Application of digital slide scanning in external quality assessment program on intestinal parasites

BACKGROUND:
Intestinal parasitic infections remain prevalent in Viet Nam. Therefore, ensuring quality assurance in intestinal parasite testing is crucial for screening laboratories. The challenges associated with liquid or glass slide samples necessitate the exploration of digital slide applications, which can offer numerous benefits to program suppliers and participants.


OBJECTIVES:
Compare the true and concordance rates of digital and glass slides for diagnosis.


DESIGN:
Experimental research design.


MATERIALS AND METHODS:
In total, 30 medical professionals from 30 hospitals participated in the trial. The sets of slides encompassed a range of densities, including negative and coinfected slides. Seven types of glass slides were selected for scanning and digital slide production.


MAIN OUTCOME MEASURES:
The primary outcomes were true and concordance variables. Secondary outcomes included time sample sending and time completion. The digital slides were uploaded to a secure website for participant access while glass slides were sent individually by mail. Data collection involved participants analyzing specimens and reporting their results using a scoring method based on parasite detection and identification accuracy.


SAMPLE SIZE:
210 glass and digital slide-reading results each.


RESULTS:
The mean true rate between original and glass slides diagnosis was 97.6% (range 90.0%–100%), and it slightly increased to 98.1% (range 90.0%–100%) when using digital slides. The average concordance diagnosis rate between glass and digital slides was 99.5%. Importantly, there were no differences in the diagnostic results between glass and digital slides. The findings revealed that the use of digital slides reduced the total time required by approximately 1.1 days compared with that of glass slides.


CONCLUSION:
Altogether, the application of digital slides in the external quality assessment program for intestinal parasites offers convenience for users through online platforms and saves operational time process.


LIMITATIONS:
The small sample size in this experimental study limited the statistical significance of the comparisons.