EXTERNAL QUALITY ASSESSMENT
includes all relevant information from the manufacturer of the digital slide scanner, through to how the slides are coverslipped.
Assessment of the images and slides will include scoring by expert peer assessors utilising the same format as other UKNEQAS CPT schemes employ during assessment sessions, using pre- defined assessment criteria. The main difference is that the image quality is reviewed using software designed for viewing digital pathology images without altering the format in which they are submitted. This main difference is key to ensuring any peer feedback is applicable to the image being viewed within the individual laboratory.
One of the primary challenges that UK NEQAS CPT is facing is the standardisation of digital pathology systems and workflows. Unlike traditional microscopy, digital pathology relies on digital images displayed on computer monitors; variations in image acquisition, processing and display can significantly impact the interpretation of resulting images. Therefore, establishing uniform standards for image quality, resolution, colour representation and file types becomes imperative for effective EQA in digital pathology. UK NEQAS CPT participants currently use seven different manufacturers for their digital slide scanners, 10 different image management system software manufacturers, and eight different file types once exported. During the pre-pilot in February 2024 the software being trialled as the installed image management system was sub-optimal as it did not allow all of the file types to be opened as anticipated. Acquiring software designed for viewing all digital pathology images, and in turn without altering the format in which they were submitted, has proved to be a major challenge and obstacle in developing this scheme.
Ensuring data security and patient privacy adds a further layer of complexity. Digital pathology involves the storage and transmission of large volumes of sensitive data thus raising concerns about unauthorised access, data breaches and compliance with regulatory requirements such as the General Data Protection Regulation (GDPR). Developing robust encryption protocols, access controls, and secure data transmission mechanisms are essential components of any EQA scheme for digital pathology. During the February pre-pilot it was discussed that NHS trusts may need a Data Protection Impact Assessment (DPIA). This is a mandatory process that
WWW.PATHOLOGYINPRACTICE.COM JUNE 2024
Variations in image acquisition, processing and display can significantly impact the interpretation of resulting images. Therefore, establishing uniform standards for image quality, resolution, colour representation and file types becomes imperative for effective EQA in digital pathology
identifies potential risks that come with data processing. The metadata that are contained within the digital images does pose a risk and UK NEQAS CPT is currently collating the information needed to help trusts complete this process to achieve approval by the data protection officer (DPO).
A further significant hurdle is the
need for scheme assessor training and education in digital pathology. UK NEQAS CPT scheme assessors are chosen for their technical experience and expertise in their specialist field. Seasoned assessors may have years of experience in cellular pathology laboratories as biomedical scientists, biotechnologists, and technical experts
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