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Biomedical subjects

P J Harkin

Publications and source records attributed to P J Harkin.

7 recordsLinked to original sources

Pathological variables determining the prognosis of non-Hodgkin's lymphomas.

The aim of the study was to assess the role of pathological grade, cell proliferation, ploidy, immunophenotype and site in determining the prognosis of non-Hodgkin's lymphomas. Of particular interest was the relative value of grades derived from the Kiel classification as opposed to the National Cancer Institute (NCI) working formulation. The study consisted of 181 cases, treated in a relatively uniform way over an 18-month period spanning 1986. Using life table analysis, both NCI working formulation grade and Kiel grade correlated strongly with survival. However, the differences between grades were entirely due to an excess of early deaths in the high-grade and intermediate-grade categories. In patients surviving greater than 0.1 years (37 days), phenotype, site, ploidy and cell proliferation had no effect on survival. There was no evidence that intermediate-grade tumours, when subdivided into Kiel low- and high-grade types, differed in survival from tumours graded as low- or high-grade by both methods. However, NCI working, formulation high-grade tumours, especially those with a high proliferation rate, formed a group with a very high likelihood of death within 0.1 years.

Adult

Computer assisted selection and assessment of antibodies in the diagnosis of lymphomas.

With increasing numbers of reagents the problem of selecting appropriate antibodies to solve problems in the diagnosis of lymphoma is becoming more complex. One approach is to use a computer program to optimise the selection process. Such a program was devised, incorporating data from an extensive literature search. When presented with a differential diagnosis it selects the most appropriate antibody panel and when given the results evaluates the relative likelihood of each possible diagnosis. In a retrospective study 81% of the tests used had been non-discriminatory, but using the results of the remaining 19% of the tests, the computer was able to select the "correct" diagnosis with a high degree of certainty. The development and use of this system illustrated several problems in the application of computer assisted diagnostic techniques in histopathology. These problems include incomplete data and lack of understanding of the process of histopathological diagnosis.

Algorithms

Morphometric assessment of ovarian stromal proliferation--a clinicopathological study.

Ovarian stromal hyperplasia is commonly observed in peri- and post-menopausal ovaries. Assessment has, hitherto, been largely subjective or dependent on arbitrary criteria, which has made comparison of studies difficult. In this study, the stroma of a large number of ovaries was assessed morphometrically. Data were related to clinicopathological and cytomorphological information. A significant association was noted between the degree of stromal proliferation and post-menopausal endometrial adenocarcinoma (P = 0.004). There were no significant correlations between the degree of stromal proliferation and average cytomorphological dimensions.

Adenocarcinoma

Computer viruses.

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Software

How do we teach pathology? The laser videodisc and computer-assisted learning.

A laser videodisc, holding 54,000 still frames per side, can be used to provide visual material of excellent quality for pathology teaching. In a collaborative project between ten pathology departments, the first pathology videodisc has recently been completed and the production of the disc is described. When used as illustrative material for computer-assisted learning programs, the videodisc offers accurate random access of still frames and allows the overlay of computer-generated graphics onto the video picture. This can be used to pre-identify every individual feature of a particular frame, and an example tutorial program is described to show how this may be used to improve the students' understanding of what they see. Details and costs are given for a workstation suitable for this application and potential future developments for this teaching method are discussed. Although objective assessment of the cost-effectiveness of interactive video in teaching pathology has yet to be undertaken, one suitably designed program can give individual tuition to many students, making this a most efficient use of teaching time.

Computer-Assisted Instruction

Continual audit of clinical diagnostic accuracy by computer: a study of 592 autopsy cases.

In a prospective study of 592 autopsy cases, correlations between clinical and pathological data were made by computer from a novel protocol on which morphological and functional diagnoses were separated. The accuracy of diagnosis was analysed with respect to time in hospital, specialty, consultant in charge, and other criteria. Overall, there were 168 clinical 'overdiagnoses', not confirmed at autopsy; 492 'underdiagnoses', not made clinically; and 432 'agreements' between clinical and pathological diagnoses. The computer program allows the data to be analysed at any time as the number of cases increases. Entry of information entails comparatively little extra work and a similar system could be incorporated into the service commitment of any pathology department with a suitable microcomputer and access to a mainframe computer.

Autopsy