INTRODUCING …

What is PathCONSULT? 線上診斷臨床決策支援，涵蓋一般病理學的每一個次專科範圍 設計用來滿足point of work的需要. 包含數以千計的圖片，可放大觀看 功能強大的鑑別診斷工具 包括 1200 種常見的疾病

It all started with a book.. 3000 pages >8000 images organized by organ system 9th edition includes diagnostic pearls So now to the case study….It all started with a book, and not just any book – its one of the bibles for pathologists, one of the books they pretty much all have It is a large book (actually 2 volumes), it is basically a large atlas of photo’s taken down a microscope. It is images of diseased tissue that’s been stained, mostly tumors of all shapes and sizes. Is is organized per body part and it includes text with each set of images as background to help in the diagnosis.這是一本很大的書(事實上包含兩冊) 基本上是包含了許多在顯微鏡底下的照片的圖解集，許多染色的疾病組織，許多各種形狀大小的腫瘤，按照身體部位編排，每一組圖片包含文字作為幫助診斷的背景知識。 But instead of simply plonking the content online which would have been quick and fairly easy for us, we decided to first of all understand how and why the pathologist used this book – after all they all buy it, why? 取代只是把這本書的內容線上化，這對我們是非常容易的工作，但我們決定首先了解如何及為什麼病理師使用這本書，畢竟他們都買了這本書

What is a Pathologist? A physician who uses the tools of contemporary science to diagnose and to produce data to guide clinicians in the accurate diagnosis and management of disease. 75% of the typical medical record is produced by labs run by pathologaists. 病理師主要任務是做病理診斷，提供臨床醫師治療的參考 由此可見病理科對於臨床醫師的重要性

What does a pathologist do? 90% of what a pathologist does is: 注視顯微鏡下的載玻片 & 做出診斷 If they cannot make a diagnosis, they: 查詢資訊 or 問同事 or 增加一個染色的圖片 or 請教專家 Why do they look up information? 他們不確定所看到的圖片是什麼 他們在兩個或多個可能的診斷裡無法下決定 他們知道正確的診斷是什麼但是需要知道更多資訊 他們需要知道要採取什麼行動以判別一個診斷的資訊 We discovered what they did and why they needed information, in a nutshell概括地說, they spend all their time staring down a microscope. Their goal is to make an accurate diagnosis as fast as possible so that they can do as many as possible in a day. They use information to confirm what they think but most importantly when confronted by a sample that is ambiguous, that could be different things – some diseases have tissue samples that look very similar – the pathologist needs to make an accurate diagnosis (lives depend on it – most often they are called to decide if a tissues benign or malignant) and they’d like to make as many diagnoses per day since that’s how they are paid. This is differential diagnosis and is the most critical reason for a pathologist to look for information

Scope of Pathology Practice 70% 15% 15% <1%

Pathologists at work And where do they work? Well we visited them, and observed them, shadowed them in field study We saw that they are hooked on books, that they all have pc’s, that the pc’s are next t the microscopes that are next to the books, we saw them open multiple books, and shove markers into different pages…..then flip between them

What do we do if we have a histology look-alike? GO TO THE PICTURE BOOKS! Just one problem: Who owns enough picture books to guarantee they will find the one picture they need?

PathConsult®: The Solution 將Elsevier出版的圖片整合至一個容易進入的資源 摘要跟編輯相對應的文字敘述，反應病理學家如何思考的入口 持續更新使PathConsult成為一個珍貴的資源

PathConsult Benefits 幫助避免誤診 增加臨床效率 節省時間 提供超過任何一本書所能包括的圖片 即時 快速導覽 以知名的參考書籍為根據 Rosai, McKee, Weedon, Odze, Fletcher, Enziger and Weiss

Information Sources from Rosai: Rosai and Ackerman's Surgical Pathology 9/e Ahmed: Diagnostic Breast Pathology 1/e Atkinson: Atlas of Diagnostic Cytopathology 2/e Bostwick: Urologic Surgical Pathology 1/e Bullough: Orthopedic Pathology 4/e Corrin: Pathology of the Lungs 2/e Crum: Diagnostic Gynecologic and Obstetric Pathology 1/e Ellison: Neuropathology 2/e Fletcher: Diagnostic Histopathology of Tumors 2/e Fogo: Diagnostic Atlas of Renal Pathology 1/e Geisinger: Modern Cytopathology 1/e Kanel: Atlas of Liver Pathology 2/e Kern: Atlas of Renal Pathology 1/e Kilpatrick: Diagnostic Musculoskeletal Surgical Pathology 1/e

Information Sources from Leslie and Wick: Practical Pulmonary Pathology 1/e McKee: Pathology of the Skin 3/e Miettinen: Diagnostic Soft Tissue Pathology 1/e Odze: Surgical Pathology of the GI Tract, Liver, Biliary Tract & Pancreas 1/e Prat: Pathology of the Ovary 1/e Prayson: Neuropathology 1/e Robboy: Pathology of the Female Reproductive Tract 1/e Silverberg: Silverberg's Principles & Practice of Surgical Pathology & Cytopathology 4/e Tannenbaum: Diagnostic Atlas of Genitourinary Pathology 1/e Taylor: Immunomicroscopy 3/e Thompson: Endocrine Pathology 1/e Weiss: Enzinger & Weiss's Soft Tissue Tumors 4/e Wenig: Atlas of Endocrine Pathology 1/e Wenig: Atlas of Head and Neck Pathology 2/e

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