How digital pathology helps India enhance the disease detection

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Being a motor that drives healthcare by detecting diseases, pathology holds significant power in the industry. According to a study published in The Pathologist magazine by Andrey Bychkov, 108,000 pathologists spread over 162 countries represent 98.5 % of the world’s population. When it comes to different regions, there are glaring disparities in numbers. In addition, there was no global registry of pathologists till now, which made it difficult to identify the worldwide overview of the pathologist workforce.

Poster by Andrey Bychkov,MD,PhD on the global supply of pathologists presented at the annual meeting of United States and Canadian Academy of Pathology 2022.

Andrey Bychkov, MD, PhD, Director of Pathology at Kameda Medical Centre in Japan developed this ground-breaking report that mapped the efficient pathologists worldwide and their supply around the globe and was published in The Pathologist magazine. The mean number of pathologists for each million population is 14, but there are 65 pathologists per million in the United States, while in Africa, it’s lesser than three pathologists per million.

The countries that top the list of 10 countries with the highest number of pathologists are the US, India, China, Iran and the UK. The WHO estimated the number of medical doctors to be approximately 13.2 million, which shows that about one in every 120 doctors is a pathologist (0.8 per cent). Now around the world, an acute shortage of pathologists is dogging diagnostics and treatment for a wide range of diseases.

This shortage can seriously affect the speed of disease detection, affecting the survival rates of critical diseases like cancer. Countries like Africa are in dire need of digital pathology. Uganda has only 18 WHO-certified Level 1 pathologists. The average time a woman shows breast cancer symptoms and gets diagnosed is 11 months because of the unavailability of histopathology analysers.

India, in short for pathologists

Like any other country, India is also facing a shortage of pathologists and microbiologists. The unavailability of enough technology to diagnose samples emphasises the need for technologies like Artificial Intelligence in pathology. Though India has about 3 lakh medical testing labs, only 5,500 qualified MD pathologists are working. Most accredited labs work in cities, while the rural areas have to go with the non-accredited ones. Hence these non-accredited laboratories assign diploma holders to sign the lab reports. This global shortage of pathologists shows the need for turning lab work digitally through AI. Digital pathology can be a game-changer in this scenario.

What is digital pathology?

Digital pathology, also known as whole slide imaging (WSI), is a practice of pathology which employs digital imaging and is poised to become the standard care in pathology. Due to its focus on data management based on data generated from digitalised specimen slides, digital pathology has gained significance. 

Digital Pathology enhances the digitisation of the entire glass slide by creating a digital image for evaluation. The WSI scanners capture different images of the observing tissue section on the slide for a few minutes; it is then digitally combined to generate WSI that a pathologist can optimise. This offers cost-efficient diagnosis, prognosis and detection of diseases using AI and machine learning technologies.

The technology improves the way pathologists work by facilitating them to engage, evaluate and collaborate quickly and remotely with transparency and consistency, which leads to improved efficiency and productivity. In addition, its improved analysis assures good quality as the algorithms used for this slide analysis are accurate, objective and faster than microscopy.

This technology allows quick access to prior cases, and its extensive data storage helps store long-term predictive analysis. It reduces the chance for misidentification as they eliminate the breakage while barcoding and eradicates any chance for errors. Digital pathology also exhibits its ability to measure multiple automated optical inspections (AOI), which helps the pathologists to have a team annotation of slides.

Digital pathology also provides efficient collaboration in the workflow by enabling easy access in a streamlined workflow, remote access, flexible work schedules and automation. This big data that digital pathology aids pathologists to be more specialised in each disease other than the rapid diagnosis.

Challenges hinder digital pathology adoption

Though many countries are in dire need of the technology, it also exhibits challenges for its widespread adoption in various countries because of factors such as the high cost of scanners, regulations, technology limitations, difficulty in implementation etc.

The concerns regarding cyber security and the chances to integrate digital pathology systems with IT infrastructure for better swift data transfer and storage of high-quality images are other challenges to be discussed. Since the technology is new in the field, the pathologists take time to be trained and move to digital reporting as well. 




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