RESUMO
A pilot study of the use of digital images as an adjunct to telephone referral was undertaken. Hand trauma represented the majority of the twenty patients included in the study, and the system was found to be an effective aid to delivering appropriate management. We have found image analysis to be a useful addition to the telephone referral process already in use in our unit, but it is unlikely to replace the need for real time clinical assessment of the patient.
Assuntos
Linhas Diretas , Relações Médico-Paciente , Consulta Remota/estatística & dados numéricos , Cirurgia Plástica/estatística & dados numéricos , Ferimentos e Lesões , Humanos , Projetos Piloto , Cirurgia Plástica/métodos , Telemedicina/estatística & dados numéricosRESUMO
BACKGROUND: The value of histological grading was examined with emphasis on reliability of assessment in 102 cases of intraoral squamous cell carcinoma from Northern Ireland with known outcome. METHODS: Two pathologists independently graded the invasive tumour front blinded to the stage and outcome. RESULTS: Intraobserver agreement was acceptable but interobserver agreement was not satisfactory. The degree of keratinisation was assessed most consistently while nuclear polymorphism was the least reliable feature. Multivariate survival analysis showed that the total grading score was associated with overall survival while the pattern of tumour invasion was the most valuable feature in estimating regional lymph node involvement. The number of positive lymph nodes was strongly associated with regional relapse, while the treatment modality and status of the surgical margins correlated with local relapse. CONCLUSIONS: Grading of selected features in OSCC is reliable and can facilitate treatment planning.
