Lost in digitization – A systematic review about the diagnostic test accuracy of digital pathology solutions
Introduction: Digital pathology solutions are increasingly implemented for primary diagnostics in departments of pathology around the world. This has sparked a growing engagement on validation studies to evaluate the diagnostic performance of whole slide imaging (WSI) regarding safety, reliability,...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | Journal of Pathology Informatics |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2153353922007301 |
| _version_ | 1797976996256415744 |
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| author | Olsi Kusta Charlotte Vestrup Rift Torsten Risør Eric Santoni-Rugiu John Brandt Brodersen |
| author_facet | Olsi Kusta Charlotte Vestrup Rift Torsten Risør Eric Santoni-Rugiu John Brandt Brodersen |
| author_sort | Olsi Kusta |
| collection | DOAJ |
| description | Introduction: Digital pathology solutions are increasingly implemented for primary diagnostics in departments of pathology around the world. This has sparked a growing engagement on validation studies to evaluate the diagnostic performance of whole slide imaging (WSI) regarding safety, reliability, and accuracy. The aim of this review was to evaluate the performance of digital pathology for diagnostic purposes compared to light microscopy (LM) in human pathology, based on validation studies designed to assess such technologies. Methods: In this systematic review based on PRISMA guidelines, we analyzed validation studies of WSI compared with LM. We included studies of diagnostic performance of WSI regarding diagnostic test accuracy (DTA) indicators, degree of overdiagnosis, diagnostic concordance, and observer variability as a secondary outcome. Overdiagnosis is (for example) detecting a pathological condition that will either not progress or progress very slowly. Thus, the patient will never get symptoms from this condition and the pathological condition will never be the cause of death. From a search comprising four databases: PubMed, EMBASE, Cochrane Library, and Web of Science, encompassing the period 2010–2021, we selected and screened 12 peer-reviewed articles that fulfilled our selection criteria. Risk of bias was conducted through QUADAS-2 tool, and data analysis and synthesis were performed in a qualitative format. Results: We found that diagnostic performance of WSI was not inferior to LM for DTA indicators, concordance, and observer variability. The degree of overdiagnosis was not explicitly reported in any of the studies, while the term itself was used in one study and could be implicitly calculated in another. Conclusion: WSI had an overall high diagnostic accuracy based on traditional accuracy measurements; however, the degree of overdiagnosis is unknown. |
| first_indexed | 2024-04-11T04:59:56Z |
| format | Article |
| id | doaj.art-79faf609c44a470baec0161e6d5ff955 |
| institution | Directory Open Access Journal |
| issn | 2153-3539 |
| language | English |
| last_indexed | 2024-04-11T04:59:56Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pathology Informatics |
| spelling | doaj.art-79faf609c44a470baec0161e6d5ff9552022-12-26T04:08:56ZengElsevierJournal of Pathology Informatics2153-35392022-01-0113100136Lost in digitization – A systematic review about the diagnostic test accuracy of digital pathology solutionsOlsi Kusta0Charlotte Vestrup Rift1Torsten Risør2Eric Santoni-Rugiu3John Brandt Brodersen4Department of Public Health, University of Copenhagen, Øster Farimagsgade 5 opg. B, Building: 15-0-11, 1014 Copenhagen, Denmark; Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, Australia; Corresponding author.Department of Pathology, Rigshospitalet (Copenhagen University Hospital), Blegdamsvej 9, 2100 Copenhagen, DenmarkCentre for General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5 opg. Q, Building: 24-1, 1014 Copenhagen, Denmark; Norwegian Centre for E-health Research, UiT The Arctic University of Norway, Tromsø, NorwayDepartment of Pathology, Rigshospitalet (Copenhagen University Hospital), Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, DenmarkCentre for General Practice, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5 opg. Q, Building: 24-1-21, 1014 Copenhagen, Denmark; Primary Health Care Research Unit, Region Zealand, Øster Farimagsgade 5 opg. Q, Building: 24-1-21, 1014 Copenhagen, Denmark.Introduction: Digital pathology solutions are increasingly implemented for primary diagnostics in departments of pathology around the world. This has sparked a growing engagement on validation studies to evaluate the diagnostic performance of whole slide imaging (WSI) regarding safety, reliability, and accuracy. The aim of this review was to evaluate the performance of digital pathology for diagnostic purposes compared to light microscopy (LM) in human pathology, based on validation studies designed to assess such technologies. Methods: In this systematic review based on PRISMA guidelines, we analyzed validation studies of WSI compared with LM. We included studies of diagnostic performance of WSI regarding diagnostic test accuracy (DTA) indicators, degree of overdiagnosis, diagnostic concordance, and observer variability as a secondary outcome. Overdiagnosis is (for example) detecting a pathological condition that will either not progress or progress very slowly. Thus, the patient will never get symptoms from this condition and the pathological condition will never be the cause of death. From a search comprising four databases: PubMed, EMBASE, Cochrane Library, and Web of Science, encompassing the period 2010–2021, we selected and screened 12 peer-reviewed articles that fulfilled our selection criteria. Risk of bias was conducted through QUADAS-2 tool, and data analysis and synthesis were performed in a qualitative format. Results: We found that diagnostic performance of WSI was not inferior to LM for DTA indicators, concordance, and observer variability. The degree of overdiagnosis was not explicitly reported in any of the studies, while the term itself was used in one study and could be implicitly calculated in another. Conclusion: WSI had an overall high diagnostic accuracy based on traditional accuracy measurements; however, the degree of overdiagnosis is unknown.http://www.sciencedirect.com/science/article/pii/S2153353922007301Human pathologyWhole slide imaging (WSI)Validation studiesDiagnostic test accuracyDiagnostic concordanceOverdiagnosis |
| spellingShingle | Olsi Kusta Charlotte Vestrup Rift Torsten Risør Eric Santoni-Rugiu John Brandt Brodersen Lost in digitization – A systematic review about the diagnostic test accuracy of digital pathology solutions Journal of Pathology Informatics Human pathology Whole slide imaging (WSI) Validation studies Diagnostic test accuracy Diagnostic concordance Overdiagnosis |
| title | Lost in digitization – A systematic review about the diagnostic test accuracy of digital pathology solutions |
| title_full | Lost in digitization – A systematic review about the diagnostic test accuracy of digital pathology solutions |
| title_fullStr | Lost in digitization – A systematic review about the diagnostic test accuracy of digital pathology solutions |
| title_full_unstemmed | Lost in digitization – A systematic review about the diagnostic test accuracy of digital pathology solutions |
| title_short | Lost in digitization – A systematic review about the diagnostic test accuracy of digital pathology solutions |
| title_sort | lost in digitization a systematic review about the diagnostic test accuracy of digital pathology solutions |
| topic | Human pathology Whole slide imaging (WSI) Validation studies Diagnostic test accuracy Diagnostic concordance Overdiagnosis |
| url | http://www.sciencedirect.com/science/article/pii/S2153353922007301 |
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