Telepathology Consultation For Frozen Section Diagnosis In China

BACKGROUND&OBJECTIVEAs the world's most populous country,China has the largest number of cancer patients and the population is rapidly aging.The diagnosis and treatment of cancer has become an important part of China's healthcare.The distribution of medical resources in China is uneven.Pathological experts are mainly concentrated in big city hospitals.Most Basic hospitals in China could not complete the frozen section diagnosis.Telepathology(TP)provides remote pathology services for primary diagnosis practices,including intraoperative consultation of surgical pathology;it has not been widely implemented in China.In this study,we reported the result of an implementation,which lasted for two and a half year,and the experiences of the diagnosis of the intraoperative frozen sections using TP consultation platform of Southern Medical University and Guangzhou Huayin Medical Laboratory Center(SMU-HUAYIN TP)in China.MATERIALS&METHODSThe SMU-HUAYIN TP consultation platform connects 71 participated basic hospitals and 11 senior pathologists.Nanfang Hospital is a high-level hospital located in a large city in China.This retrospective study summarizes the experience and results of TP for frozen section diagnosis by comparing the data of the platform and Nanfang Hospital over a period of 2.5 years from January 2015 to June 2017.RESULTSA total of 5233 cases were submitted to the platform,including 1019 cases in 2015,2320 cases in 2016,and 1894 cases in 2017.The most common cases that were received were breast(30.42%)followed by thyroid(29.05%)and gynecological(24.86%).Average turn-around time(TAT)of the cases from the platform in 2015 and 2016was controlled within 30 minutes.In most TP cases(90.31%)and cases from Nanfang Hospital(86.14%),a definitive diagnosis was provided.The coincidence rateswere 99.77%in the TP cases and 99.35%in the cases from Nanfang Hospital.The false positive and false negative rates of TP cases were 0.04%and 0.19%,respectively.There was no significant difference in false negative rates or false positive rates between different senior pathologists(P=0.974,P=0.989,P>0.05)and between TP cases and cases from Nanfang Hospital that were diagnosed by the same senior pathologist(P>0.05).CONCLUSIONSThis study's results indicate that TP in frozen section diagnosis could improve patient care and solve the problem of unevenly distributed pathology resources in China.We believe that in the near future,TP in frozen section diagnosis will become an important component of telemedicine and will play a significant role in health care reform in China.