title: Effect of image compression on telepathology. A randomized clinical trial.
abstract: BACKGROUND
  For practitioners deploying store-and-forward telepathology systems, optimization methods such as image compression need to be studied.
  
  
  OBJECTIVE
  To determine if Joint Photographic Expert Group (JPG or JPEG) compression, a glossy image compression algorithm, negatively affects the accuracy of diagnosis in telepathology.
  
  
  METHODS
  Double-blind, randomized, controlled trial.
  
  
  METHODS
  University-based pathology departments.
  
  
  METHODS
  Resident and staff pathologists at the University of Illinois, Chicago, and University of Cincinnati, Cincinnati, Ohio.
  
  
  METHODS
  Compression of raw images using the JPEG algorithm.
  
  
  METHODS
  Image acceptability, accuracy of diagnosis, confidence level of pathologist, image quality.
  
  
  RESULTS
  There was no statistically significant difference in the diagnostic accuracy between noncompressed (bit map) and compressed (JPG) images. There were also no differences in the acceptability, confidence level, and perception of image quality. Additionally, rater experience did not significantly correlate with degree of accuracy.
  
  
  CONCLUSIONS
  For providers practicing telepathology, JPG image compression does not negatively affect the accuracy and confidence level of diagnosis. The acceptability and quality of images were also not affected.
authors.affiliation: High Performance Computing and Communications, National Library of Medicine, Bethesda, MD 20894, USA.
authors.forename: A
authors.initials: A
authors.lastname: Marcelo
authors.forename: P
authors.initials: P
authors.lastname: Fontelo
authors.forename: M
authors.initials: M
authors.lastname: Farolan
authors.forename: H
authors.initials: H
authors.lastname: Cualing
mesh_terms: D003936:Diagnosis, Computer-Assisted / Q000592:standards; D004311:Double-Blind Method; D006801:Humans; D007091:Image Processing, Computer-Assisted; D015588:Observer Variation; D010336:Pathology / Q000592:standards; D015203:Reproducibility of Results; D019113:Telepathology