title: Digitized whole slides for breast pathology interpretation: current practices and perceptions.
abstract: Digital whole slide imaging (WSI) is an emerging technology for pathology interpretation; however, little is known about pathologists' practice patterns or perceptions regarding WSI. A national sample (N = 252) of pathologists from New Hampshire, Vermont, Washington, Oregon, Arizona, Alaska, Maine, and Minnesota were surveyed in this cross-sectional study (2011-2013). The survey included questions on pathologists' experience, WSI practice patterns, and perceptions using a six-point Likert scale. Agreement was summarized with descriptive statistics to characterize pathologists' use and perceptions of WSI. The majority of participating pathologists were males (63%) between 40 and 59 years of age (70%) and not affiliated with an academic medical center (72%). Experience with WSI was reported by 49%. Types of use reported included CME/board exams/teaching (28%), tumor board/clinical conference (22%), archival purposes (6%), consultative diagnosis (4%), research (4%), and other uses (12%). Most respondents (79%) agreed that accurate diagnoses can be made with this technology, and that WSI is useful for obtaining a second opinion (88%). However, 78% of pathologists agreed that digital slides are too slow for routine clinical interpretation. Fifty-nine percent agreed that the benefits of WSI outweigh concerns. The respondents were equally split as to whether they would like to adopt WSI (51%) or not (49%). About half of pathologists reported experience with the WSI technology, largely for CME, licensure/board exams, and teaching. Positive perceptions regarding WSI slightly outweigh negative perceptions. Understanding practice patterns with WSI as dissemination advances may facilitate concordance of perceptions with adoption of the technology.
authors.affiliation: Department of Community & Family Medicine, Norris Cotton Cancer Center, and The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, HB 7927 Rubin 8-DHMC, One Medical Center Dr., Lebanon, NH, 03756, USA, Tracy.L.Onega@dartmouth.edu.
authors.forename: Tracy
authors.initials: T
authors.lastname: Onega
authors.forename: Donald
authors.initials: D
authors.lastname: Weaver
authors.forename: Berta
authors.initials: B
authors.lastname: Geller
authors.forename: Natalia
authors.initials: N
authors.lastname: Oster
authors.forename: Anna N A
authors.initials: AN
authors.lastname: Tosteson
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Carney
authors.forename: Heidi
authors.initials: H
authors.lastname: Nelson
authors.forename: Kimberly H
authors.initials: KH
authors.lastname: Allison
authors.forename: Frances P
authors.initials: FP
authors.lastname: O'Malley
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Schnitt
authors.forename: Joann G
authors.initials: JG
authors.lastname: Elmore
mesh_terms: D000328:Adult; D017677:Age Distribution; D001291:Attitude of Health Personnel; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis*; D002983:Clinical Competence / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008853:Microscopy / Q000295:instrumentation / Q000379:methods*; D008875:Middle Aged; D010338:Pathology, Clinical / Q000379:methods; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States; D014584:User-Computer Interface