ABSTRACT
Despite the increasing availability of digital slide viewing, and numerous advantages associated with its application, a lack of quality validation studies is amongst the reasons for poor uptake in routine practice. This study evaluated primary digital pathology reporting in the setting of routine subspecialist gastrointestinal pathology, commonplace in most tissue pathology laboratories and representing one of the highest volume specialties in most laboratories. Individual digital and glass slide diagnoses were compared amongst three pathologists reporting in a gastrointestinal subspecialty team, in a prospective series of 100 consecutive diagnostic cases from routine practice in a large teaching hospital laboratory. The study included a washout period of at least 6 months. Discordant diagnoses were classified, and the study evaluated against recent College of American Pathologists (CAP) recommendations for evaluating digital pathology systems for diagnostic use. The study design met all 12 of the CAP recommendations. The 100 study cases generated 300 pairs of diagnoses, comprising 100 glass slide diagnoses and 100 digital diagnoses from each of the three study pathologists. 286 of 300 pairs of diagnoses were concordant, representing intraobserver concordance of 95.3 %, broadly comparable to rates previously published in this field. In ten of the 14 discordant pairs, the glass slide diagnosis was favoured; in four cases, the digital diagnosis was favoured, but importantly, the 14 discordant intraobserver diagnoses were considered to be of minor clinical significance. Interobserver, or viewing modality independent, concordance was found in 94 of the total of 100 study cases, providing a comparable baseline discordance rate expected in any second viewing of pathology material. These overall results support the safe use of digital pathology in primary diagnostic reporting in this setting.
Subject(s)
Gastrointestinal Diseases/diagnosis , Microscopy/methods , Pathology, Clinical/methods , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Microscopy/trends , Middle Aged , Pathology, Clinical/trends , Reproducibility of Results , Young AdultABSTRACT
A better understanding of events triggering chronic myeloid leukemia progression is critical for optimized clinical management of chronic myeloid leukemia (CML). We sought to validate that increased expression of Musashi 2 (MSI2), a post-transcription regulator, is associated with progression and prognosis. Screening of 152 patients with CML showed that MSI2 was significantly decreased among patients with CML in chronic phase (CP) at diagnosis (p < 0.0001), but found no significant difference between the normal control group and treated patients with CML in CP. Moreover MSI2 was significantly increased (p < 0.0001) in patients with advance disease (AD) CML. Furthermore, our human hematopoietic cell line data imply that MSI2 and BCR-ABL1 mRNA expression are correlated. However, these data cast a doubt on earlier reports that MSI2 effects HES1 expression via NUMB-NOTCH signaling.
Subject(s)
Gene Expression Regulation, Leukemic , Hematopoietic Stem Cells/metabolism , Leukemia, Myeloid, Chronic-Phase/metabolism , Leukemia, Myeloid, Chronic-Phase/pathology , RNA-Binding Proteins/metabolism , Adolescent , Adult , Aged , Aged, 80 and over , Child , Disease Progression , Female , Follow-Up Studies , Fusion Proteins, bcr-abl/genetics , Hematopoietic Stem Cells/pathology , Humans , Immunoenzyme Techniques , Leukemia, Myeloid, Chronic-Phase/genetics , Leukemia, Myeloid, Chronic-Phase/mortality , Male , Middle Aged , Neoplasm Staging , Prognosis , RNA, Messenger/genetics , RNA-Binding Proteins/genetics , Real-Time Polymerase Chain Reaction , Retrospective Studies , Reverse Transcriptase Polymerase Chain Reaction , Signal Transduction , Survival Rate , Up-Regulation , Young AdultABSTRACT
Nursing and computer science students and faculty worked with the American Red Cross to investigate the potential for information technology to provide Red Cross disaster services nurses with improved access to accurate community resources in times of disaster. Funded by a national 3-year grant, this interdisciplinary partnership led to field testing of an information system to support local community disaster preparedness at seven Red Cross chapters across the United States. The field test results demonstrate the benefits of the technology and the value of interdisciplinary research. The work also created a sustainable learning and research model for the future. This article describes the collaborative model used in this interdisciplinary research and exemplifies the benefits to faculty and students of well-timed interdisciplinary and community collaboration.
Subject(s)
Cooperative Behavior , Faculty , Information Systems , Models, Nursing , Social Welfare , Disaster Planning , Education, Nursing , Medical Informatics , Red Cross , United StatesABSTRACT
A critical component of community-based disaster preparedness (CBDP) is a local resource database of suppliers providing physical, information and human resources for use in disaster response. Maintenance of such a database can become a collaborative responsibility among community-based non-governmental organisations (NGOs) and public and private community organisations. In addition to mobilising resources, this process raises awareness within the community and aids in assessing local knowledge and resources. This paper presents the results of a pilot study on implementing a community-based resource database through collaboration with local American Red Cross chapters and public and private community organisations. The design of the resource database is described. The resource database is accessible via the internet and offline using laptops and handheld Personal Digital Assistants. The study concludes that CBDP is strengthened through a combination of appropriate information technology and collaborative relationships between NGOs and community-based organisations.
