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[PMID]:28465449
[Au] Autor:Geller BM; Nelson HD; Weaver DL; Frederick PD; Allison KH; Onega T; Carney PA; Tosteson ANA; Elmore JG
[Ad] Endereço:Department of Family Medicine, University of Vermont, Burlington, Vermont, USA.
[Ti] Título:Characteristics associated with requests by pathologists for second opinions on breast biopsies.
[So] Source:J Clin Pathol;70(11):947-953, 2017 Nov.
[Is] ISSN:1472-4146
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Second opinions in pathology improve patient safety by reducing diagnostic errors, leading to more appropriate clinical treatment decisions. Little objective data are available regarding the factors triggering a request for second opinion despite second opinion consultations being part of the diagnostic system of pathology. Therefore we sought to assess breast biopsy cases and interpreting pathologists characteristics associated with second opinion requests. METHODS: Collected pathologist surveys and their interpretations of 60 test set cases were used to explore the relationships between case characteristics, pathologist characteristics and case perceptions, and requests for second opinions. Data were evaluated by logistic regression and generalised estimating equations. RESULTS: 115 pathologists provided 6900 assessments; pathologists requested second opinions on 70% (4827/6900) of their assessments 36% (1731/4827) of these would not have been required by policy. All associations between case characteristics and requesting second opinions were statistically significant, including diagnostic category, breast density, biopsy type, and number of diagnoses noted per case. Exclusive of institutional policies, pathologists wanted second opinions most frequently for atypia (66%) and least frequently for invasive cancer (20%). Second opinion rates were higher when the pathologist had lower assessment confidence, in cases with higher perceived difficulty, and cases with borderline diagnoses. CONCLUSIONS: Pathologists request second opinions for challenging cases, particularly those with atypia, high breast density, core needle biopsies, or many co-existing diagnoses. Further studies should evaluate whether the case characteristics identified in this study could be used as clinical criteria to prompt system-level strategies for mandating second opinions.
[Mh] Termos MeSH primário: Biópsia
Doenças Mamárias/patologia
Mama/patologia
Patologistas
Encaminhamento e Consulta
[Mh] Termos MeSH secundário: Adulto
Idoso
Atitude do Pessoal de Saúde
Competência Clínica
Estudos Transversais
Diagnóstico Diferencial
Erros de Diagnóstico/prevenção & controle
Feminino
Conhecimentos, Atitudes e Prática em Saúde
Seres Humanos
Modelos Logísticos
Masculino
Meia-Idade
Variações Dependentes do Observador
Patologistas/psicologia
Valor Preditivo dos Testes
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:180307
[Lr] Data última revisão:
180307
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1136/jclinpath-2016-204231


  2 / 92 MEDLINE  
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[PMID]:29234806
[Au] Autor:Ehteshami Bejnordi B; Veta M; Johannes van Diest P; van Ginneken B; Karssemeijer N; Litjens G; van der Laak JAWM; Hermsen M; Manson QF; Balkenhol M; Geessink O; Stathonikos N; van Dijk MC; Bult P; Beca F; Beck AH; Wang D; Khosla A; Gargeya R; Irshad H; Zhong A; Dou Q; Li Q; Chen H; Lin HJ; Heng PA; Haß C; Bruni E; Wong Q; Halici U; Öner MÜ; Cetin-Atalay R; Berseth M; Khvatkov V; Vylegzhanin A; Kraus O; Shaban M; Rajpoot N; Awan R; Sirinukunwattana K; Qaiser T; Tsang YW; Tellez D; Annuscheit J; Hufnagl P; Valkonen M; Kartasalo K; Latonen L; Ruusuvuori P; Liimatainen K; the CAMELYON16 Consortium
[Ad] Endereço:Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
[Ti] Título:Diagnostic Assessment of Deep Learning Algorithms for Detection of Lymph Node Metastases in Women With Breast Cancer.
[So] Source:JAMA;318(22):2199-2210, 2017 12 12.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Application of deep learning algorithms to whole-slide pathology images can potentially improve diagnostic accuracy and efficiency. Objective: Assess the performance of automated deep learning algorithms at detecting metastases in hematoxylin and eosin-stained tissue sections of lymph nodes of women with breast cancer and compare it with pathologists' diagnoses in a diagnostic setting. Design, Setting, and Participants: Researcher challenge competition (CAMELYON16) to develop automated solutions for detecting lymph node metastases (November 2015-November 2016). A training data set of whole-slide images from 2 centers in the Netherlands with (n = 110) and without (n = 160) nodal metastases verified by immunohistochemical staining were provided to challenge participants to build algorithms. Algorithm performance was evaluated in an independent test set of 129 whole-slide images (49 with and 80 without metastases). The same test set of corresponding glass slides was also evaluated by a panel of 11 pathologists with time constraint (WTC) from the Netherlands to ascertain likelihood of nodal metastases for each slide in a flexible 2-hour session, simulating routine pathology workflow, and by 1 pathologist without time constraint (WOTC). Exposures: Deep learning algorithms submitted as part of a challenge competition or pathologist interpretation. Main Outcomes and Measures: The presence of specific metastatic foci and the absence vs presence of lymph node metastasis in a slide or image using receiver operating characteristic curve analysis. The 11 pathologists participating in the simulation exercise rated their diagnostic confidence as definitely normal, probably normal, equivocal, probably tumor, or definitely tumor. Results: The area under the receiver operating characteristic curve (AUC) for the algorithms ranged from 0.556 to 0.994. The top-performing algorithm achieved a lesion-level, true-positive fraction comparable with that of the pathologist WOTC (72.4% [95% CI, 64.3%-80.4%]) at a mean of 0.0125 false-positives per normal whole-slide image. For the whole-slide image classification task, the best algorithm (AUC, 0.994 [95% CI, 0.983-0.999]) performed significantly better than the pathologists WTC in a diagnostic simulation (mean AUC, 0.810 [range, 0.738-0.884]; P < .001). The top 5 algorithms had a mean AUC that was comparable with the pathologist interpreting the slides in the absence of time constraints (mean AUC, 0.960 [range, 0.923-0.994] for the top 5 algorithms vs 0.966 [95% CI, 0.927-0.998] for the pathologist WOTC). Conclusions and Relevance: In the setting of a challenge competition, some deep learning algorithms achieved better diagnostic performance than a panel of 11 pathologists participating in a simulation exercise designed to mimic routine pathology workflow; algorithm performance was comparable with an expert pathologist interpreting whole-slide images without time constraints. Whether this approach has clinical utility will require evaluation in a clinical setting.
[Mh] Termos MeSH primário: Neoplasias da Mama/patologia
Metástase Linfática/diagnóstico
Aprendizado de Máquina
Patologistas
[Mh] Termos MeSH secundário: Algoritmos
Feminino
Seres Humanos
Metástase Linfática/patologia
Patologia Clínica
Curva ROC
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.14585


  3 / 92 MEDLINE  
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[PMID]:29283537
[Au] Autor:Duke M
[Ti] Título:Harry Goldblatt (1891-1977): Pathologist and Medical Researcher.
[So] Source:Vesalius;22(2):30-36, 2016 Dec.
[Is] ISSN:1373-4857
[Cp] País de publicação:Belgium
[La] Idioma:eng
[Ab] Resumo:Harry Goldblatt (1891-1977) was an American pathologist whose research and experiments on renovascular hypertension were an important contribution to understanding and treating this disease. His life and his legacy are discussed in this paper.
[Mh] Termos MeSH primário: Hipertensão Renovascular/história
Patologistas/história
[Mh] Termos MeSH secundário: California
História do Século XX
Ohio
Pesquisadores/história
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; JOURNAL ARTICLE; PORTRAITS
[Ps] Nome de pessoa como assunto:Goldblatt H
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180212
[Lr] Data última revisão:
180212
[Sb] Subgrupo de revista:QIS
[Da] Data de entrada para processamento:171229
[St] Status:MEDLINE


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[PMID]:29061860
[Au] Autor:Chio J
[Ad] Endereço:Toronto, Ont.
[Ti] Título:COPD research and treatment pioneer.
[So] Source:CMAJ;189(42):E1320-E1321, 2017 10 23.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Patologistas/história
Doença Pulmonar Obstrutiva Crônica/terapia
Pneumologia/história
[Mh] Termos MeSH secundário: Distinções e Prêmios
Canadá
História do Século XX
História do Século XXI
Seres Humanos
[Pt] Tipo de publicação:BIOGRAPHY; HISTORICAL ARTICLE; NEWS; PORTRAITS
[Ps] Nome de pessoa como assunto:Hogg J
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171101
[Lr] Data última revisão:
171101
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171025
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.109-5458


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[PMID]:28898361
[Au] Autor:Abbasi J
[Ti] Título:Expanded Tissue Samples Poised to Assist Pathologists.
[So] Source:JAMA;318(10):898, 2017 Sep 12.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Biópsia/métodos
[Mh] Termos MeSH secundário: Seres Humanos
Patologistas
[Pt] Tipo de publicação:NEWS
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170913
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.13167


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[PMID]:28759008
[Au] Autor:Watanabe N; Santostefano KE; Yachnis AT; Terada N
[Ad] Endereço:Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
[Ti] Título:A pathologist's perspective on induced pluripotent stem cells.
[So] Source:Lab Invest;97(10):1126-1132, 2017 Oct.
[Is] ISSN:1530-0307
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Induced pluripotent stem cell (iPSC) technology was originally developed in 2006. Essentially, it converts somatic cells into pluripotent stem cells by transiently expressing a few transcriptional factors. Once generated, these iPSCs can differentiate into all the cell types of our body, theoretically, which has attracted great attention for clinical research including disease pathobiology studies. Could this technology then become an additional research or diagnostic tool widely available to practicing pathologists? Here we summarize progress in iPSC research toward disease pathobiology studies, its future potential, and remaining problems from a pathologist's perspective. A particular focus will be on introducing the effort to recapitulate disease-related morphological changes through three-dimensional culture of stem cells such as organoid differentiation.
[Mh] Termos MeSH primário: Células-Tronco Pluripotentes Induzidas
Patologia Clínica
Pesquisa com Células-Tronco
[Mh] Termos MeSH secundário: Seres Humanos
Células-Tronco Pluripotentes Induzidas/citologia
Células-Tronco Pluripotentes Induzidas/fisiologia
Patologistas
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170801
[St] Status:MEDLINE
[do] DOI:10.1038/labinvest.2017.81


  7 / 92 MEDLINE  
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[PMID]:28716438
[Au] Autor:Kirsch R; Assarzadegan N; Messenger DE; Juda A; Riddell RH; Pollett A; Streutker CJ; Divaris DX; Newell KJ; Price RG; Smith S; Al-Haddad S; Parfitt JR; Driman DK
[Ad] Endereço:Mount Sinai Hospital and University of Toronto, Toronto, Ontario, Canada M5G 1X5. Electronic address: rkirsch@mtsinai.on.ca.
[Ti] Título:The impact of knowledge transfer on the detection of venous invasion in colorectal cancer.
[So] Source:Hum Pathol;67:45-53, 2017 Sep.
[Is] ISSN:1532-8392
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Venous invasion (VI) is an independent predictor of hematogenous metastasis and mortality in colorectal cancer (CRC) yet remains widely underreported. Its detection may require recognition of subtle morphologic clues, which at times are only unmasked with an elastin stain. This study evaluates the impact of a knowledge transfer initiative (KTI) on VI detection in a "real-world" pathology practice setting. Following participation in an interobserver variability study of VI detection (Kirsch et al, 2013), 12 participants received educational materials highlighting key issues in VI detection. Eighteen months later, participants were invited to submit pathology reports from all CRC resections signed out 18 months prior to and 18 months following the KTI (n = 266 and n = 244, respectively). Nine pathologists participated. Reports were reviewed for VI and other established prognostic factors. Numbers of elastin stains and tumor-containing blocks were also recorded. Comparative analyses were adjusted for baseline differences in tumor, lymph node, and metastasis stage; tumor location; use of neoadjuvant therapy; and number of tumor-containing blocks. VI detection increased significantly post-KTI versus pre-KTI (39.3% versus 18.4%, adjusted odds ratio [OR] 2.86 [1.91-4.28], P < .001). Increased VI detection post-KTI was observed in both stage II (31.8% versus 12.5%, adjusted OR 3.27 [1.45-7.42], P = .004) and stage III CRC (62.4% versus 28.2%, adjusted OR 4.23 [2.37-7.55], P < .001). All pathologists demonstrated increased VI detection post-KTI. Use of elastin stains was significantly higher post-KTI versus pre-KTI (61.5% versus 5.3% of cases respectively, P < .001). This study demonstrates the effectiveness of knowledge transfer in increasing VI detection in routine pathology practice.
[Mh] Termos MeSH primário: Neoplasias Colorretais/patologia
Educação Médica Continuada/métodos
Capacitação em Serviço/métodos
Patologistas/educação
Patologia Clínica/educação
Veias/patologia
[Mh] Termos MeSH secundário: Biomarcadores Tumorais/análise
Biópsia
Competência Clínica
Neoplasias Colorretais/química
Neoplasias Colorretais/terapia
Elastina/análise
Seres Humanos
Invasividade Neoplásica
Estadiamento de Neoplasias
Variações Dependentes do Observador
Ontário
Valor Preditivo dos Testes
Reprodutibilidade dos Testes
Coloração e Rotulagem/métodos
Veias/química
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 9007-58-3 (Elastin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE


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[PMID]:28656956
[Au] Autor:Makarov IY; Fetisov VA; Filimonov BA; Gusarov AA
[Ad] Endereço:Federal state budgetary institution 'Russian Centre of Forensic Medical Expertise', Russian Ministry of Health, Moscow, Russia, 125284; Russian Medical Academy of Post-Graduate Education, Russian Ministry of Health, Moscow, Russia, 125993.
[Ti] Título:[The coroner's autopsies in the Great Britain: the problems related to the quality of the studies, standardization, auditing, financial support and the approaches to their solution].
[Ti] Título:Koronerskaia autopsiia v Velikobritanii: problemy kachestva issledovanii, standartizatsii, audita, finansirovaniia i puti ikh resheniia..
[So] Source:Sud Med Ekspert;60(3):57-63, 2017.
[Is] ISSN:0039-4521
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:The objective of the present study was to analyze the experience of the coroners and pathologists in the Great Britain based on the results of the coroner's autopsies and recommendations of the experts involved in the activities carried out in the framework of the National Confidential Enquiry into Patient Outcome and Death program (NCEPOD). The recommendations are designed to reform the country's medical examiner system, improve the equipment of the mortuary facilities, and optimize funding for the autopsy studies. The authors consider in the chronological order the following issues of the coroners and pathologists' activities: organization of their work and its procedural aspects, ordering coroner's autopsies, preparation for their performance, analysis of the relevant documentation (autopsy reports) and medical case histories (discharge summaries). Also discussed are the recommendations of the NCEPOD experts for the improvement of the said studies with the detailed analysis of the causes underlying the aforementioned problems and concise comments of the authors.
[Mh] Termos MeSH primário: Autopsia
Médicos Legistas/organização & administração
Patologistas/organização & administração
[Mh] Termos MeSH secundário: Autopsia/métodos
Autopsia/normas
Seres Humanos
Competência Profissional
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170831
[Lr] Data última revisão:
170831
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170629
[St] Status:MEDLINE
[do] DOI:10.17116/sudmed201760357-63


  9 / 92 MEDLINE  
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[PMID]:28605400
[Au] Autor:Roma AA; Liu X; Patil DT; Xie H; Allende D
[Ad] Endereço:Department of Anatomic Pathology, University of California San Diego, San Diego, CA.
[Ti] Título:Proposed Terminology for Anal Squamous Lesions: Its Application and Interobserver Agreement Among Pathologists in Academic and Community Hospitals.
[So] Source:Am J Clin Pathol;148(1):81-90, 2017 Jul 01.
[Is] ISSN:1943-7722
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives: To analyze interobserver reproducibility and compare practice patterns between academic and community settings of Lower Anogenital Squamous Terminology (LAST). Methods: In total, 132 anal biopsy slides were revised as well as p16 immunostains. Results: LAST was used in 49% of cases (academic center, 68%; satellite hospitals [community practice setting], 32%). After pathology review and consensus interpretation, 23 (17%) case diagnoses were reclassified: eight (34.8%) cases (benign or low-grade squamous intraepithelial lesion [LSIL]) were upgraded to high-grade squamous intraepithelial lesion (HSIL) (p16 confirmed ordered during review); four (17.4%) cases originally classified as HSIL were downgraded to LSIL (p16 originally ordered in one case). There was no significant difference in discrepancies between original and consensus diagnosis in the community vs academic setting or by subspecialty (gynecological vs gastrointestinal). Overall interobserver agreement among reviewers was substantial (κ = 0.63) and improved with the use of p16 immunostain in challenging cases (κ = 0.71; P < .001). Conclusions: This new terminology is not yet uniformly used by pathologists in anal/perianal biopsy specimens; this two-tier system has a good interobserver agreement and is further improved with p16 use in appropriate cases.
[Mh] Termos MeSH primário: Neoplasias do Ânus/diagnóstico
Carcinoma de Células Escamosas/diagnóstico
Terminologia como Assunto
[Mh] Termos MeSH secundário: Neoplasias do Ânus/patologia
Biomarcadores Tumorais
Carcinoma de Células Escamosas/patologia
Hospitais Comunitários
Seres Humanos
Imuno-Histoquímica
Variações Dependentes do Observador
Patologistas
Patologia Cirúrgica
Padrões de Prática Médica
Reprodutibilidade dos Testes
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171009
[Lr] Data última revisão:
171009
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170613
[St] Status:MEDLINE
[do] DOI:10.1093/ajcp/aqx044


  10 / 92 MEDLINE  
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[PMID]:28425135
[Au] Autor:Helliwell TR
[Ad] Endereço:University of Liverpool, Liverpool, UK.
[Ti] Título:Image editing for pathologists.
[So] Source:Histopathology;71(3):496-497, 2017 09.
[Is] ISSN:1365-2559
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Processamento de Imagem Assistida por Computador
Patologistas
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER; COMMENT
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170421
[St] Status:MEDLINE
[do] DOI:10.1111/his.13241



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