title: Image quality issues in a static image-based telepathology consultation practice.
abstract: Field selection and image quality have often been identified as impediments in the successful employment of static-image telepathology. One thousand seven hundred fifty-three electronic consultations using static images were performed at the Department of Telemedicine, Armed Forces Institute of Pathology (AFIP) between November 1994 and September 2001, with 98.3% receiving a telepathology diagnosis. In 47.9% of cases, imagery was considered good by AFIP consultants, 38.5% were considered adequate, and 14.6% of cases were considered to have poor-quality imagery. Deficiencies in image quality were recorded for each case. Cases with imagery rated as good averaged significantly fewer deficiencies per case (0.45, range: 0 to 3) than cases with imagery rated adequate (0.95, range: 0 to 6) or poor (2.4, range: 0 to 7). Deficiencies in focus were most commonly identified in this series of cases (28.1%), followed by improper white balancing of the capture device (14.1%) and inadequate resolution (10%). Cases in which images were of inadequate resolution showed an increased likelihood for discordance between the telepathology diagnosis and the diagnosis rendered on follow-up material ("truth diagnosis"). Inadequate field selection, although only cited in 6.7% of cases overall, was seen with a significantly higher frequency in cases in which there was discordance between the telepathology and truth diagnosis. A review of common image deficiencies in static-image telepathology and possible causes is presented.
authors.affiliation: Department of Telepathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA.
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Williams
authors.forename: In Soon
authors.initials: IS
authors.lastname: Hong
authors.forename: Florabel G
authors.initials: FG
authors.lastname: Mullick
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Butler
authors.forename: Roderick F
authors.initials: RF
authors.lastname: Herring
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: O'Leary
mesh_terms: D003951:Diagnostic Errors; D006801:Humans; D010338:Pathology, Clinical / Q000592:standards; D011786:Quality Control; D019114:Remote Consultation / Q000592:standards; D015203:Reproducibility of Results; D019113:Telepathology / Q000592:standards