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Jennings C, Treanor D, Brettle D. Pathologists light level preferences using the microscope-study to guide digital pathology display use. J Pathol Inform 2024; 15:100379. [PMID: 38846642 PMCID: PMC11153930 DOI: 10.1016/j.jpi.2024.100379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/05/2024] [Accepted: 04/26/2024] [Indexed: 06/09/2024] Open
Abstract
Background Currently, there is a paucity of guidelines relating to displays used for digital pathology making procurement decisions, and optimal display configuration, challenging.Experience suggests pathologists have personal preferences for brightness when using a conventional microscope which we hypothesized could be used as a predictor for display setup. Methods We conducted an online survey across six NHS hospitals, totalling 108 practicing pathologists, to capture brightness adjustment habits on both microscopes and displays.A convenience subsample of respondents was then invited to take part in a practical task to determine microscope brightness and display luminance preferences in the normal working environment. A novel adaptation for a lightmeter was developed to directly measure the light output from the microscope eyepiece. Results The survey (response rate 59% n=64) indicates 81% of respondents adjust the brightness on their microscope. In comparison, only 11% report adjusting their digital display. Display adjustments were more likely to be for visual comfort and ambient light compensation rather than for tissue factors, common for microscope adjustments. Part of this discrepancy relates to lack of knowledge of how to adjust displays and lack of guidance on whether this is safe; But, 66% felt that the ability to adjust the light on the display was important.Twenty consultants took part in the practical brightness assessment. Light preferences on the microscope showed no correlation with display preferences, except where a pathologist has a markedly brighter microscope light preference. All of the preferences in this cohort were for a display luminance of <500 cd/m2, with 90% preferring 350 cd/m2 or less. There was no correlation between these preferences and the ambient lighting in the room. Conclusions We conclude that microscope preferences can only be used to predict display luminance requirements where the microscope is being used at very high brightness levels. A display capable of a brightness of 500 cd/m2 should be suitable for almost all pathologists with 300 cd/m2 suitable for the majority. Although display luminance is not frequently changed by users, the ability to do so was felt to be important by the majority of respondents.Further work needs to be undertaken to establish the relationship between diagnostic performance, luminance preferences, and ambient lighting levels.
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Affiliation(s)
- Charlotte Jennings
- National Pathology Imaging Co-operative, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Section of Pathology and Data Analytics, Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Darren Treanor
- National Pathology Imaging Co-operative, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Section of Pathology and Data Analytics, Leeds Institute of Medical Research, University of Leeds, Leeds, UK
- Centre for Diagnostics, Division of Neurobiology, Department of Clinical and Experimental Medicine, Department of Clinical Pathology, Linköping University, Linköping, Sweden
| | - David Brettle
- National Pathology Imaging Co-operative, Leeds Teaching Hospitals NHS Trust, Leeds, UK
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Goelz L, Arndt H, Hausmann J, Madeja C, Mutze S. Obstacles and Solutions Driving the Development of a National Teleradiology Network. Healthcare (Basel) 2021; 9:healthcare9121684. [PMID: 34946410 PMCID: PMC8701208 DOI: 10.3390/healthcare9121684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 02/07/2023] Open
Abstract
Background: Teleradiology has the potential to link medical experts and specialties despite geographical separation. In a project report about hospital-based teleradiology, the significance of technical and human factors during the implementation and growth of a teleradiology network are explored. Evaluation: The article identifies major obstacles during the implementation and growth of the teleradiology network of the Berlin Trauma Hospital (BG Unfallkrankenhaus Berlin) between 2004 and 2020 in semi-structured interviews with senior staff members. Quantitative analysis of examination numbers, patient numbers, and profits relates the efforts of the staff members to the monetary benefits and success of the network. Identification of qualitative and quantitative factors for success: Soft and hard facilitators and solutions driving the development of the national teleradiology network are identified. Obstacles were often solved by technical innovations, but the time span between required personal efforts, endurance, and flexibility of local and external team members. The article describes innovations driven by teleradiology and hints at the impact of teleradiology on modern medical care by relating the expansion of the teleradiology network to patient transfers and profits. Conclusion: In addition to technical improvements, interpersonal collaborations were key to the success of the teleradiology network of the Berlin Trauma Hospital and remained a unique feature and selling point of this teleradiology network.
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Affiliation(s)
- Leonie Goelz
- Department of Radiology and Neuroradiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany; (H.A.); (J.H.); (C.M.); (S.M.)
- Correspondence: ; Tel.: +49-30-56813829; Fax: +49-30-56813803
| | - Holger Arndt
- Department of Radiology and Neuroradiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany; (H.A.); (J.H.); (C.M.); (S.M.)
| | - Jens Hausmann
- Department of Radiology and Neuroradiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany; (H.A.); (J.H.); (C.M.); (S.M.)
| | - Christian Madeja
- Department of Radiology and Neuroradiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany; (H.A.); (J.H.); (C.M.); (S.M.)
| | - Sven Mutze
- Department of Radiology and Neuroradiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany; (H.A.); (J.H.); (C.M.); (S.M.)
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
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Iannessi A, Marcy PY, Clatz O, Bertrand AS, Sugimoto M. A review of existing and potential computer user interfaces for modern radiology. Insights Imaging 2018; 9:599-609. [PMID: 29770927 PMCID: PMC6108970 DOI: 10.1007/s13244-018-0620-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 03/08/2018] [Accepted: 03/15/2018] [Indexed: 12/16/2022] Open
Abstract
Abstract The digitalization of modern imaging has led radiologists to become very familiar with computers and their user interfaces (UI). New options for display and command offer expanded possibilities, but the mouse and keyboard remain the most commonly utilized, for usability reasons. In this work, we review and discuss different UI and their possible application in radiology. We consider two-dimensional and three-dimensional imaging displays in the context of interventional radiology, and discuss interest in touchscreens, kinetic sensors, eye detection, and augmented or virtual reality. We show that UI design specifically for radiologists is key for future use and adoption of such new interfaces. Next-generation UI must fulfil professional needs, while considering contextual constraints. Teaching Points • The mouse and keyboard remain the most utilized user interfaces for radiologists. • Touchscreen, holographic, kinetic sensors and eye tracking offer new possibilities for interaction. • 3D and 2D imaging require specific user interfaces. • Holographic display and augmented reality provide a third dimension to volume imaging. • Good usability is essential for adoption of new user interfaces by radiologists.
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Affiliation(s)
- Antoine Iannessi
- Interventional and Diagnostic Imaging Department, Cancer Center Antoine Lacassagne Nice, Nice, France.
| | | | | | - Anne-Sophie Bertrand
- Interventional and Diagnostic Imaging Department, Cancer Center Antoine Lacassagne Nice, Nice, France
| | - Maki Sugimoto
- International University of Health Welfare, Otawara, Japan
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Alami H, Fortin JP, Gagnon MP, Pollender H, Têtu B, Tanguay F. The Challenges of a Complex and Innovative Telehealth Project: A Qualitative Evaluation of the Eastern Quebec Telepathology Network. Int J Health Policy Manag 2018; 7:421-432. [PMID: 29764106 PMCID: PMC5953525 DOI: 10.15171/ijhpm.2017.106] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 08/29/2017] [Indexed: 11/22/2022] Open
Abstract
Background: The Eastern Quebec Telepathology Network (EQTN) has been implemented in the province of Quebec (Canada) to support pathology and surgery practices in hospitals that are lack of pathologists, especially in rural and remote areas. This network includes 22 hospitals and serves a population of 1.7 million inhabitants spread over a vast territory. An evaluation of this network was conducted in order to identify and analyze the factors and issues associated with its implementation and deployment, as well as those related to its sustainability and expansion.
Methods: Qualitative evaluative research based on a case study using: (1) historical analysis of the project documentation (newsletters, minutes of meetings, articles, ministerial documents, etc); (2) participation in meetings of the committee in charge of telehealth programs and the project; and (3) interviews, focus groups, and discussions with different stakeholders, including decision-makers, clinical and administrative project managers, clinicians (pathologists and surgeons), and technologists. Data from all these sources were cross-checked and synthesized through an integrative and interpretative process.
Results: The evaluation revealed numerous socio-political, regulatory, organizational, governance, clinical, professional, economic, legal and technological challenges related to the emergence and implementation of the project. In addition to technical considerations, the development of this network was associated with major changes and transformations of production procedures, delivery and organization of services, clinical practices, working methods, and clinicaladministrative processes and cultures (professional/organizational).
Conclusion: The EQTN reflects the complex, structuring, and innovative projects that organizations and health systems are required to implement today. Future works should be more sensitive to the complexity associated with the emergence of telehealth networks and no longer reduce them to technological considerations.
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Affiliation(s)
- Hassane Alami
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), CIUSSS-Capitale Nationale, Quebec City, QC, Canada.,University Hospital Center of Quebec-Laval University Research Center, Quebec City, QC, Canada
| | - Jean-Paul Fortin
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), CIUSSS-Capitale Nationale, Quebec City, QC, Canada.,Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - Marie-Pierre Gagnon
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), CIUSSS-Capitale Nationale, Quebec City, QC, Canada.,University Hospital Center of Quebec-Laval University Research Center, Quebec City, QC, Canada.,Faculty of Nursing, Laval University, Quebec City, QC, Canada
| | - Hugo Pollender
- Institute of Health and Social Services in Primary Care, Research Center on Healthcare and Services in Primary Care of Laval University (CERSSPL-UL), CIUSSS-Capitale Nationale, Quebec City, QC, Canada
| | - Bernard Têtu
- University Hospital Center of Quebec-Laval University Research Center, Quebec City, QC, Canada.,Faculty of Medicine, Laval University, Quebec City, QC, Canada
| | - France Tanguay
- Integrated Health and Social Services Centre of Chaudière-Appalaches Hôtel-Dieu de Lévis, Lévis City, QC, Canada
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Bertram R, Kaakinen J, Bensch F, Helle L, Lantto E, Niemi P, Lundbom N. Eye Movements of Radiologists Reflect Expertise in CT Study Interpretation: A Potential Tool to Measure Resident Development. Radiology 2016; 281:805-815. [DOI: 10.1148/radiol.2016151255] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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La Cruz A, Medina R, Vega F, Perez W, Ochoa B, Saquicela V, Espinoza M, Solano-Quinde L, Vidal ME. Mobile teleradiology system suitable for m-health services supporting content and semantic based image retrieval on a grid infrastructure. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2016:5380-5383. [PMID: 28269475 DOI: 10.1109/embc.2016.7591943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Teleradiology systems tackle the problem of transferring radiological images between medical image workstations for facilitating different medical activities, e.g., diagnosis, treatment and follow up a patient, medical training, or consulting second opinion. Nowadays, m-Health (aka mobile health) is becoming popular because of high quality of mobile displays, although remains a work in progress. In this paper a mobile teleradiology system is reported, which main contribution is the development of a platform: (1) supported by a Grid infrastructure, (2) using biomedical ontologies for adding semantic annotations on medical images, and (3) supporting semantic and content-based image retrieval. Images are located physically in different repositories like; hospitals and diagnostic imaging centers. All these features make the system ubiquitous, portable, and suitable for m-Health services.
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Zabala-Travers S, Choi M, Cheng WC, Badano A. Effect of color visualization and display hardware on the visual assessment of pseudocolor medical images. Med Phys 2016; 42:2942-54. [PMID: 26127048 DOI: 10.1118/1.4921125] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Even though the use of color in the interpretation of medical images has increased significantly in recent years, the ad hoc manner in which color is handled and the lack of standard approaches have been associated with suboptimal and inconsistent diagnostic decisions with a negative impact on patient treatment and prognosis. The purpose of this study is to determine if the choice of color scale and display device hardware affects the visual assessment of patterns that have the characteristics of functional medical images. METHODS Perfusion magnetic resonance imaging (MRI) was the basis for designing and performing experiments. Synthetic images resembling brain dynamic-contrast enhanced MRI consisting of scaled mixtures of white, lumpy, and clustered backgrounds were used to assess the performance of a rainbow ("jet"), a heated black-body ("hot"), and a gray ("gray") color scale with display devices of different quality on the detection of small changes in color intensity. The authors used a two-alternative, forced-choice design where readers were presented with 600 pairs of images. Each pair consisted of two images of the same pattern flipped along the vertical axis with a small difference in intensity. Readers were asked to select the image with the highest intensity. Three differences in intensity were tested on four display devices: a medical-grade three-million-pixel display, a consumer-grade monitor, a tablet device, and a phone. RESULTS The estimates of percent correct show that jet outperformed hot and gray in the high and low range of the color scales for all devices with a maximum difference in performance of 18% (confidence intervals: 6%, 30%). Performance with hot was different for high and low intensity, comparable to jet for the high range, and worse than gray for lower intensity values. Similar performance was seen between devices using jet and hot, while gray performance was better for handheld devices. Time of performance was shorter with jet. CONCLUSIONS Our findings demonstrate that the choice of color scale and display hardware affects the visual comparative analysis of pseudocolor images. Follow-up studies in clinical settings are being considered to confirm the results with patient images.
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Affiliation(s)
- Silvina Zabala-Travers
- Division of Imaging, Diagnostics, and Software Reliability, OSEL/CDRH/FDA, Silver Spring, Maryland 20993
| | - Mina Choi
- Division of Imaging, Diagnostics, and Software Reliability, OSEL/CDRH/FDA, Silver Spring, Maryland 20993
| | - Wei-Chung Cheng
- Division of Imaging, Diagnostics, and Software Reliability, OSEL/CDRH/FDA, Silver Spring, Maryland 20993
| | - Aldo Badano
- Division of Imaging, Diagnostics, and Software Reliability, OSEL/CDRH/FDA, Silver Spring, Maryland 20993
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8
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Levenson RM, Krupinski EA, Navarro VM, Wasserman EA. Pigeons (Columba livia) as Trainable Observers of Pathology and Radiology Breast Cancer Images. PLoS One 2015; 10:e0141357. [PMID: 26581091 PMCID: PMC4651348 DOI: 10.1371/journal.pone.0141357] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 10/07/2015] [Indexed: 02/07/2023] Open
Abstract
Pathologists and radiologists spend years acquiring and refining their medically essential visual skills, so it is of considerable interest to understand how this process actually unfolds and what image features and properties are critical for accurate diagnostic performance. Key insights into human behavioral tasks can often be obtained by using appropriate animal models. We report here that pigeons (Columba livia)—which share many visual system properties with humans—can serve as promising surrogate observers of medical images, a capability not previously documented. The birds proved to have a remarkable ability to distinguish benign from malignant human breast histopathology after training with differential food reinforcement; even more importantly, the pigeons were able to generalize what they had learned when confronted with novel image sets. The birds’ histological accuracy, like that of humans, was modestly affected by the presence or absence of color as well as by degrees of image compression, but these impacts could be ameliorated with further training. Turning to radiology, the birds proved to be similarly capable of detecting cancer-relevant microcalcifications on mammogram images. However, when given a different (and for humans quite difficult) task—namely, classification of suspicious mammographic densities (masses)—the pigeons proved to be capable only of image memorization and were unable to successfully generalize when shown novel examples. The birds’ successes and difficulties suggest that pigeons are well-suited to help us better understand human medical image perception, and may also prove useful in performance assessment and development of medical imaging hardware, image processing, and image analysis tools.
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Affiliation(s)
- Richard M Levenson
- Department of Pathology and Laboratory Medicine, University of California Davis Medical Center, Sacramento, California, United States of America
| | - Elizabeth A Krupinski
- Department of Radiology & Imaging Sciences, College of Medicine, Emory University, Atlanta, Georgia, United States of America
| | - Victor M Navarro
- Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, Iowa, United States of America
| | - Edward A Wasserman
- Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, Iowa, United States of America
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Kostkova P. Grand challenges in digital health. Front Public Health 2015; 3:134. [PMID: 26000272 PMCID: PMC4419711 DOI: 10.3389/fpubh.2015.00134] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 04/20/2015] [Indexed: 12/02/2022] Open
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Telemedicine, Telehealth and m-Health: New Frontiers in Medical Practice. Healthcare (Basel) 2014; 2:250-2. [PMID: 27429274 PMCID: PMC4934470 DOI: 10.3390/healthcare2020250] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 06/06/2014] [Accepted: 06/06/2014] [Indexed: 11/17/2022] Open
Abstract
Telemedicine is changing the practice of medicine. It is part of the ever-growing use of communications technology in health care being used in prevention, disease management, home health care, long-term (chronic) care, emergency medicine, remote medical imaging, and many other applications. The pace at which telemedicine is being adopted and integrated into the healthcare enterprise is exponential and, for many (even those in the field!), it is often difficult to keep up with all of the changes occurring. Thus, it is useful periodically to stand back and summarize recent advances, to take stock, analyze where we have been, and project where we are headed. [...].
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