exist in the marketplace for entry-level pathologists' assistants (PathAs), defined as recent...
OBJECTIVES
The aim of this study was to assess expectations of performance that exist in the marketplace for entry-level pathologists' assistants (PathAs), defined as recent graduates of a pathologists' assistant program on their first day of employment.
METHODS
A voluntary, anonymous survey was distributed to pathologist and PathA members of the American Society for Clinical Pathology by email. We assessed 98 professional activities of PathAs using a 5-point scale of expectations based on levels of trust placed in them. We also collected demographic information.
RESULTS
A total of 728 participants responded to this survey, including 280 pathologists and 448 PathAs. We classified 98 activities according to expectations: independent performance (20/98), developing independence (48/98), and not expected of PathAs (5/98). Some activities (25/98) were indeterminate yet likely represent areas of developing independence.
CONCLUSIONS
This study demonstrates an expectation for entry-level PathAs to perform some activities included in the scope of practice independently but eventually to develop independent proficiency for most professional activities. A minority of activities were identified as responsibilities that are not expected of PathAs. Entry-level PathAs, therefore, remain "works in progress," with an expectation for independent performance of core activities while developing abilities in many areas of professional practice.
Topics: Humans; Motivation; Pathologists; Pathology, Clinical; Surveys and Questionnaires; United States
PubMed: 35760554
DOI: 10.1093/ajcp/aqac065 -
The American Journal of Pathology May 2021Correct use of statistical methods is important to ensure the reliability and value of the published experimental pathology literature. Considering increasing interest... (Review)
Review
Correct use of statistical methods is important to ensure the reliability and value of the published experimental pathology literature. Considering increasing interest in the quality of statistical reporting in pathology, the statistical methods used in 10 recent issues of the American Journal of Pathology were reviewed. The statistical tests performed in the articles were summarized, with attention to their implications for contemporary pathology research and practice. Among the 195 articles identified, 93% reported using one or more statistical tests. Retrospective statistical review of the articles revealed several key findings. First, tests for normality were infrequently reported, and parametric hypothesis tests were overutilized. Second, studies reporting multisample hypothesis tests (eg, analysis of variance) infrequently performed post hoc tests to explore differences between study groups. Third, correlation, regression, and survival analysis techniques were underutilized. On the basis of these findings, a primer on relevant statistical concepts and tests is presented, including issues related to optimal study design, descriptive and comparative statistics, and regression, correlation, survival, and genetic data analysis.
Topics: Humans; Pathology; Periodicals as Topic; Reproducibility of Results; Research Design; Retrospective Studies; Statistics as Topic
PubMed: 33652018
DOI: 10.1016/j.ajpath.2021.02.009 -
Pathology, Research and Practice Dec 2022The development of whole slide image and deep neural network technologies has contributed to the paradigm shift in diagnostic pathology and has received much attention... (Review)
Review
BACKGROUND
The development of whole slide image and deep neural network technologies has contributed to the paradigm shift in diagnostic pathology and has received much attention from researchers, with related publications increasing yearly and "exploding" in recent years. However, few studies have systematically reviewed "digital pathology" using bibliometric tools. In this study, we will use multiple approaches to visualize and analyze "digital pathology" to provide a comprehensive and objective picture of the field's historical evolution and future development.
METHODS
We use VOSviewer, CiteSpace, Gephi, and R to analyze the authors, institutional and national collaboration networks, keyword co-occurrence, and co-citation analysis to visualize the current status of global digital pathology research.
RESULTS
Digital pathology-related research is mainly active in "molecular, biological, and immunology" journal groups, "pharmaceutical, medical, and clinical" journal groups, and "psychology, education, and health" journal groups; in addition to "digital pathology," "diagnosis," "deep learning," "histopathology," and "surgical pathology" are also active research topics; the U.S. has significant research results in digital pathology, with the top 10 publishing institutions all coming from the U.S. In the past two decades, global digital pathology-related research can be divided into two major research areas. One is about system verification and optimization of WSI, and the other is about the application and development of artificial intelligence technology in digital pathology. Among them, based on the development of computer technology and the update of the machine learning concept, the research results for deep neural network technologies have been more concentrated in recent years. The robust performance of deep neural networks in feature extraction and image analysis provides a new research direction for improving digital pathology-aided diagnosis systems, which is where the research hotspots have been in recent years.
CONCLUSIONS
The bibliometric analysis may help better understand the current status of research within the field of digital pathology and provide references and lessons for future related research.
Topics: Humans; Artificial Intelligence; Bibliometrics; Pathology, Surgical; Image Processing, Computer-Assisted
PubMed: 36274267
DOI: 10.1016/j.prp.2022.154171 -
American Journal of Clinical Pathology Nov 2021Corruption is a widely acknowledged problem in the health sector of low- and middle-income countries (LMICs). Yet, little is known about the types of corruption that... (Review)
Review
OBJECTIVES
Corruption is a widely acknowledged problem in the health sector of low- and middle-income countries (LMICs). Yet, little is known about the types of corruption that affect the delivery of pathology and laboratory medicine (PALM) services. This review is a first step at examining corruption risks in PALM.
METHODS
We performed a critical review of medical literature focused on health sector corruption in LMICs. To provide context, we categorized cases of laboratory-related fraud and abuse in the United States.
RESULTS
Forms of corruption in LMICs that may affect the provision of PALM services include informal payments, absenteeism, theft and diversion, kickbacks, self-referral, and fraudulent billing.
CONCLUSIONS
Corruption represents a functional reality in many LMICs and hinders the delivery of services and distribution of resources to which individuals and entities are legally entitled. Further study is needed to estimate the extent of corruption in PALM and develop appropriate anticorruption strategies.
Topics: Fraud; Humans; Laboratories; Pathology; United States
PubMed: 34219146
DOI: 10.1093/ajcp/aqab046 -
Surgical Pathology Clinics Sep 2021Pre-analytical factors in molecular oncology diagnostics are reviewed. Issues around sample collection, storage, and transport that might affect the stability of nucleic... (Review)
Review
Pre-analytical factors in molecular oncology diagnostics are reviewed. Issues around sample collection, storage, and transport that might affect the stability of nucleic acids and the ability to perform molecular testing are addressed. In addition, molecular methods used commonly in clinical diagnostic laboratories, including newer technologies such as next-generation sequencing and digital droplet polymerase chain reaction, as well as their applications, are reviewed. Finally, we discuss considerations in designing a molecular test menu to deliver accurate and timely results in an efficient and cost-effective manner.
Topics: High-Throughput Nucleotide Sequencing; Humans; Molecular Diagnostic Techniques; Pathology, Molecular; Polymerase Chain Reaction
PubMed: 34373088
DOI: 10.1016/j.path.2021.05.001 -
Forensic Science International Sep 2016To investigate what is currently known about skeletal blunt force trauma (BFT) resulting from falls, and how valuable that research is in contributing to forensic... (Review)
Review
To investigate what is currently known about skeletal blunt force trauma (BFT) resulting from falls, and how valuable that research is in contributing to forensic anthropology investigations and interpretations of circumstances of death, a comprehensive review of forensic anthropology, forensic pathology and clinical medicine literature was performed. Forensic anthropology literature identified that establishing the type of fall from the analysis of BFT is difficult given the uniqueness of each fall event, the complexities involved with identify BFT and, in particular, the limited available research documenting fracture patterning and morphologies. Comparatively, skeletal BFT resulting from fatal falls is well documented in the forensic pathology and clinical medicine literature. These disciplines cover a wide range of fall types (free falls, falls in juveniles, specific fractures produced from falls, falls down staircases, falls resulting in impalements, and 'other' fall types), provide details on how the nature of the fall influences the skeletal fracturing, and documents the anatomical regions susceptible to fracturing. Whilst these contributions may assist forensic anthropologists, they provide limited details of fracture patterns and morphologies and thus further research investigating the details of skeletal BFT resulting from fatal falls is required.
Topics: Accidental Falls; Forensic Pathology; Fractures, Bone; Humans
PubMed: 27264682
DOI: 10.1016/j.forsciint.2016.04.037 -
European Journal of Human Genetics :... Feb 2024Variants of uncertain significance (VUS) are a significant issue for the molecular diagnosis of rare diseases. The publication of episignatures as effective biomarkers...
Variants of uncertain significance (VUS) are a significant issue for the molecular diagnosis of rare diseases. The publication of episignatures as effective biomarkers of certain Mendelian neurodevelopmental disorders has raised hopes to help classify VUS. However, prediction abilities of most published episignatures have not been independently investigated yet, which is a prerequisite for an informed and rigorous use in a diagnostic setting. We generated DNA methylation data from 101 carriers of (likely) pathogenic variants in ten different genes, 57 VUS carriers, and 25 healthy controls. Combining published episignature information and new validation data with a k-nearest-neighbour classifier within a leave-one-out scheme, we provide unbiased specificity and sensitivity estimates for each of the signatures. Our procedure reached 100% specificity, but the sensitivities unexpectedly spanned a very large spectrum. While ATRX, DNMT3A, KMT2D, and NSD1 signatures displayed a 100% sensitivity, CREBBP-RSTS and one of the CHD8 signatures reached <40% sensitivity on our dataset. Remaining Cornelia de Lange syndrome, KMT2A, KDM5C and CHD7 signatures reached 70-100% sensitivity at best with unstable performances, suffering from heterogeneous methylation profiles among cases and rare discordant samples. Our results call for cautiousness and demonstrate that episignatures do not perform equally well. Some signatures are ready for confident use in a diagnostic setting. Yet, it is imperative to characterise the actual validity perimeter and interpretation of each episignature with the help of larger validation sample sizes and in a broader set of episignatures.
Topics: Humans; Pathology, Molecular; Neurodevelopmental Disorders; DNA Methylation; Biomarkers
PubMed: 37872275
DOI: 10.1038/s41431-023-01474-x -
The American Journal of Pathology Oct 2021Significant advances in artificial intelligence (AI), deep learning, and other machine-learning approaches have been made in recent years, with applications found in... (Review)
Review
Significant advances in artificial intelligence (AI), deep learning, and other machine-learning approaches have been made in recent years, with applications found in almost every industry, including health care. AI is capable of completing a spectrum of mundane to complex medically oriented tasks previously performed only by boarded physicians, most recently assisting with the detection of cancers difficult to find on histopathology slides. Although computers will likely not replace pathologists any time soon, properly designed AI-based tools hold great potential for increasing workflow efficiency and diagnostic accuracy in pathology. Recent trends, such as data augmentation, crowdsourcing for generating annotated data sets, and unsupervised learning with molecular and/or clinical outcomes versus human diagnoses as a source of ground truth, are eliminating the direct role of pathologists in algorithm development. Proper integration of AI-based systems into anatomic-pathology practice will necessarily require fully digital imaging platforms, an overhaul of legacy information-technology infrastructures, modification of laboratory/pathologist workflows, appropriate reimbursement/cost-offsetting models, and ultimately, the active participation of pathologists to encourage buy-in and oversight. Regulations tailored to the nature and limitations of AI are currently in development and, when instituted, are expected to promote safe and effective use. This review addresses the challenges in AI development, deployment, and regulation to be overcome prior to its widespread adoption in anatomic pathology.
Topics: Artificial Intelligence; Cloud Computing; Humans; Pathologists; Pathology; Practice Patterns, Physicians'; Social Control, Formal
PubMed: 33245914
DOI: 10.1016/j.ajpath.2020.10.018 -
ACS Applied Bio Materials Oct 2023Sensitive, rapid, and portable molecular diagnostics is the future of disease surveillance, containment, and therapy. The recent SARS-CoV-2 pandemic has reminded us of... (Review)
Review
Sensitive, rapid, and portable molecular diagnostics is the future of disease surveillance, containment, and therapy. The recent SARS-CoV-2 pandemic has reminded us of the vulnerability of lives from ever-evolving pathogens. At the same time, it has provided opportunities to bridge the gap by translating basic molecular biology into therapeutic tools. One such molecular biology technique is CRISPR (clustered regularly interspaced short palindromic repeat) which has revolutionized the field of molecular diagnostics at the need of the hour. The use of CRISPR-Cas systems has been widespread in biology research due to the ease of performing genetic manipulations. In 2012, CRISPR-Cas systems were, for the first time, shown to be reprogrammable, i.e., capable of performing sequence-specific gene editing. This discovery catapulted the field of CRISPR-Cas research and opened many unexplored avenues in the field of gene editing, from basic research to therapeutics. One such field that benefitted greatly from this discovery was molecular diagnostics, as using CRISPR-Cas technologies enabled existing diagnostic methods to become more sensitive, accurate, and portable, a necessity in disease control. This Review aims to capture some of the trajectories and advances made in this arena and provides a comprehensive understanding of the methods and their potential use as point-of-care diagnostics.
Topics: Pathology, Molecular; Gene Editing; CRISPR-Cas Systems; Genetic Therapy; Point-of-Care Testing
PubMed: 37788375
DOI: 10.1021/acsabm.3c00439 -
International Journal of Medical... 2020The advantages of atomic force microscopy (AFM) in biological research are its high imaging resolution, sensitivity, and ability to operate in physiological conditions.... (Review)
Review
The advantages of atomic force microscopy (AFM) in biological research are its high imaging resolution, sensitivity, and ability to operate in physiological conditions. Over the past decades, rigorous studies have been performed to determine the potential applications of AFM techniques in disease diagnosis and prognosis. Many pathological conditions are accompanied by alterations in the morphology, adhesion properties, mechanical compliances, and molecular composition of cells and tissues. The accurate determination of such alterations can be utilized as a diagnostic and prognostic marker. Alteration in cell morphology represents changes in cell structure and membrane proteins induced by pathologic progression of diseases. Mechanical compliances are also modulated by the active rearrangements of cytoskeleton or extracellular matrix triggered by disease pathogenesis. In addition, adhesion is a critical step in the progression of many diseases including infectious and neurodegenerative diseases. Recent advances in AFM techniques have demonstrated their ability to obtain molecular composition as well as topographic information. The quantitative characterization of molecular alteration in biological specimens in terms of disease progression provides a new avenue to understand the underlying mechanisms of disease onset and progression. In this review, we have highlighted the application of diverse AFM techniques in pathological investigations.
Topics: Biomechanical Phenomena; Cell Adhesion; Cytoskeleton; Diabetes Mellitus, Type 2; Extracellular Matrix; Humans; Image Processing, Computer-Assisted; Inflammation; Membrane Proteins; Microscopy, Atomic Force; Molecular Imaging; Pathology, Clinical; Pathology, Molecular
PubMed: 32308537
DOI: 10.7150/ijms.41805