Telecytology validation: is there a recipe for everybody?

Telecytology offers a suitable solution to the cost and time efficiency questions on rapid onsite evaluation (ROSE). An increasing number of institutions are adopting new telecytology systems to meet the increasing ROSE requests, although there is no agreement on the details of how a telecytology validation study needs to be conducted. We propose a standardized approach for telecytology validation studies that could be done in a variety of practices. Consecutive cases from 6 months prior were chosen to reflect a case mix comparable to real life. A fellow assessed the slides at the ROSE site while 6 cytopathology faculty convened in a conference room with a television screen, and noted the adequacy, diagnostic category, and specific diagnoses. All participants were blinded to the original adequacy assessment and final diagnoses. For each case, evaluation time and the slides counts were noted. Fine-needle aspiration specimens from 52 patients were included in the study. Of these, 13 cases were used in the first "test" session. The adequacy concordance rates ranged between 92.3% and 100%, with an overall concordance rate of 94.8%. The diagnostic category concordance rates ranged between 90.3% and 95.5%, with an overall concordance rate of 91.9%. The specific diagnosis concordance rates ranged between 84.6% and 92.9%, with an overall concordance rate of 88.1%. Validation of telecytology requires a standardized approach just like any other new technology. In this study, we propose an efficient and accurate method for cytopathology departments of various case volumes to conduct telecytology validation studies. • A standardized approach to telecytology validation studies is presented. • A retrospective case mix comparable to real life was included after a 6-month wash-out period. • All cytopathologists were exposed to the same images at the same time, using a dynamic digital pathology tool. • The study was conducted in 2 steps where a small number of cases were used for the "training" phase, and a larger number of cases were used for "validation". • Overall concordance rate among 4 cytopathologists was 94.8% for adequacy, not crediting any discrepancies. • Overall concordance rate among 4 cytopathologists was 91.9% for diagnostic category, not crediting any discrepancies. [ABSTRACT FROM AUTHOR]