What is the potential workplace efficiency impact of computational pathology?
David Snead: It will be able to automate tasks – either removing them from the workflow entirely or speeding up the time a pathologist would take to do them. For example, in the recognition of normal tissue and finding regions of interest in samples which are abnormal. This work will save some of the time spent by pathologists looking for areas of abnormality, such as the spread of breast cancer to lymph nodes, or prostate cancer in prostatic chippings. These are exciting developments from a service and capacity point of view. We've been thinking about those for some years now and we’re convinced that this is the right track.
But to do this, you have to digitize your workflow. That's going to drive changes in laboratory configuration, changes in the way the services are provided across regions of the country, as well as how pathologists are trained. So there are quite significant things to get to grips with.
I think it’s fair to say that most pathologists are highly skeptical that this technology is ready or nearly ready for adoption. I think they can all see it coming but are thinking it will take years to arrive and may be quite limited in its extent. We must produce the data to convince them, but pathologists are only one facet of the service. A lot of the decisions about implementing these ways of working will be made by clinical directors, chief medical officers and hospital management committees. Pathologists are an important voice, but they’re not the only one.
Are there any countries outside the UK that are leading the way in this field?
Nasir Rajpoot: There have been major inroads in Canada and some European countries, such as Sweden. We meet with colleagues from all over the world and UK investment into ISCF centers of excellence on AI in pathology is as good as anywhere in this discipline.
The Future Health Index 2019 report indicates that the general population in China, Russia and Saudi Arabia are more likely to associate AI technologies with more accurate diagnosis. Why do you think this might be the case?
David Snead: Most patients have a very limited understanding of what happens behind the scenes of their care. And pathology is, certainly in the UK and I suspect most countries, a very backroom job and is not something that patients normally interact with. The countries you mentioned probably are an exception, in that it's not unusual for patients there to hang on to their samples and scans and bring them with them when they go to consultations. These are health economies where the patient keeps his or her own records, their own data if you like, with them and go to the next doctor. So that is quite different to how most health economies work.
Nasir Rajpoot: With regards to sharing data, there is some work to be done. The industry, academia and NHS need to work together with funding agencies and patient groups to come up with clear guidelines for the ethical use of medical data for research purposes and for the benefit of the population at large.