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Archives of Pathology & Laboratory... Apr 2019
Topics: Humans; Medical Overuse; Pathologists; Radiologists; Thyroid Neoplasms
PubMed: 30920863
DOI: 10.5858/arpa.2018-0512-LE -
Cancer Cytopathology Jun 2018
Topics: Humans; Paris; Pathologists
PubMed: 29757490
DOI: 10.1002/cncy.22007 -
Arquivos de Gastroenterologia 2023•Diagnosis of microscopic colitis necessitates effective communication among gastroenterologists, endoscopists, and pathologists. •The gastroenterologist should...
•Diagnosis of microscopic colitis necessitates effective communication among gastroenterologists, endoscopists, and pathologists. •The gastroenterologist should refer every patient with chronic watery diarrhea to perform a colonoscopy in spite of the benign course of the disease and the absence of alarm symptoms. •The endoscopist should take 2 or 3 biopsy samples of the colonic mucosa from the right and left colon, put in separate recipients, despite that the mucosa looked macroscopically normal. •The pathologist should be encouraged to use objective histological criteria to make the diagnosis. Microscopic colitis is a chronic inflammatory bowel disease characterized by non-bloody diarrhea that can range from mild to severe. It is difficult to attribute up to 10-20% of chronic diarrhea to microscopic colitis. The three determinants factors of the diagnosis are characteristic clinical symptoms, normal endoscopic picture of the colon, and pathognomonic histological picture. This manuscript aimed to update considerations and recommendations for professionals involved (gastroenterologist, endoscopists and pathologist) in the diagnosis of MC. In addition, a short recommendation about treatment.
Topics: Humans; Gastroenterologists; Pathologists; Biopsy; Colitis, Microscopic; Colon; Colonoscopy; Diarrhea; Colitis
PubMed: 37556744
DOI: 10.1590/S0004-2803.20230222-143 -
Archives of Pathology & Laboratory... Mar 2019
Topics: Humans; Pathologists; Pathology; Social Media
PubMed: 30816833
DOI: 10.5858/arpa.2018-0431-ED -
Pathology, Research and Practice Nov 2020During the COVID-19 pandemic, many deaths occurred especially among the old patients with cardiovascular comorbidities. Many questions have been asked and few simple... (Review)
Review
During the COVID-19 pandemic, many deaths occurred especially among the old patients with cardiovascular comorbidities. Many questions have been asked and few simple answers have been given. The autopsy data are few and the aspects often observed are pulmonary diffuse alveolar damage (DAD), myocarditis, acute myocardial infarction (AMI), and disseminated intravascular coagulation (DIC); these aspects are not only in COVID-19 but also in other viral infections and in sepsis. It should be considered that coronavirus with its pathological organ changes have already been described in the years preceding the pandemic.
Topics: Autopsy; Betacoronavirus; COVID-19; Coronavirus Infections; Humans; Lung; Myocarditis; Pandemics; Pathologists; Pneumonia, Viral; SARS-CoV-2
PubMed: 32890939
DOI: 10.1016/j.prp.2020.153195 -
Veterinary Pathology Jan 2022Digital microscopy (DM) is increasingly replacing traditional light microscopy (LM) for performing routine diagnostic and research work in human and veterinary... (Review)
Review
Digital microscopy (DM) is increasingly replacing traditional light microscopy (LM) for performing routine diagnostic and research work in human and veterinary pathology. The DM workflow encompasses specimen preparation, whole-slide image acquisition, slide retrieval, and the workstation, each of which has the potential (depending on the technical parameters) to introduce limitations and artifacts into microscopic examination by pathologists. Performing validation studies according to guidelines established in human pathology ensures that the best-practice approaches for patient care are not deteriorated by implementing DM. Whereas current publications on validation studies suggest an overall high reliability of DM, each laboratory is encouraged to perform an individual validation study to ensure that the DM workflow performs as expected in the respective clinical or research environment. With the exception of validation guidelines developed by the College of American Pathologists in 2013 and its update in 2021, there is no current review of the application of methods fundamental to validation. We highlight that there is high methodological variation between published validation studies, each having advantages and limitations. The diagnostic concordance rate between DM and LM is the most relevant outcome measure, which is influenced (regardless of the viewing modality used) by different sources of bias including complexity of the cases examined, diagnostic experience of the study pathologists, and case recall. Here, we review 3 general study designs used for previous publications on DM validation as well as different approaches for avoiding bias.
Topics: Animals; Humans; Microscopy; Pathologists; Pathology, Veterinary; Reproducibility of Results; Specimen Handling
PubMed: 34433345
DOI: 10.1177/03009858211040476 -
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 -
The Journal of Pathology Jul 2022The role of pathology in patient management has evolved over time from the retrospective review of cells, tissue, and disease ('what happened') to a prospective outlook... (Review)
Review
The role of pathology in patient management has evolved over time from the retrospective review of cells, tissue, and disease ('what happened') to a prospective outlook ('what will happen'). Examination of a static, two-dimensional hematoxylin and eosin (H&E)-stained tissue slide has traditionally been the pathologist's primary task, but novel ancillary techniques enabled by technological breakthroughs have supported pathologists in their increasing ability to predict disease status and behaviour. Nevertheless, the informational limits of 2D, fixed tissue are now being reached and technological innovation is urgently needed to ensure that our understanding of disease entities continues to support improved individualized treatment options. Here we review pioneering work currently underway in the field of cancer pathology that has the potential to capture information beyond the current basic snapshot. A selection of exciting new technologies is discussed that promise to facilitate integration of the functional and multidimensional (space and time) information needed to optimize the prognostic and predictive value of cancer pathology. Learning how to analyse, interpret, and apply the wealth of data acquired by these new approaches will challenge the knowledge and skills of the pathology community. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
Topics: Humans; Neoplasms; Pathologists; Prognosis; Prospective Studies; United Kingdom
PubMed: 35438188
DOI: 10.1002/path.5915 -
Turk Patoloji Dergisi 2021Job satisfaction affects productivity and professional performance in many aspects; however, there is limited data regarding pathologists' job satisfaction. Hence, in...
OBJECTIVE
Job satisfaction affects productivity and professional performance in many aspects; however, there is limited data regarding pathologists' job satisfaction. Hence, in this study, we aimed to evaluate surgical pathologists' job satisfaction in Turkey.
MATERIALS AND METHODS
We conducted a 59-item web-based survey questioning respondents' institutional background, history of training, continuing education status/research activities, physical conditions, professional well-being, and job satisfaction level. Likert-type and open/ close ended questions were asked and scored. The participants were also asked to complete the Minnesota Satisfaction Questionnaire-Short Form.
RESULTS
Of the 321 respondents, 75% were female, the median age was 41 years (range 28-71 years), experience as a pathologist ranged between 0.12 and 44 years (mean 11.4±9.16 years). Academic pathologists, senior pathologists with ≥20 years of experience, and pathologists working at large institutions and living in developed cities expressed better physical conditions, higher satisfaction with working conditions and, therefore, higher overall job satisfaction (p < 0.05). 98% agreed that pathologists have a critical impact on patient management; however, the majority ( > 80%) thought that patients barely know what pathologists do and other physicians rarely understand the difficulty and limitations in pathology practice. 82% were happy to have chosen pathology but 45% reported to experience the feeling of being "burnt out".
CONCLUSIONS
Our findings suggest that younger pathologists are less satisfied with their jobs and a surgical pathologist's job satisfaction increases with the physical and technical quality of the pathology laboratory/institution, and years of experience. Pathologists seem to be aware of their important role in patient management although they think that pathology remains "invisible" to many physicians and patients.
Topics: Adult; Age Factors; Aged; Attitude of Health Personnel; Female; Humans; Job Satisfaction; Male; Middle Aged; Pathologists; Professional Role; Surveys and Questionnaires; Turkey
PubMed: 33372264
DOI: 10.5146/tjpath.2020.01513 -
BMJ Open Oct 2022We aimed to assess the learning curves and the influence of the pathologist's performance on the endobronchial ultrasound transbronchial needle aspiration's...
Learning curves and association of pathologist's performance with the diagnostic accuracy of linear endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA): a cohort study in a tertiary care reference centre.
OBJECTIVES
We aimed to assess the learning curves and the influence of the pathologist's performance on the endobronchial ultrasound transbronchial needle aspiration's (EBUS-TBNA's) diagnostic accuracy in a real-world study.
DESIGN/SETTING
Cohort study conducted in a tertiary care university hospital (single centre) with patients referred for EBUS-TBNA.
PARTICIPANTS/INTERVENTION
We initially evaluated 376 patients (673 lymph nodes), 368 (660 lymph nodes) of whom were recruited. The inclusion criterion was EBUS-TBNA indicated for the study of mediastinal or hilar lesions. The exclusion criteria were the absence of mediastinal and hilar lesions during EBUS confirmed by a normal mediastinum and hilum on chest CT (except in cases of mediastinal staging of cancer) and lost to follow-up.
PRIMARY AND SECONDARY OUTCOME MEASURES
Diagnostic accuracy and related outcomes.
METHODS
We included patients from a prospectively constructed database. We performed a logistic regression multivariate analysis to adjust for potential confounders of the association between pathologist performance and EBUS-TBNA accuracy. The Cumulative Summation (CUSUM) analysis was used to assess pathologists' performance and learning curves.
RESULTS
Most indications for EBUS were suspicion of malignancy, including intrathoracic tumours (68.3%), extrathoracic tumours (9.8%) and cancer staging (7.0%). The patients' mean age was 63.7 years, and 71.5% were male. Overall EBUS-TBNA accuracy was 80.8%. In the multivariate logistic regression model, the factors independently associated with EBUS-TBNA accuracy included certain pathologists (ORs ranging from 0.16 to 0.41; p<0.017), a lymph node short-axis diameter <1 cm (OR: 0.36; 95% CI 0.21 to 0.62; p<0.001), and the aetiology of lymph node enlargement (ORs ranging from 7 to 37; p<0.001). CUSUM analysis revealed four different learning curve patterns, ranging from almost immediate learning to a prolonged learning phase, as well as a pattern consistent with performance attrition.
CONCLUSIONS
Pathologists' proficiency conditioned EBUS-TBNA accuracy. This human factor is a potential source of error independent of factors conditioning tissue sample adequacy.
Topics: Female; Humans; Male; Middle Aged; Bronchoscopy; Cohort Studies; Learning Curve; Neoplasms; Pathologists; Tertiary Healthcare
PubMed: 36261243
DOI: 10.1136/bmjopen-2021-051257