# Validation of A Nationwide Digital Pediatric Pathology Consultation Network

## TL;DR

A nationwide digital pathology consultation network for pediatric cancer cases in Canada was validated with high diagnostic concordance.

## Contribution

This study presents a unique validation of a large digital pediatric pathology network using real-world clinical processes.

## Key findings

- 269 diagnostic data points were generated with 95.5% concordance between digital and glass slide diagnoses.
- The validation exceeded the College of American Pathologists' 95% concordance recommendation.
- The network was successfully validated with participation from all hospitals and pathologists in the network.

## Abstract

Digital pathology facilitates remote pathology consultations. Pediatric pathologists in Canada formed a nationwide digital pathology consultation network, mostly for second opinion review of pediatric cancer cases. Validation of such a large network for clinical use is challenging. Here we report our unique validation process of this digital pathology network.

This study was designed in keeping with the College of American Pathologist (CAP) guidelines, and included 14 pathologists from 9 hospitals across Canada. All cases are pediatric pathology cases. Each pathologist reviewed multiple digital cases and the corresponding glass slide cases. For each review, intra-observer concordance (diagnosis on digital case versus diagnosis on glass slide case) was recorded, creating a data point.

The study generated 269 valid diagnostic data points. Out of the 269 data points, 257 were concordant (95.5% concordance), exceeding the CAP recommendation of 95% concordance. Thus, the network was successfully validated.

This is a unique validation study for a large nationwide digital pediatric pathology network. The study involved all pathologists/hospitals in the network, closely emulating real world clinical process. The network was successfully validated.