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Authors

Authors. Dana Grzybicki, MD, PhD Evaluation Team – Principal Investigator Russell Silowash, BS Evaluation Team – Research Analyst Robb Wilson, MA Evaluation Team – Project Manager Leslie Anthony, MA UPMC IMITS Telepathology Project – Project Manager. Background.

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  1. Authors Dana Grzybicki, MD, PhD Evaluation Team – Principal Investigator Russell Silowash, BS Evaluation Team – Research Analyst Robb Wilson, MA Evaluation Team – Project Manager Leslie Anthony, MA UPMC IMITS Telepathology Project – Project Manager University of Pittsburgh Department of Biomedical Informatics

  2. Background • Through appropriations in the defense-spending bills for 2002 and 2004, the University of Pittsburgh Medical Center (UPMC) and the United State Air Force Medical Service (AFMS) created a partnership called the Integrated Medical Information Technology System (IMITS) Program • Telepathology is a branch of the IMITS program that implements and validates digital pathology practices University of Pittsburgh Department of Biomedical Informatics

  3. Introduction • Purpose of evaluation research • Independent examination of questions related to: • Technical validity • Feasibility • Effectiveness • To our knowledge, there are no generally available validated tools for evaluating WSI cases • The UPMC Digital Pathology Imaging Group is working on the validation of a unique evaluation tool University of Pittsburgh Department of Biomedical Informatics

  4. Participants • The validation of this tool was part of our telepathology evaluation project involving 5 UPMC pathologists • 2 pathology fellows • 3 staff pathologists with training in GU pathology University of Pittsburgh Department of Biomedical Informatics

  5. Case Selection • 30 difficult prostate biopsy foci University of Pittsburgh Department of Biomedical Informatics

  6. University of Pittsburgh Department of Biomedical Informatics

  7. University of Pittsburgh Department of Biomedical Informatics

  8. Hypotheses • Content Validity • The assessment is asking the proper questions for the study at hand • Internal Validity • There will be a positive correlation between the number of slides/images in a case and the time needed to complete the case University of Pittsburgh Department of Biomedical Informatics

  9. Hypotheses (continued) • External Validity • Whole slide image quality will be positively correlated with glass slide quality • Construct Validity • There will be a negative correlation between the diagnostic confidence of a participant and the case complexity rating University of Pittsburgh Department of Biomedical Informatics

  10. Content Validity Results • Content validity has been obtained by gaining feedback from pathologists that are part of the Digital Pathology Imaging Group (DPIG) University of Pittsburgh Department of Biomedical Informatics

  11. Internal Validity Results • Statistically significant for only one participant (r2=0.327, p<0.01) • Our inability to demonstrate internal validity for most of the participants was most likely due to time categorical variables that were too broad University of Pittsburgh Department of Biomedical Informatics

  12. External Validity Results • A positive correlation exists between WSI quality and glass slide quality • There were statistically significant positive correlations for 3 of the 5 subjects University of Pittsburgh Department of Biomedical Informatics

  13. Construct Validity Results • Negative correlation exists in WSI phase of study between confidence in diagnosis and case complexity • 3 of 5 pathologists had statistically significant positive correlations in the WSI Phase University of Pittsburgh Department of Biomedical Informatics

  14. Construct Validity Results (continued) • Negative correlation exists in the Glass phase between case complexity and diagnostic confidence • 3 of 5 pathologists had statistically significant positive correlations in the Glass Phase University of Pittsburgh Department of Biomedical Informatics

  15. Summary • We are able to establish content, external and construct validity, however internal validity at this point has not been definitively established. • Low internal validity could be due to time categories being too broad University of Pittsburgh Department of Biomedical Informatics

  16. Next Steps • Change the categories for the time variable • Implement an automatic timing solution University of Pittsburgh Department of Biomedical Informatics

  17. Next Steps (continued) • Continue the validation of this tool by obtaining additional data and testing internal validity utilizing the modified time variables University of Pittsburgh Department of Biomedical Informatics

  18. Funding • This work was supported by funding from the U.S. Air Force administered by the U.S. Army Medical Research Acquisition Activity, Fort Detrick, Maryland (Award No. W81XWH-04-2-0030 and Contract No. DAMD 17-0302-0017). The content of the information does not imply U.S. Air Force or Government endorsement of factual accuracy or opinion University of Pittsburgh Department of Biomedical Informatics

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