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Virchows Arch. 2019 Feb 21. doi: 10.1007/s00428-019-02540-w. [Epub ahead of print]

The International Society of Urological Pathology Education web-a web-based system for training and testing of pathologists.

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Department of Oncology and pathology, Karolinska Institutet, Karolinska University Hospital, 171 76, Stockholm, Sweden.
Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health sciences, University of Otago, Wellington, New Zealand.
Aquesta Uropathology and University of Queensland, Brisbane, QLD, Australia.
Department of Urology, Laboratory of Medical Research, University of Sao Paulo Medical School, São Paulo, Brazil.
Department of Pathology, N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology, Branch of the National Medical Radiological Research Centre of the Ministry of the Russian Federation, Moscow, Russia.
Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Nagasaki, Japan.
Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi'an, People's Republic of China.
Division Anatomia Patologica, Hospital JM Ramos Mejia, Buenos Aires, Argentina.
Department of Surgical Pathology, School of Medicine, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Japan.
Department of Oncology and pathology, Karolinska Institutet, Karolinska University Hospital, 171 76, Stockholm, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.


Pathology training resources remain scarce in many parts of the world. With rapid economic development comes the need to educate new pathologists to meet the medical care demands. Our aim was to set up a cost-effective system for training and testing the diagnostic skills of pathologists. Pathologists in nine countries in Asia and South America were invited by the International Society of Urological Pathology (ISUP) to participate in a prostate pathology education course combining image-based tests with lectures and on-line tutorials. The tests and tutorials are available free of charge at the ISUP education website . A total of 603 pathologists registered on the website. Of these, 224 completed pre- and post-lecture assessments (tests 1 and 2). Replies were classified as correct/acceptable, when a lesion was accurately classified into clinically relevant categories (benign, cancer, high-grade prostatic intraepithelial neoplasia, intraductal carcinoma of the prostate). The rate of correct/acceptable replies increased from 60.7 to 72.3% in Tests 1 and 2, respectively. In Test 1, pathologists from upper middle, lower middle, and low resource countries gave a correct/acceptable diagnosis in 65.8%, 61.0%, and 47.4%, respectively. Their results improved in Test 2 to 76.4%, 72.5%, and 62.8%, respectively. The greatest improvement in diagnostic ability was achieved in pathologists from the low resource group of countries. The use of web-based testing and training, combined with lectures, is an efficient method for improving diagnostic skills of pathologists in low to middle resource countries.


Bladder; Database; Diagnosis; Grading; Kidney; Pathology; Prostate; Standardization


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