In a recent note, I discussed HistoQuery, a crowd-sourcing web site to which surgical pathology case images can be uploaded (see: A New Tool for Obtaining Crowd-Sourced Diagnoses for Pathology Images). It was developed by Dr. Ulysses Balis and colleagues at the University of Michigan Medical School and intended as a pathology teaching resource. It seems to me that, in addition to such an audience, surgical pathologists from around the world could potentially use the site to obtain a consensus diagnosis for cases from his or her daily workload. The question then arises as to what type of cases would be uploaded to the web site to seek a crowd-sourced diagnosis for a case.
For me, it seems clear that such cases would most likely be those for which the submitting pathologist is leaning in a particular direction for the diagnosis and then seeking a validation, albeit crowd-sourced and therefore not attributable to any one named colleague or consultant. Contrast this with a challenging case encountered by a pathologist who then seeks a consultation from an eminent pathologist or pathology department. Here such a case would certainly be sent to specific consultant (see: "Eminence-Based" Surgical Pathology and the Digital Pathology Department). In return, the submitting pathologist receives a signed report from an expert (generally) with a specific diagnosis. On to the next case!
In addition, I need to give more thought to the question of the appropriateness of physicians in developing countries with an acute shortage of pathologists uploading surgical pathology images to HistoQuery. In such countries, there may be an insufficient number of qualified pathologists to whom such cases could be sent or it may take many weeks to obtain a surgical pathology report. Is a crowd-sourced diagnosis better than none at all? In addition, images submitted from another country would be beyond the reach of U.S. regulatory authorities. However, we need to focus here on what is ethically correct. Is a crowd-sourced consensus from unnamed parties superior to no diagnosis at all for a patient?
Addendum on 7/29/2019
Coverage of HistoQuery in CAP Today: A killer app comes out of the crowd
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