title: Feasibility and diagnostic agreement in teledermatopathology using a virtual slide system.
abstract: We investigated the feasibility and diagnostic agreement of a virtual slide system (VSS) in teledermatopathology. Forty-six biopsy specimens from inflammatory skin diseases were selected and scanned with a VSS at the Research Unit of Teledermatology, Medical University of Graz, Graz, Austria. Images were stored on a virtual slide server on which a specific Web application suited for telepathology (http://telederm.org/research/dermatopath/) runs. Twelve teleconsultants from 6 different countries reviewed the 46 cases, working directly on the Web application. Telediagnoses agreed with gold standard and conventional diagnosis with an average of 73% and 74%, respectively. Complete concordance among all teleconsultants with gold standard and conventional diagnosis was found in 20% of the cases. In 10 cases in which complete clinical data were missing, the average agreement of telediagnosis with gold standard diagnosis and conventional diagnosis decreased to 65% and 66%, respectively. Only 3 of 4 cases of inflammatory skin diseases were correctly diagnosed remotely with VSS. The system that we have used, despite its usability, is not completely feasible for teledermatopathology of inflammatory skin disease. Moreover, the performance seems to have been influenced by the availability of complete clinical data and by the intrinsic difficulty of the pathology of inflammatory skin diseases.
authors.affiliation: Department of Dermatology, Medical University of Graz, A-8036 Graz, Austria.
authors.forename: Cesare
authors.initials: C
authors.lastname: Massone
authors.forename: H Peter
authors.initials: HP
authors.lastname: Soyer
authors.forename: Gian Piero
authors.initials: GP
authors.lastname: Lozzi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Di Stefani
authors.forename: Bernd
authors.initials: B
authors.lastname: Leinweber
authors.forename: Gerald
authors.initials: G
authors.lastname: Gabler
authors.forename: Masoud
authors.initials: M
authors.lastname: Asgari
authors.forename: Renata
authors.initials: R
authors.lastname: Boldrini
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bugatti
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Canzonieri
authors.forename: Gerardo
authors.initials: G
authors.lastname: Ferrara
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kodama
authors.forename: Darius
authors.initials: D
authors.lastname: Mehregan
authors.forename: Franco
authors.initials: F
authors.lastname: Rongioletti
authors.forename: Shahbaz A
authors.initials: SA
authors.lastname: Janjua
authors.forename: Vahid
authors.initials: V
authors.lastname: Mashayekhi
authors.forename: Ismini
authors.initials: I
authors.lastname: Vassilaki
authors.forename: Bernhard
authors.initials: B
authors.lastname: Zelger
authors.forename: Borut
authors.initials: B
authors.lastname: Zgavec
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cerroni
authors.forename: Helmut
authors.initials: H
authors.lastname: Kerl
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000379:methods; D002648:Child; D003880:Dermatology / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012871:Skin Diseases / Q000175:diagnosis / Q000473:pathology*; D019113:Telepathology / Q000379:methods* / Q000592:standards*; D014584:User-Computer Interface