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Digital Morphology Imaging Aim of Project

(H). Digital Morphology Imaging Aim of Project To develop Web based technology in EQA for digital morphological examination Brereton M, Burthem J, Wells E, Serrant A, Ardern J, Hickman L, Seal L, Hutchinson C, Parker-Williams J, De La Salle B, McTaggart P, Hyde K. (H).

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Digital Morphology Imaging Aim of Project

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  1. (H) Digital Morphology Imaging Aim of Project To develop Web based technology in EQA for digital morphological examination Brereton M, Burthem J, Wells E, Serrant A, Ardern J, Hickman L, Seal L, Hutchinson C, Parker-Williams J, De La Salle B, McTaggart P, Hyde K

  2. (H) Web Based Morphology Exercises 2001 • 2 cases, 5 digital images each • Limited response n = 30 – more images per case 2003 • 1 case, 12 images with expert opinion • Same case with educational element • Same case ‘Stitched Image’ of 12 images • Response n = 128 – positive feedback

  3. (H) Priorities for 2004 Web Page Utilisation • Archive / education record • Images from each survey with results and feedback. Electronic slide • Develop larger field of view • Maintain resolution • Virtual slide • Precious material • All see the same cells

  4. (H) Image Library Multiple images with expert opinion and top five features from original survey. All surveys presented from end 2002 On going – image review process - surveys added. Preview available at manlab.co.uk (department morphology); Link via web pilot. January 2005 available via the NEQAS(H) site. CPD Image Library

  5. (H) Priorities for 2004 Web Page Utilisation • Archive / education record • Images from each survey with results and feedback. Electronic slide • Develop larger field of view • Maintain resolution • Virtual slide • Precious material • All see the same cells 2001 2004

  6. (H) Electronic Slide • Response to feedback • Individual images taken at high magnification consecutively then stitched together • 12 images “stitched” together in 2003 compared to 40 images “stitched” together in 2004

  7. Use + and - to zoom in/out click and hold left mouse button over image, then drag to pan.0301 BF1The five most commonly reported features were:Nucleated red cellsBlast cellsMacrocytic plateletsMyelocytesMegakaryocyte fragments. Stitched Image (2003) 0301bf1.mov

  8. (H) Exercise for 2004 4 cases from previous surveys • Participants not informed that images were actual surveys. • Cases chosen were 0001BF2 (HbSS), 0002BF1 (Bcell PLL),0403BF1 (CGL) and 0403PA1 (malaria) • 40 images “stitched” per case • Images presented with same basic information given with standard surveys (age, sex, WBC, Hb). • Participants asked to give 5 comments per case Result sheets and questionnaire returned to UK NEQAS(H)

  9. (H) Exercise for 2004 Dr. John Burthem Manchester Royal Infirmary.

  10. (H) Response • 166 returned completed coded morphology forms. • 162 also completed questionnaire

  11. (H) Was the image of adequate size to allow an opinion?

  12. (H) Rate the Exercise

  13. (H) Rate the Exercise (overview) 2.7 Comparison to glass 3.5 Download time 4.5 CPD 4.1 Follow-up 4.2 Archive 4.6 Teaching aid 4.6 “Rare” Image Poor OK Excellent

  14. (H) The cases: 0001BF2(HbSS) 0403BF1 (CGL) 0403PA1 (P.Ovale) 0002BF1 (Bcell PLL)

  15. (H) 0403BF1 (CGL)

  16. (H) 0001BF2 (HbSS) Responses: Sickle disorder: 84% HA: 4% Splenectomy: 5%

  17. (H) 0002BF1 (Bcell PLL) Diagnosis virtual: CLL (33); LPD (26) PLL (25) lymphoma (11) AL (9) CMML (2) viral (2)

  18. (H) 0403PA1 (P.Ovale) **

  19. Future developments (Go here to the BM stitch)

  20. (H) Future Developments Introducing CPD, maintain and develop image library. Incorporation of stitched images. Driven by participants, cases from users. Exploring education. Getting feedback to participants.

  21. (H) Acknowledgements All respondents of exercises Staff at UK NEQAS(H). www.ukneqas-haem.org.uk Staff in Haematology at Manchester Royal Infirmary. www.manlab.co.uk (department morphology). Universities of Salford & Manchester Metropolitan.

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