Evaluation of a smartphone for telepathology: Lessons learned

Background: Mobile networks and smartphones are growing in developing countries. Expert telemedicine consultation will become more convenient and feasible. We wanted to report on our experience in using a smartphone and a 3-D printed adapter for capturing microscopic images. Methods: Images and vide...

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Main Authors: Paul Fontelo, Fang Liu, Yukako Yagi
Format: Article
Language:English
Published: Elsevier 2015-01-01
Series:Journal of Pathology Informatics
Subjects:
Online Access:http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2015;volume=6;issue=1;spage=35;epage=35;aulast=Fontelo
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author Paul Fontelo
Fang Liu
Yukako Yagi
author_facet Paul Fontelo
Fang Liu
Yukako Yagi
author_sort Paul Fontelo
collection DOAJ
description Background: Mobile networks and smartphones are growing in developing countries. Expert telemedicine consultation will become more convenient and feasible. We wanted to report on our experience in using a smartphone and a 3-D printed adapter for capturing microscopic images. Methods: Images and videos from a gastrointestinal biopsy teaching set of referred cases from the AFIP were captured with an iPhone 5 smartphone fitted with a 3-D printed adapter. Nine pathologists worldwide evaluated the images for quality, adequacy for telepathology consultation, and confidence rendering a diagnosis based on the images viewed on the web. Results: Average Likert scales (ordinal data) for image quality (1=poor, 5=diagnostic) and adequacy for diagnosis (1=No, 5=Yes) had modes of 3 and 4, respectively. Adding a video overview of the specimen improved diagnostic confidence. The mode of confidence in diagnosis based on the images reviewed was four. In 31 instances, reviewers′ diagnoses completely agreed with AFIP diagnosis, with partial agreement in 9 and major disagreement in 5. There was strong correlation between image quality and confidence (r = 0.78), image quality and adequacy of image (r = 0.73) and whether images were found adequate when reviewers were confident (r = 0.72). Intraclass Correlation for measuring reliability among the four reviewers who finished a majority of cases was high (quality=0.83, adequacy= 0.76 and confidence=0.92). Conclusions: Smartphones allow pathologists and other image dependent disciplines in low resource areas to transmit consultations to experts anywhere in the world. Improvements in camera resolution and training may mitigate some limitations found in this study.
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spelling doaj.art-7d854a1d947c48a6878a3114d44f44f32022-12-22T02:34:35ZengElsevierJournal of Pathology Informatics2153-35392015-01-0161353510.4103/2153-3539.158912Evaluation of a smartphone for telepathology: Lessons learnedPaul FonteloFang LiuYukako YagiBackground: Mobile networks and smartphones are growing in developing countries. Expert telemedicine consultation will become more convenient and feasible. We wanted to report on our experience in using a smartphone and a 3-D printed adapter for capturing microscopic images. Methods: Images and videos from a gastrointestinal biopsy teaching set of referred cases from the AFIP were captured with an iPhone 5 smartphone fitted with a 3-D printed adapter. Nine pathologists worldwide evaluated the images for quality, adequacy for telepathology consultation, and confidence rendering a diagnosis based on the images viewed on the web. Results: Average Likert scales (ordinal data) for image quality (1=poor, 5=diagnostic) and adequacy for diagnosis (1=No, 5=Yes) had modes of 3 and 4, respectively. Adding a video overview of the specimen improved diagnostic confidence. The mode of confidence in diagnosis based on the images reviewed was four. In 31 instances, reviewers′ diagnoses completely agreed with AFIP diagnosis, with partial agreement in 9 and major disagreement in 5. There was strong correlation between image quality and confidence (r = 0.78), image quality and adequacy of image (r = 0.73) and whether images were found adequate when reviewers were confident (r = 0.72). Intraclass Correlation for measuring reliability among the four reviewers who finished a majority of cases was high (quality=0.83, adequacy= 0.76 and confidence=0.92). Conclusions: Smartphones allow pathologists and other image dependent disciplines in low resource areas to transmit consultations to experts anywhere in the world. Improvements in camera resolution and training may mitigate some limitations found in this study.http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2015;volume=6;issue=1;spage=35;epage=35;aulast=FonteloDigital pathology, image quality, telepathology, telemedicine, 3-D printer
spellingShingle Paul Fontelo
Fang Liu
Yukako Yagi
Evaluation of a smartphone for telepathology: Lessons learned
Journal of Pathology Informatics
Digital pathology, image quality, telepathology, telemedicine, 3-D printer
title Evaluation of a smartphone for telepathology: Lessons learned
title_full Evaluation of a smartphone for telepathology: Lessons learned
title_fullStr Evaluation of a smartphone for telepathology: Lessons learned
title_full_unstemmed Evaluation of a smartphone for telepathology: Lessons learned
title_short Evaluation of a smartphone for telepathology: Lessons learned
title_sort evaluation of a smartphone for telepathology lessons learned
topic Digital pathology, image quality, telepathology, telemedicine, 3-D printer
url http://www.jpathinformatics.org/article.asp?issn=2153-3539;year=2015;volume=6;issue=1;spage=35;epage=35;aulast=Fontelo
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AT yukakoyagi evaluationofasmartphonefortelepathologylessonslearned