Evaluation of the use of digital images for a national prostate core external quality assurance scheme.
OBJECTIVE
To evaluate the use of virtual images as an alternative to glass slides to expand the number of participants in the External Quality Assurance Scheme for prostatic biopsies.


RESULTS
Benign and neoplastic cases, previously circulated as glass slides, were selected to include cases that had demonstrated a high level of agreement (n = 10) and a lesser degree of agreement (n = 10). Whole slide virtual images were circulated to 68 pathologists; 51 responses were returned. The levels of agreement for the primary diagnosis and for Gleason grading of cancers were analysed using kappa statistics. Responses for glass slides versus images were compared for the 24 pathologists for whom data were available. Levels of agreement for diagnostic categories using virtual slides were moderate to substantial, comparable to those found using glass slides. The level of agreement for Gleason grades 8-10 was substantial, but for lower grades was fair or moderate, poorer than for the glass slide circulation.


CONCLUSIONS
Circulation of virtual images of biopsy material is a suitable alternative to glass slide-based schemes for the evaluation of diagnostic consistency. The majority of participants agreed that the ability to evaluate limited diagnostic material outweighed the disadvantages of a virtual system.
Histopathology, Leeds Teaching Hospitals NHS Trust, St James's University Hospital, Leeds, UK. Patricia.Harnden@leedsth.nhs.uk
Patricia
P
Harnden
Derek
D
Coleman
Sue
S
Moss
Sandhya
S
Kodikara
Nick R
NR
Griffin
Jane
J
Melia
D001706:Biopsy; D003952:Diagnostic Imaging / Q000379:methods; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008853:Microscopy; D015588:Observer Variation; D010338:Pathology, Clinical / Q000592:standards*; D011467:Prostate / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards; D019113:Telepathology / Q000379:methods; D014584:User-Computer Interface