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Anatomical Sciences Education Mar 2019This descriptive article describes the use of clinical case-based portfolios in histopathology teaching laboratories in conjunction with virtual microscopy not only to...
This descriptive article describes the use of clinical case-based portfolios in histopathology teaching laboratories in conjunction with virtual microscopy not only to integrate histology and pathology disciplines for first and second year medical students but also to stimulate student engagement, promote self-directed and group-based learning and enhance student-to-student interaction in a structured manner. Portfolios consisted of PowerPoint files encompassing four to five clinical case studies relevant to the topics covered that week. Portfolios integrated study materials provided in the module-specific lectures, clinical skill lectures, and online interactive content. Two sets of portfolios, Individual and Group, were used. Individual Portfolios were completed by each student and uploaded prior to the laboratory session. Group Portfolios were completed by students working together in small groups during the laboratory session with minimal faculty assistance. The functional utility and acceptance of Individual and Group Portfolios among first- and second-year medical students was evaluated using electronic surveys and examination performances. Both first- and second-year students agreed that the use of portfolios in conjunction with virtual microscopy promoted understanding and encouraged discussion of the topics covered during the week and that group members worked well together and contributed to the completion of the portfolios. Performances on the Histology and Cell Biology and Pathology sections on the United States Medical Licensing Examination (USMLE ) remained consistent and in line with national averages. Overall, use of portfolios promoted peer teaching and contributed towards successful transition to the new system-based integrated curriculum with continued strong performance on the USMLE.
Topics: Computer-Assisted Instruction; Curriculum; Education, Medical, Undergraduate; Educational Measurement; Histology; Humans; Pathology; Personal Satisfaction; Students, Medical; Surveys and Questionnaires; User-Computer Interface
PubMed: 30118571
DOI: 10.1002/ase.1794 -
Journal of Clinical Apheresis Dec 2017Physicians from diverse training backgrounds practice apheresis medicine. Pathology residents' exposure to apheresis may vary depending on which department performs...
INTRODUCTION
Physicians from diverse training backgrounds practice apheresis medicine. Pathology residents' exposure to apheresis may vary depending on which department performs these procedures. Milestones for Apheresis education were published in 2012, but the degree of utilization in residency curriculum development is unknown. This study describes the current state of apheresis education for pathology residents.
METHODS
We sent a 15 question electronic survey to 141 pathology programs identified through the American Medical Association Residency and Fellowship Database.
RESULTS
Forty-three (30.5%) of the 141 programs responded. Pathology performed apheresis procedures in 29 (67.4%) programs. In the remaining 14 programs, apheresis was performed by nephrology (10), hematology (4), and a regional blood center (1); in one program, both nephrology and hematology performed apheresis procedures. For combined anatomic and clinical pathology (AP/CP) residents, 26 of 28 (93%) were required to train in apheresis medicine when pathology performed the procedures compared to only 5 of 14 (36%) when they were performed by another department (P = 0.0002). For CP-only residents, 18 of 19 (95%) were required to train in apheresis medicine when pathology performed the procedures compared to 5 of 7 (71%) when they were performed by another department (P = 0.1669). Thirty (68.9%) respondents had a written apheresis medicine curriculum. Seventeen (39.5%) of the 43 respondents were aware of the Milestones for Apheresis education, and 8 (18.6%) used the milestones in creating their apheresis curriculum.
CONCLUSIONS
The pathology department performed apheresis procedures in two-thirds of pathology residency programs surveyed. AP/CP residents were more likely to be required to train in apheresis medicine if the pathology department performed these procedures at their institution. Apheresis medicine practitioners should review the Milestones for Apheresis education with their residency program director to optimize learning and clinical skills development.
Topics: Adult; Blood Component Removal; Clinical Competence; Curriculum; Education, Medical, Graduate; Female; Humans; Internship and Residency; Male; Pathology; Surveys and Questionnaires; Young Adult
PubMed: 28485096
DOI: 10.1002/jca.21531 -
Folia Histochemica Et Cytobiologica Jan 2009The technological progress in digitalization of complete histological glass slides has opened a new door in tissue--based diagnosis. The presentation of microscopic... (Review)
Review
The technological progress in digitalization of complete histological glass slides has opened a new door in tissue--based diagnosis. The presentation of microscopic images as a whole in a digital matrix is called virtual slide. A virtual slide allows calculation and related presentation of image information that otherwise can only be seen by individual human performance. The digital world permits attachments of several (if not all) fields of view and the contemporary visualization on a screen. The presentation of all microscopic magnifications is possible if the basic pixel resolution is less than 0.25 microns. To introduce digital tissue--based diagnosis into the daily routine work of a surgical pathologist requires a new setup of workflow arrangement and procedures. The quality of digitized images is sufficient for diagnostic purposes; however, the time needed for viewing virtual slides exceeds that of viewing original glass slides by far. The reason lies in a slower and more difficult sampling procedure, which is the selection of information containing fields of view. By application of artificial intelligence, tissue--based diagnosis in routine work can be managed automatically in steps as follows: 1. The individual image quality has to be measured, and corrected, if necessary. 2. A diagnostic algorithm has to be applied. An algorithm has be developed, that includes both object based (object features, structures) and pixel based (texture) measures. 3. These measures serve for diagnosis classification and feedback to order additional information, for example in virtual immunohistochemical slides. 4. The measures can serve for automated image classification and detection of relevant image information by themselves without any labeling. 5. The pathologists' duty will not be released by such a system; to the contrary, it will manage and supervise the system, i.e., just working at a "higher level". Virtual slides are already in use for teaching and continuous education in anatomy and pathology. First attempts to introduce them into routine work have been reported. Application of AI has been established by automated immunohistochemical measurement systems (EAMUS, www.diagnomX.eu). The performance of automated diagnosis has been reported for a broad variety of organs at sensitivity and specificity levels >85%). The implementation of a complete connected AI supported system is in its childhood. Application of AI in digital tissue--based diagnosis will allow the pathologists to work as supervisors and no longer as primary "water carriers". Its accurate use will give them the time needed to concentrating on difficult cases for the benefit of their patients.
Topics: Artificial Intelligence; Diagnosis, Computer-Assisted; Humans; Image Processing, Computer-Assisted; Immunohistochemistry; Pathology
PubMed: 20164018
DOI: 10.2478/v10042-009-0087-y -
Annales de Pathologie Apr 2004Descriptive statistics in the field of medicine are usually based on univariate analysis. However, a multivariate descriptive analysis can often be usefull to jointly... (Review)
Review
Descriptive statistics in the field of medicine are usually based on univariate analysis. However, a multivariate descriptive analysis can often be usefull to jointly describe all variables considered for study. This multivariate description is difficult to perform and visualize for more than three variables at a time. Multiple correspondence analysis (MCA) provides a means of performing multivariate description of categorical data. The method consists in projecting the data of an n-dimensional space which is constituted by the variables under study onto a succession of two-dimensional planes. The relationships between variables can then be deduced from the relative positions of the modalities of the variables on the planes. At the same time, numerical indices are used in parallel to specify and validate the observed relationships. The use of MCA is illustrated with a prospective series of renal carcinomas for which different histological characteristics are given. The main applications of MCA are detailed with comments on practical implementation.
Topics: Carcinoma, Renal Cell; Humans; Image Processing, Computer-Assisted; Kidney Neoplasms; Multivariate Analysis; Neoplasm Staging; Pathology
PubMed: 15220834
DOI: 10.1016/s0242-6498(04)93938-7 -
Current Opinion in Oncology May 2021Pathology is the cornerstone of cancer care. Pathomics, which represents the use of artificial intelligence in digital pathology, is an emerging and promising field that... (Review)
Review
PURPOSE OF REVIEW
Pathology is the cornerstone of cancer care. Pathomics, which represents the use of artificial intelligence in digital pathology, is an emerging and promising field that will revolutionize medical and surgical pathology in the coming years. This review provides an overview of pathomics, its current and future applications and its most relevant applications in Head and Neck cancer care.
RECENT FINDINGS
The number of studies investigating the use of artificial intelligence in pathology is rapidly growing, especially as the utilization of deep learning has shown great potential with Whole Slide Images. Even though numerous steps still remain before its clinical use, Pathomics has been used for varied applications comprising of computer-assisted diagnosis, molecular anomalies prediction, tumor microenvironment and biomarker identification as well as prognosis evaluation. The majority of studies were performed on the most frequent cancers, notably breast, prostate, and lung. Interesting results were also found in Head and Neck cancers.
SUMMARY
Even if its use in Head and Neck cancer care is still low, Pathomics is a powerful tool to improve diagnosis, identify prognostic factors and new biomarkers. Important challenges lie ahead before its use in a clinical practice, notably the lack of information on how AI makes its decisions, the slow deployment of digital pathology, and the need for extensively validated data in order to obtain authorities approval. Regardless, pathomics will most likely improve pathology in general, including Head and Neck cancer care in the coming years.
Topics: Artificial Intelligence; Biomarkers, Tumor; Head and Neck Neoplasms; Humans; Image Processing, Computer-Assisted; Pathology; Tumor Microenvironment
PubMed: 33782358
DOI: 10.1097/CCO.0000000000000731 -
Legal Medicine (Tokyo, Japan) Sep 2022Forensic pathologists often encounter autopsies that require an assessment of antemortem general conditions (e.g., infection, metabolic disorders). To establish...
Forensic pathologists often encounter autopsies that require an assessment of antemortem general conditions (e.g., infection, metabolic disorders). To establish evaluation clues for such cases, we quantitatively examined macrophages and the general pathology of bone marrow in samples from 180 forensic autopsy cases of decedents with various conditions. Hematoxylin-eosin staining, Berlin blue staining, and immunostainings for CD163, CD138, and CD61 were performed. We determined the numbers per field (density) of total macrophages, swollen macrophages, macrophages with hemophagocytosis, and hemosiderin-laden macrophages. Each density was standardized by identifying its ratio to the total number of macrophages. The decedents' background data (cause of death, other pathological findings, postmortem interval, antemortem symptoms, and presence of resuscitation) were extracted. No correlations were found between the postmortem interval and the other decedent data, indicating that these data are not affected by postmortem changes. In the group in which inflammatory disease was the cause of death, there were significant elevations in the ratio of the swollen macrophage density to total macrophages. Significantly higher ratios of the density of swollen and hemophagocytic macrophages were observed in the group in which conditions with a prolonged agonal period were the cause of death. The group with a return of spontaneous circulation to resuscitation showed a significantly higher ratio of macrophage density with hemophagocytosis. This study provides the first statistical analysis focused on bone marrow histopathology in forensic autopsies. The results will be useful for elucidating causes of death and agonal-period conditions.
Topics: Autopsy; Bone Marrow; Forensic Pathology; Humans; Macrophages; Postmortem Changes
PubMed: 35490477
DOI: 10.1016/j.legalmed.2022.102079 -
Annual International Conference of the... Jul 2023In dealing with the lack of sufficient annotated data and in contrast to supervised learning, unsupervised, self-supervised, and semi-supervised domain adaptation...
In dealing with the lack of sufficient annotated data and in contrast to supervised learning, unsupervised, self-supervised, and semi-supervised domain adaptation methods are promising approaches, enabling us to transfer knowledge from rich labeled source domains to different (but related) unlabeled target domains, reducing distribution discrepancy between the source and target domains. However, most existing domain adaptation methods do not consider the imbalanced nature of the real-world data, affecting their performance in practice. We propose to overcome this limitation by proposing a novel domain adaptation approach that includes two modifications to the existing models. Firstly, we leverage the focal loss function in response to class-imbalanced labeled data in the source domain. Secondly, we introduce a novel co-training approach to involve pseudo-labeled target data points in the training process. Experiments show that the proposed model can be effective in transferring knowledge from source to target domain. As an example, we use the classification of prostate cancer images into low-cancerous and high-cancerous regions.
Topics: Humans; Male; Prostatic Neoplasms; Pathology; Image Interpretation, Computer-Assisted
PubMed: 38083470
DOI: 10.1109/EMBC40787.2023.10340049 -
Advances in Anatomic Pathology Nov 2020Artificial intelligence (AI) is having an increasing impact on the field of pathology, as computation techniques allow computers to perform tasks previously performed by... (Review)
Review
Artificial intelligence (AI) is having an increasing impact on the field of pathology, as computation techniques allow computers to perform tasks previously performed by people. Here, we offer a simple and practical guide to AI methods used in pathology, such as digital image analysis, next-generation sequencing, and natural language processing. We not only provide a comprehensive review, but also discuss relevant history and future directions of AI in pathology. We additionally provide a short tabular dictionary of AI terminology which will help practicing pathologists and researchers to understand this field.
Topics: Artificial Intelligence; High-Throughput Nucleotide Sequencing; Humans; Machine Learning; Pathology
PubMed: 32773432
DOI: 10.1097/PAP.0000000000000277 -
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 -
American Journal of Clinical Pathology Apr 2021The ongoing global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic necessitates adaptations in the practice of surgical pathology at scale. Primary...
OBJECTIVES
The ongoing global severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic necessitates adaptations in the practice of surgical pathology at scale. Primary diagnosis by whole-slide imaging (WSI) is a key component that would aid departments in providing uninterrupted histopathology diagnosis and maintaining revenue streams from disruption. We sought to perform rapid validation of the use of WSI in primary diagnosis meeting recommendations of the College of American Pathologists guidelines.
METHODS
Glass slides from clinically reported cases from 5 participating pathologists with a preset washout period were digitally scanned and reviewed in settings identical to typical reporting. Cases were classified as concordant or with minor or major disagreement with the original diagnosis. Randomized subsampling was performed, and mean concordance rates were calculated.
RESULTS
In total, 171 cases were included and distributed equally among participants. For the group as a whole, the mean concordance rate in sampled cases (n = 90) was 83.6% counting all discrepancies and 94.6% counting only major disagreements. The mean pathologist concordance rate in sampled cases (n = 18) ranged from 90.49% to 97%.
CONCLUSIONS
We describe a novel double-blinded method for rapid validation of WSI for primary diagnosis. Our findings highlight the occurrence of a range of diagnostic reproducibility when deploying digital methods.
Topics: COVID-19; Double-Blind Method; Humans; Image Interpretation, Computer-Assisted; Observer Variation; Pandemics; Pathology, Surgical; Practice Guidelines as Topic; Reproducibility of Results; Retrospective Studies; Telepathology
PubMed: 33511392
DOI: 10.1093/ajcp/aqaa280