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Evaluation of a telemedicine system for the transmission of morpho/immunological data aiming at the inclusion of patients in a therapeutic trial.

Lesesve JF, Garand R - Int J Telemed Appl (2009)

Bottom Line: Due to their high levels of achievement and efficiency, image digitalization and teletransmission tools are more and more frequently used.We were able to set out new standards of image sampling for CLL, solve the semantic divergences, and point out interobserver variability as regards morphology.The limiting factors were the important need for expert investment, but they more importantly concerned the first line morphologists who should benefit from adequate tools, in terms of computer equipment as well as members of staff, so as to apprehend this second reading system as a quality control procedure.

View Article: PubMed Central - PubMed

Affiliation: Centre Hospitalier Universitaire de Nancy et de Nantes (CHU Nancy et Nantes), 54000 Nancy, France.

ABSTRACT
Due to their high levels of achievement and efficiency, image digitalization and teletransmission tools are more and more frequently used. Applied to cellular haematology, these tools often contribute to diagnosis confrontation, sometimes within the framework of therapeutic trials. We present one of the first approaches of the use of telehaematology for the inclusion of patients in the GOELAMS chronic lymphocytic leukaemia 98 trial. The advantages were (1) the creation of a unique, protected, stable data bank that could be remotely consulted, (2) the use of digitized pictures which made expertise on identical documents possible, (3) the facility of computer exchanges between experts, in terms of reception as well as replying time delays. We were able to set out new standards of image sampling for CLL, solve the semantic divergences, and point out interobserver variability as regards morphology. The limiting factors were the important need for expert investment, but they more importantly concerned the first line morphologists who should benefit from adequate tools, in terms of computer equipment as well as members of staff, so as to apprehend this second reading system as a quality control procedure.

No MeSH data available.


Related in: MedlinePlus

Average numbers of captured lymphocytesfunctions of the morphologic type of CLL.
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig6: Average numbers of captured lymphocytesfunctions of the morphologic type of CLL.

Mentions: This criterium is essentialfor the feasibility of this method (review is quicker when cell concentrationis higher) and quite a number of cells have to be analyzed before giving one'sopinion. The total number of images acquired in this protocol was 1460,consisting of 2938 lymphocytes, which (theoretically) represents an average of2 cells per picture. The minimum number of lymphocytes captured per image was 1and the maximum 17, which corresponded to a 508 × 109/L lymphocytosis,namely the highest concentration that could be found in our series (Figure 3).The minimum number of pictures per file was 9 and the maximum 48 (Figure 4). Theminimum number of captured lymphocytes for one file was 15 and the maximum 121(corresponding to the 508 G/L lymphocytosis, Figure 5), the median being 38. 42lymphocytes per file was the theoretical average (2938 photographedlymphocytes/70 files). Consequently, photographing around 40 lymphocytes perpatient seemed appropriate to us as regards this type of lymphoproliferativesyndrome. This figure enables the observer taking the pictures to provide theothers with a sampling representative of the blood smear and the expert canthus reach a relevant diagnosis.


Evaluation of a telemedicine system for the transmission of morpho/immunological data aiming at the inclusion of patients in a therapeutic trial.

Lesesve JF, Garand R - Int J Telemed Appl (2009)

Average numbers of captured lymphocytesfunctions of the morphologic type of CLL.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2630421&req=5

fig6: Average numbers of captured lymphocytesfunctions of the morphologic type of CLL.
Mentions: This criterium is essentialfor the feasibility of this method (review is quicker when cell concentrationis higher) and quite a number of cells have to be analyzed before giving one'sopinion. The total number of images acquired in this protocol was 1460,consisting of 2938 lymphocytes, which (theoretically) represents an average of2 cells per picture. The minimum number of lymphocytes captured per image was 1and the maximum 17, which corresponded to a 508 × 109/L lymphocytosis,namely the highest concentration that could be found in our series (Figure 3).The minimum number of pictures per file was 9 and the maximum 48 (Figure 4). Theminimum number of captured lymphocytes for one file was 15 and the maximum 121(corresponding to the 508 G/L lymphocytosis, Figure 5), the median being 38. 42lymphocytes per file was the theoretical average (2938 photographedlymphocytes/70 files). Consequently, photographing around 40 lymphocytes perpatient seemed appropriate to us as regards this type of lymphoproliferativesyndrome. This figure enables the observer taking the pictures to provide theothers with a sampling representative of the blood smear and the expert canthus reach a relevant diagnosis.

Bottom Line: Due to their high levels of achievement and efficiency, image digitalization and teletransmission tools are more and more frequently used.We were able to set out new standards of image sampling for CLL, solve the semantic divergences, and point out interobserver variability as regards morphology.The limiting factors were the important need for expert investment, but they more importantly concerned the first line morphologists who should benefit from adequate tools, in terms of computer equipment as well as members of staff, so as to apprehend this second reading system as a quality control procedure.

View Article: PubMed Central - PubMed

Affiliation: Centre Hospitalier Universitaire de Nancy et de Nantes (CHU Nancy et Nantes), 54000 Nancy, France.

ABSTRACT
Due to their high levels of achievement and efficiency, image digitalization and teletransmission tools are more and more frequently used. Applied to cellular haematology, these tools often contribute to diagnosis confrontation, sometimes within the framework of therapeutic trials. We present one of the first approaches of the use of telehaematology for the inclusion of patients in the GOELAMS chronic lymphocytic leukaemia 98 trial. The advantages were (1) the creation of a unique, protected, stable data bank that could be remotely consulted, (2) the use of digitized pictures which made expertise on identical documents possible, (3) the facility of computer exchanges between experts, in terms of reception as well as replying time delays. We were able to set out new standards of image sampling for CLL, solve the semantic divergences, and point out interobserver variability as regards morphology. The limiting factors were the important need for expert investment, but they more importantly concerned the first line morphologists who should benefit from adequate tools, in terms of computer equipment as well as members of staff, so as to apprehend this second reading system as a quality control procedure.

No MeSH data available.


Related in: MedlinePlus