title: Use of Digital Whole Slide Imaging in Dermatopathology.
abstract: Digital whole slide imaging (WSI) is an emerging technology for pathology interpretation, with specific challenges for dermatopathology, yet little is known about pathologists' practice patterns or perceptions regarding WSI for interpretation of melanocytic lesions. A national sample of pathologists (N = 207) was recruited from 864 invited pathologists from ten US states (CA, CT, HI, IA, KY, LA, NJ, NM, UT, and WA). Pathologists who had interpreted melanocytic lesions in the past year were surveyed in this cross-sectional study. The survey included questions on pathologists' experience, WSI practice patterns and perceptions using a 6-point Likert scale. Agreement was summarized with descriptive statistics to characterize pathologists' use and perceptions of WSI. The majority of participating pathologists were between 40 and 59 years of age (62%) and not affiliated with an academic medical center (71%). Use of WSI was seen more often among dermatopathologists and participants affiliated with an academic medical center. Experience with WSI was reported by 41%, with the most common type of use being for education and testing (CME, board exams, and teaching in general, 71%), and clinical use at tumor boards and conferences (44%). Most respondents (77%) agreed that accurate diagnoses can be made with this technology, and 59% agreed that benefits of WSI outweigh concerns. However, 78% of pathologists reported that digital slides are too slow for routine clinical interpretation. The respondents were equally split as to whether they would like to adopt WSI (49%) or not (51%). The majority of pathologists who interpret melanocytic lesions do not use WSI, but among pathologists who do, use is 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 Biomedical Data Science, Department of Epidemiology, Norris Cotton Cancer Center, Lebanon, NH, USA. Tracy.L.Onega@dartmouth.edu.|Geisel School of Medicine at Dartmouth, The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, NH, USA. Tracy.L.Onega@dartmouth.edu.
authors.forename: Tracy
authors.initials: T
authors.lastname: Onega
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Reisch
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Frederick
authors.affiliation: Department of Family Medicine, University of Vermont Burlington, Burlington, VT, USA.
authors.forename: Berta M
authors.initials: BM
authors.lastname: Geller
authors.affiliation: Oregon Health & Sciences University, Portland, OR, USA.
authors.forename: Heidi D
authors.initials: HD
authors.lastname: Nelson
authors.affiliation: Yale University, New Haven, CT, USA.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Lott
authors.affiliation: University of Washington, Seattle, WA, USA.
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Radick
authors.affiliation: Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Elder
authors.affiliation: Department of Pathology, Institut Curie, Paris, France.|University of California, Los Angeles, CA, USA.
authors.forename: Raymond L
authors.initials: RL
authors.lastname: Barnhill
authors.affiliation: Division of Dermatology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.|Dermatopathology Northwest, Bellevue, WA, USA.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Piepkorn
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Joann G
authors.initials: JG
authors.lastname: Elmore
mesh_terms: D006801:Humans; D008527:Medulloblastoma / Q000000981:diagnostic imaging* / Q000473:pathology; D008853:Microscopy / Q000592:standards; D015588:Observer Variation; D010338:Pathology, Clinical / Q000379:methods*; D012867:Skin / Q000000981:diagnostic imaging / Q000473:pathology; D014584:User-Computer Interface
keywords: Dermatopathology; Digital whole slide imaging; Melanocytic lesions