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Integrating such data into the study of whole slide images is a challenge for the digital pathology space at large, Dr. Hewitt says, noting that data sets often are discontinuous and that the systems used to display whole slide images aren’t designed to handle quantitative data queries. Though image analysis and analytics are routinely performed on whole slide images, “only when we include the metadata in those analytics do we accomplish substantial gains,” he says. “I think the COVID-DPR will evolve so that in the future, researchers will be able to perform analyses on these images, but right now it’s very much ‘come and view.’” Furthermore, the version of Halo used for the repository doesn’t include the full analytics package offered by Indica Labs, though it may be added later. “That doesn’t mean we’re not taking the images—especially the NIH images—and running them through advanced analytics, but that’s happening on our internal platforms,” Dr. Hewitt says.

Using artificial intelligence to analyze images in the COVID-DPR too has been challenging, though the repository was conceived with an eye toward AI applications. Early in the pandemic, Dr. Hewitt says, researchers assumed that SARS-CoV-2 infection gave “a consistent and static histopathology. We didn’t know what it looked like, so everybody assumed it was unique and somewhat fixed.” But the autopsies that emerged in the initial weeks of the outbreak demonstrated an inconsistent histopathology, particularly pertaining to the lungs. For example, time of infection to time of death was a significant vector with regard to lung injury. Furthermore, several patterns of lung injury were observed, including thromboemboli, pulmonary edema, and progressive acute respiratory distress syndrome with diffuse alveolar damage.

Preanalytic variables involving the patient’s course of infection, as well as specimen handling, also complicated the potential for AI analysis. For instance, the CDC requires 72 hours of fixation for autopsy tissue specimens, Dr. Hewitt says, “which is a major preanalytic variable impacting quality.”

“Now, if you have a small or large fixed set of organs handled with a very tight protocol, such as a 24-hour postmortem protocol,” he explains, “AI may be more interesting to do. We’re pursuing that now, looking at hearts, kidneys, livers, and eventually lungs. One of the questions we’re more interested in today—compared to what people thought they were going to focus on at the beginning of the pandemic—is not, ‘Is this SARS or not?’ but ‘What is the contribution of comorbidities to the pathology that we see?’ We’re saying, ‘Is it COVID related, or is it hypertension, diabetes, or obesity?’ So we’re using AI to try to understand the intersection of the comorbidities with SARS-CoV-2.”

As Dr. Hewitt tackles these and other COVID-related issues, he acknowledges the irony that the subject of his investigation is the very thing that slows his efforts to enhance the repository. “If I had more hands in the laboratory,” he says, “I could better utilize my virtual collaborators.”
—Charna Albert

PathAI purchases Poplar Healthcare Management

The digital pathology and artificial intelligence firm PathAI has acquired Poplar Healthcare Management, the management service organization for the anatomic pathology laboratory services provider Poplar Healthcare PLLC.

Under terms of the transaction, Poplar’s facilities and approximately 350 employees now compose PathAI’s diagnostics division. Poplar Healthcare supports a nationwide client base of gastroenterologists, dermatologists, oncologists, urologists, and gynecologists, and their patients.

PathAI and Poplar will focus on further digitizing the Poplar laboratory workflow and leveraging PathAI’s image-analysis and algorithm-development capabilities to develop new clinical applications, according to a joint press release from the companies.

PathAI, 617-500-8457

LigoLab offers TestDirectly for at-home specimen collection

LigoLab Information Systems’ Test­Directly patient-engagement platform supports at-home specimen self-collection for diagnostic testing and preventative screening.

Patients can place orders online for test kits from pathology laboratories throughout the United States that are featured in TestDirectly’s platform. Via interfaces to national shipping services, TestDirectly provides laboratories with backend support for shipping test kits to patients and tracks the delivery of kits to patients and the resulting specimens to laboratories. The platform also tracks laboratory processing of specimens.

The TestDirectly portal uses email and SMS notifications for automated delivery of test results to patients. LigoLab most recently added functionality that allows patients to participate in videoconferencing and schedule consultations via the platform.

TestDirectly is an agnostic, cloud-based solution that can be integrated with laboratory information systems and revenue cycle management solutions to simplify the ordering, collection, and testing of specimen samples and provide patient reporting.

LigoLab Information Systems, 818-395-4659

Dr. Aller practices clinical informatics in Southern California. He can be reached at raller@usc.edu. Dennis Winsten is founder of Dennis Winsten & Associates, Healthcare Systems Consultants. He can be reached at dwinsten.az@gmail.com.