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Antonini P, Santonicco N, Pantanowitz L, Girolami I, Rizzo PC, Brunelli M, Bellevicine C, Vigliar E, Negri G, Troncone G, Fadda G, Parwani A, Marletta S, Eccher A. Relevance of the College of American Pathologists guideline for validating whole slide imaging for diagnostic purposes to cytopathology. Cytopathology 2023; 34:5-14. [PMID: 36082410 PMCID: PMC10087327 DOI: 10.1111/cyt.13178] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/17/2022] [Accepted: 08/31/2022] [Indexed: 12/14/2022]
Abstract
Whole slide imaging (WSI) allows pathologists to view virtual versions of slides on computer monitors. With increasing adoption of digital pathology, laboratories have begun to validate their WSI systems for diagnostic purposes according to reference guidelines. Among these the College of American Pathologists (CAP) guideline includes three strong recommendations (SRs) and nine good practice statements (GPSs). To date, the application of WSI to cytopathology has been beyond the scope of the CAP guideline due to limited evidence. Herein we systematically reviewed the published literature on WSI validation studies in cytology. A systematic search was carried out in PubMed-MEDLINE and Embase databases up to November 2021 to identify all publications regarding validation of WSI in cytology. Each article was reviewed to determine if SRs and/or GPSs recommended by the CAP guideline were adequately satisfied. Of 3963 retrieved articles, 25 were included. Only 4/25 studies (16%) satisfied all three SRs, with only one publication (1/25, 4%) fulfilling all three SRs and nine GPSs. Lack of a suitable validation dataset was the main missing SR (16/25, 64%) and less than a third of the studies reported intra-observer variability data (7/25, 28%). Whilst the CAP guideline for WSI validation in clinical practice helped the widespread adoption of digital pathology, more evidence is required to routinely employ WSI for diagnostic purposes in cytopathology practice. More dedicated validation studies satisfying all SRs and/or GPSs recommended by the CAP are needed to help expedite the use of WSI for primary diagnosis in cytopathology.
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Affiliation(s)
- Pietro Antonini
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Nicola Santonicco
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Liron Pantanowitz
- Department of Pathology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ilaria Girolami
- Department of Pathology, Provincial Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy
| | - Paola Chiara Rizzo
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Matteo Brunelli
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | | | - Elena Vigliar
- Public Health, University of Naples Federico II, Naples, Italy
| | - Giovanni Negri
- Department of Pathology, Provincial Hospital of Bolzano (SABES-ASDAA), Bolzano-Bozen, Italy
| | | | - Guido Fadda
- Section of Pathological Anatomy, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University Hospital G. Martino, University of Messina, Messina, Italy
| | - Anil Parwani
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Stefano Marletta
- Section of Pathology, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy
| | - Albino Eccher
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
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Sugiura-Nakazato M, Takase H, Nakazato T. A Functional Platform for Remote use of Electron Microscopes Using Web Conferencing Systems. Microscopy (Oxf) 2022; 71:242-244. [PMID: 35639614 DOI: 10.1093/jmicro/dfac026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/27/2022] [Accepted: 05/25/2022] [Indexed: 11/13/2022] Open
Abstract
In this study, we propose a useful system for remote sharing of transmission electron microscope (TEM) images by connecting three computers: a computer connected to a TEM, a computer distributing images, and a computer receiving images. Then, we confirmed the performance of three web conferencing systems, Microsoft Teams, Zoom, and Google Meet, to evaluate the usefulness of their remote use based on the clarity of images, smoothness of movement, and time lag in images on each computer in the system. A screen image can be captured using the following two methods: a virtual camera of a video distribution software that provided a good reaction speed to transfer images and the screen sharing by conference system software that could share high-quality images.
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Affiliation(s)
| | - Hiroshi Takase
- Core Laboratory, Nagoya City University Graduate School of Medical Sciences.,Department of Pathology and Molecular Diagnostics, Nagoya City University Graduate School of Medical Sciences
| | - Takeru Nakazato
- Database Center for Life Science (DBCLS), Joint Support-Center for Data Science Research, Research Organization of Information and Systems
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3
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Santonicco N, Marletta S, Pantanowitz L, Fadda G, Troncone G, Brunelli M, Ghimenton C, Antonini P, Paolino G, Girolami I, Eccher A. Impact of mobile devices on cancer diagnosis in cytology. Diagn Cytopathol 2021; 50:34-45. [PMID: 34677909 DOI: 10.1002/dc.24890] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND Digital pathology has widened pathologists' opportunities to examine both surgical and cytological samples. Recently, portable mobile devices like tablets and smartphones have been tested for application with digital technologies including static, dynamic, and more recently whole slide imaging. This study aimed to review the published literature on the impact of mobile devices on cancer diagnoses in cytology. This analysis focused on their diagnostic potential, technical details, critical issues and pitfalls, and economical aspects. METHODS A systematic search was carried out in the electronic databases Embase and PubMed. Studies dealing with the application of mobile devices for diagnosing cancer on cytological specimens were included. The quality of studies was assessed with the QUADAS-2 tool. The main themes addressed were the comparison of manual examination with light microscopy and the use of mobile tools for primary diagnosis. The technical features of different models of smartphones and tablets, software, and adapters were also studied in terms of feasibility and costs-analysis. RESULTS Of 2458 retrieved articles, 18 were included. Concordance with light microscopy was good and diagnostic performance comparable with an expert pathologist's diagnosis. The mobile devices studied differed, sometimes significantly, in terms of speed and cost. The utility was improved by employing specifically designed adapters. Image acquisition and transmission represent the main critical points in almost all studies. CONCLUSION The use of mobile devices demonstrated promising results regarding the digital evaluation of cytological samples. Widespread adoption even in underserved areas is anticipated following validation studies, technology improvements, and reduction in the costs.
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Affiliation(s)
- Nicola Santonicco
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - Stefano Marletta
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - Liron Pantanowitz
- Department of Pathology & Clinical Labs, University of Michigan, Ann Arbor, Michigan, USA
| | - Guido Fadda
- Department of Human Pathology of the Adulthood and of the Developing Age "Gaetano Barresi", University of Messina Faculty of Medicine and Surgery, Messina, Italy
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - Claudio Ghimenton
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
| | - Pietro Antonini
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - Gaetano Paolino
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, Verona, Italy
| | - Ilaria Girolami
- Division of Pathology, Central Hospital Bolzano, Bolzano, Italy
| | - Albino Eccher
- Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
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4
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Katare P, Gorthi SS. Recent technical advances in whole slide imaging instrumentation. J Microsc 2021; 284:103-117. [PMID: 34254690 DOI: 10.1111/jmi.13049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 11/28/2022]
Abstract
Microscopic observation of biological specimen smears is the mainstay of diagnostic pathology, as defined by the Digital Pathology Association. Though automated systems for this are commercially available, their bulky size and high cost renders them unusable for remote areas. The research community is investing much effort towards building equivalent but portable, low-cost systems. An overview of such research is presented here, including a comparative analysis of recent reports. This paper also reviews recently reported systems for automated staining and smear formation, including microfluidic devices; and optical and computational automated microscopy systems including smartphone-based devices. Image pre-processing and analysis methods for automated diagnosis are also briefly discussed. It concludes with a set of foreseeable research directions that could lead to affordable, integrated and accurate whole slide imaging systems.
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Affiliation(s)
- Prateek Katare
- Department of Instrumentation and Applied Physics, Indian Institute of Science, Bangalore, India
| | - Sai Siva Gorthi
- Department of Instrumentation and Applied Physics, Indian Institute of Science, Bangalore, India
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Tang HP, Cai D, Kong YQ, Ye H, Ma ZX, Lv HS, Tuo LR, Pan QJ, Liu ZH, Han X. Cervical cytology screening facilitated by an artificial intelligence microscope: A preliminary study. Cancer Cytopathol 2021; 129:693-700. [PMID: 33826796 DOI: 10.1002/cncy.22425] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/02/2021] [Accepted: 01/26/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cervical cytology screening is usually laborious with a heavy workload and poor diagnostic consistency. The authors have developed an artificial intelligence (AI) microscope that can provide onsite diagnostic assistance for cervical cytology screening in real time. METHODS A total of 2167 cervical cytology slides were selected from a cohort of 10,601 cases from Shenzhen Maternity and Child Healthcare Hospital, and the training data set consisted of 42,073 abnormal cervical epithelial cells. The recognition results of an AI technique were presented in a microscope eyepiece by an augmented reality technique. Potentially abnormal cells were highlighted with binary classification results in a 10× field of view (FOV) and with multiclassification results according to the Bethesda system in 20× and 40× FOVs. In addition, 486 slides were selected for the reader study to evaluate the performance of the AI microscope. RESULTS In the reader study, which compared manual reading with AI assistance, the sensitivities for the detection of low-grade squamous intraepithelial lesions and high-grade squamous intraepithelial lesions were significantly improved from 0.837 to 0.923 (P < .001) and from 0.830 to 0.917 (P < .01), respectively; the κ score for atypical squamous cells of undetermined significance (ASCUS) was improved from 0.581 to 0.637; the averaged pairwise κ of consistency for multiclassification was improved from 0.649 to 0.706; the averaged pairwise κ of consistency for binary classification was improved from 0.720 to 0.798; and the averaged pairwise κ of ASCUS was improved from 0.557 to 0.639. CONCLUSIONS The results of this study show that an AI microscope can provide real-time assistance for cervical cytology screening and improve the efficiency and accuracy of cervical cytology diagnosis.
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Affiliation(s)
- Hong-Ping Tang
- Department of Pathology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - De Cai
- AI Lab, Tencent, Shenzhen, China
| | - Yan-Qing Kong
- Department of Pathology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Hu Ye
- AI Lab, Tencent, Shenzhen, China
| | | | - Huai-Sheng Lv
- Department of Pathology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Lin-Rong Tuo
- Department of Pathology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Qin-Jing Pan
- Department of Pathology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China.,Department of Pathology, Cancer Institute and Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Zhi-Hua Liu
- Department of Gynecology, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Xiao Han
- AI Lab, Tencent, Shenzhen, China
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Abel JT, Ouillette P, Williams CL, Blau J, Cheng J, Yao K, Lee WY, Cornish TC, Balis UGJ, McClintock DS. Display Characteristics and Their Impact on Digital Pathology: A Current Review of Pathologists' Future "Microscope". J Pathol Inform 2020; 11:23. [PMID: 33042602 PMCID: PMC7518209 DOI: 10.4103/jpi.jpi_38_20] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/22/2020] [Accepted: 05/28/2020] [Indexed: 01/04/2023] Open
Abstract
Digital displays (monitors) are an indispensable component of a pathologists’ daily workflow, from writing reports, viewing whole-slide images, or browsing the Internet. Due to a paucity of literature and experience surrounding display use and standardization in pathology, the Food and Drug Administration's (FDA) has currently restricted FDA-cleared whole-slide imaging systems to a specific model of display for each system, which at this time consists of only medical-grade (MG) displays. Further, given that a pathologists’ display will essentially become their new surrogate “microscope,” it becomes exceedingly important that all pathologists have a basic understanding of fundamental display properties and their functional consequences. This review seeks to: (a) define and summarize the current and emerging display technology, terminology, features, and regulation as they pertain to pathologists and review the current literature on the impact of different display types (e.g. MG vs. consumer off the shelf vs. professional grade) on pathologists’ diagnostic performance and (b) discuss the impact of the recent digital pathology device componentization and the coronavirus disease 2019 public emergency on the pixel pathway and display use for remote digital pathology. Display technology has changed dramatically over the past 20 years and continues to change at a rapid rate. There is a paucity of published studies to date that investigate how display type affects pathologist performance, with more research necessary in order to develop standards and minimum specifications for displays in digital pathology. Given the complexity of modern displays, pathologists must become better informed regarding display technology if they wish to have more choice over their future “microscopes.”
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Affiliation(s)
- Jacob T Abel
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Peter Ouillette
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Christopher L Williams
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - John Blau
- Department of Pathology, University of Iowa, Iowa, USA
| | - Jerome Cheng
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Keluo Yao
- Departments of Pathology and Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Winston Y Lee
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Toby C Cornish
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA
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Patil SK, Nair MR, Manjunath AB, Mujib BRA. Evaluation and comparison between smartphone and photomicrography based whole slide imaging. J Family Med Prim Care 2020; 9:2319-2323. [PMID: 32754495 PMCID: PMC7380768 DOI: 10.4103/jfmpc.jfmpc_18_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/11/2020] [Accepted: 04/03/2020] [Indexed: 11/04/2022] Open
Abstract
Context In recent years, a new concept has emerged at the forefront of slide-based diagnosis and telepathology. This is the concept of whole slide imaging. This has very recently also been tried with smartphones using complex software for photo analysis and stitching. This study is aimed to evaluate and compare the use of Jenoptik photomicrograph camera and smartphone camera-based whole slide imaging (WSI) for various microscopic preparations and slides. The study also uses a commonly available IOS smartphone device, a commonly available phone to microscope attachment, and the most commonly used Adobe Photoshop software for all stitching purposes. Aim To evaluate and compare smartphone and photomicrography-based whole slide imaging. Subjects and Methods The study was conducted at the Department of Oral Pathology and Microbiology in Bapuji Dental College and Hospital, Davangere. The samples included in this study are 10 slides of routine hematoxylin and eosin stain slides and 10 ground section slides of teeth and bone samples. Continuous photographs of the entire slide were captured using an IOS device and a Jenoptik camera attached research microscope at 10× magnification. The photographs were stitched using Adobe Photoshop 2017 software to obtain a whole slide image. Then, two observers analyzed the whole slide image for a possible diagnosis and thus compared the efficiency of both the methods. Statistical Analysis Used The statistical Chi-square test and analysis of variance (ANOVA) H test were done using Statistical Package for the Social Sciences (SPSS) 2010 Software. Results Percentage of measure of agreement was 79.5%, 83.7% and 86.3%, 89.1% for the whole slide images taken in the smartphone and photomicrograph and analyzed by Observer 1 and Observer 2, respectively. Conclusions In this study, it can be seen that the WSI by research microscopes is better than that with a smartphone and a compound microscope but still both the methods are equally good and can be followed with accurate results.
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Affiliation(s)
- Shruthi K Patil
- Department of Oral Pathology and Microbiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Mukund R Nair
- Department of Oral Pathology and Microbiology, Coorg Institute of Dental Sciences, Virajpet, Karnataka, India
| | - A B Manjunath
- Department of Oral Pathology and Microbiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - B R Ahmed Mujib
- Department of Oral Pathology and Microbiology, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Dixit S, Tanveer N, Kumar H, Diwan H. Smartphone-Assisted Telecytopathology: An Intraobserver Concordance Study. Acta Cytol 2020; 64:399-405. [PMID: 32074596 DOI: 10.1159/000506145] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/25/2020] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Telecytology is the practice of cytology at a distance. The images captured by a camera are sent to the cytopathologist at a different location who views the images and reaches a diagnosis. Recently, smartphone-assisted telepathology has been evaluated for different subspecialities of pathology including cytology for second opinion. MATERIALS AND METHODS For the purpose of the study, a total of 151 cases of fine needle aspiration and 10 cases of urine cytology reported by a single pathologist were retrieved from the records. The images of all the cases were captured by a trained pathologist using the primary camera of a smartphone from the ocular of a binocular microscope. The images were sent by WhatsApp to the same pathologist who had made the conventional microscopy diagnosis. The images were viewed on the smartphone screen by the pathologist who replied with the diagnosis after analysing all the images with or without digital zoom. RESULTS A total of 154 cases out of 161 were correctly diagnosed on smartphone-assisted telepathology (overall intraobserver concordance of 95.6%). For head and neck swellings, the concordance was 65/70 (92.9%), for breast lesions, it was 23/24 (95.8%), and for miscellaneous swellings, it was 57/57 (100%). For urine cytology, the concordance rate was 9/10 (90%). CONCLUSION Though the results of this study are encouraging, further improvement in the smartphone camera resolution and internet connectivity would enhance the utility of smartphone-assisted telecytopathology.
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Affiliation(s)
- Sonali Dixit
- Department of Pathology, University College of Medical Sciences, Delhi University, Delhi, India
| | - Nadeem Tanveer
- Department of Pathology, University College of Medical Sciences, Delhi University, Delhi, India,
| | - Harresh Kumar
- Department of Pathology, University College of Medical Sciences, Delhi University, Delhi, India
| | - Himanshi Diwan
- Department of Pathology, University College of Medical Sciences, Delhi University, Delhi, India
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Mondal H, Mondal S. Why smartphone is a low-cost alternative in whole slide imaging? J Family Med Prim Care 2020; 9:5391. [PMID: 33409226 PMCID: PMC7773128 DOI: 10.4103/jfmpc.jfmpc_1347_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/10/2020] [Accepted: 09/13/2020] [Indexed: 11/04/2022] Open
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Yang X, Kovarik CL. A systematic review of mobile health interventions in China: Identifying gaps in care. J Telemed Telecare 2019; 27:3-22. [PMID: 31319759 DOI: 10.1177/1357633x19856746] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Mobile health has a promising future in the healthcare system in most developed countries. China's rapidly developing mobile technology infrastructure offers an unprecedented opportunity for wide adoption of mobile health interventions in the delivery of effective and timely healthcare services. However, there is little data on the current extent of the mobile health landscape in China. The aim of this study was to systematically review the existing mobile health initiatives in China, characterise the technology used, disease categories targeted, location of the end user (urban versus rural), and examine the potential effects of mobile health on health system strengthening in China. Furthermore, we identified gaps in development and evaluation of the effectiveness of mobile health interventions. METHODS A systematic review of the literature published from 18 December 2015 - 3 April 2019 was conducted and yielded 2863 articles from English and Chinese retrieval database and trial registries, including PubMed, EMBASE, China National Knowledge of Infrastructure and World Health Organization International Clinical Trials Registry Platform. Studies were included if they used mobile health to support patient healthcare outcomes. RESULTS A total of 1129 full-text articles were assessed and 338 were included in this study. The review found that most studies targeted client education and behaviour change via applications (apps) (65.4%), including WeChat, and text messaging (short text messages) (19.8%) to improve patient medical treatment outcomes such as compliance and appointment reminders. The most common disease-specific mobile health interventions focused primarily on chronic disease management and behaviour change in cardiology (13.3%), endocrinology/diabetes (12.1%), behavioural health (11.8%), oncology (11.2%) and neurology (6.8%). The mobile health interventions related to nutrition (0.6%) and chronic respiratory diseases (1.6%) are underrepresented in mobile health in comparison to the burden of disease in China. The majority (90.0%) of the mobile health interventions were conducted exclusively in urban areas, with few opportunities reaching rural populations. CONCLUSIONS Overall, mobile health has a promising future in China, with recent rapid growth in initiatives. The majority are focused on education and behaviour change in the realm of chronic diseases and target patients in urban areas. The imbalance in mobile health between the urban and rural areas, as well as between population disease spectrum and health service delivery, pose substantial dilemmas. However, mobile health may be redirected to correct this imbalance, possibly improving access to healthcare services, and filling the gaps in order to improve health equity for the underserved populations in China.
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Affiliation(s)
- Xiaoshi Yang
- Department of Social Medicine, China Medical University, P.R. China.,Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, USA
| | - Carrie L Kovarik
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, USA
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Williams V, Kovarik C. Long-Range Diagnosis of and Support for Skin Conditions in Field Settings. Trop Med Infect Dis 2018; 3:E84. [PMID: 30274480 PMCID: PMC6160944 DOI: 10.3390/tropicalmed3030084] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/06/2018] [Accepted: 08/07/2018] [Indexed: 12/20/2022] Open
Abstract
Skin diseases are a significant cause of morbidity and mortality worldwide; however, access to dermatology services are critically limited, particularly in low- to middle-income countries (LMIC), where there is an overall shortage of physicians. Implementation of long-range technological support tools has been growing in an effort to provide quality dermatology care to even the most remote settings globally. eHealth strategies can provide realistic healthcare solutions if implemented in a feasible and sensitive way, customizing tools to address the unique needs and resource limitations of the local setting. This article summarizes the various types of telemedicine and mobile health (mHealth) tools and their practical applications and benefits for patient care. The challenges and barriers of teledermatology are discussed, as well as steps to consider when implementing a new teledermatology initiative. eHealth arguably offers one of the most flexible and realistic tools for providing critically needed access to dermatology skills in underserved LMICs.
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Affiliation(s)
- Victoria Williams
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | - Carrie Kovarik
- Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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