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Article: Lignes directrices de l'association canadienne des pathologistes concernant l'implantation d'un service de télépathologie diagnostique à l'aide de lames virtuelles.

Têtu, Bernard

2014 Volume 34, Issue 4, Page(s) 256–257

Title translation	The Canadian Association of Pathology guidelines for establishing a diagnostic telepathology service using whole-slide imaging.
MeSH term(s)	Canada ; Guidelines as Topic ; Humans ; Information Dissemination ; Information Services/organization & administration ; Libraries, Digital ; Microscopy/methods ; Pathology, Clinical/methods ; Pathology, Clinical/organization & administration ; Societies, Medical/standards ; Telepathology/organization & administration ; Telepathology/standards ; User-Computer Interface
Language	French
Publishing date	2014-08
Publishing country	France
Document type	Journal Article
ZDB-ID	225720-8
ISSN	0242-6498
ISSN	0242-6498
DOI	10.1016/j.annpat.2014.06.012
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Article: The 'wrong pocket' problem as a barrier to the integration of telehealth in health organisations and systems.

Alami, Hassane / Shaw, Sara E / Fortin, Jean-Paul / Savoldelli, Mathilde / Fleet, Richard / Têtu, Bernard

Digital health

2023 Volume 9, Page(s) 20552076231169835

Abstract: The COVID-19 pandemic has accelerated the deployment of telehealth services in many countries around the world. It also revealed many barriers and challenges to the use of digital health technologies in health organisations and systems that have ... ...

Abstract	The COVID-19 pandemic has accelerated the deployment of telehealth services in many countries around the world. It also revealed many barriers and challenges to the use of digital health technologies in health organisations and systems that have persisted for decades. One of these barriers is what is known as the 'wrong pocket' problem - where an organisation or sector makes expenditures and investments to address a given problem, but the benefits (return on investment) are captured by another organisation or sector (the wrong pocket). This problem is the origin of many difficulties in public policies and programmes (e.g. education, environment, justice and public health), especially in terms of sustainability and scaling-up of technology and innovation. In this essay/perspective, we address the wrong pocket problem in the context of a major telehealth project in Canada. We show how the problem of sharing investments and expenses, as well as the redistribution of economies among the different stakeholders involved, may have threatened the sustainability and scaling-up of this project, even though it has demonstrated the clinical utility and contributed to improving the health of populations. In conclusion, the wrong pocket problem may be decisive in the reduced take-up, and potential failure, of certain telehealth programmes and policies. It is not enough for a telehealth service to be clinically relevant and 'efficient', it must also be mutually beneficial to the various stakeholders involved, particularly in terms of the equitable sharing of costs and benefits (return on investment) associated with the implementation of this new service model. Finally, the wrong pocket concept offers a helpful lens for studying the success, sustainability, and scale-up of digital transformations in health organisations and systems. This needs to be considered in future research and evaluations in the field.
Language	English
Publishing date	2023-04-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2819396-9
ISSN	2055-2076
ISSN	2055-2076
DOI	10.1177/20552076231169835
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Article ; Online: The ‘wrong pocket’ problem as a barrier to the integration of telehealth in health organisations and systems

Hassane Alami / Sara E Shaw / Jean-Paul Fortin / Mathilde Savoldelli / Richard Fleet / Bernard Têtu

Digital Health, Vol

2023 Volume 9

Abstract	The COVID-19 pandemic has accelerated the deployment of telehealth services in many countries around the world. It also revealed many barriers and challenges to the use of digital health technologies in health organisations and systems that have persisted for decades. One of these barriers is what is known as the ‘wrong pocket’ problem – where an organisation or sector makes expenditures and investments to address a given problem, but the benefits (return on investment) are captured by another organisation or sector (the wrong pocket). This problem is the origin of many difficulties in public policies and programmes (e.g. education, environment, justice and public health), especially in terms of sustainability and scaling-up of technology and innovation. In this essay/perspective, we address the wrong pocket problem in the context of a major telehealth project in Canada. We show how the problem of sharing investments and expenses, as well as the redistribution of economies among the different stakeholders involved, may have threatened the sustainability and scaling-up of this project, even though it has demonstrated the clinical utility and contributed to improving the health of populations. In conclusion, the wrong pocket problem may be decisive in the reduced take-up, and potential failure, of certain telehealth programmes and policies. It is not enough for a telehealth service to be clinically relevant and ‘efficient’, it must also be mutually beneficial to the various stakeholders involved, particularly in terms of the equitable sharing of costs and benefits (return on investment) associated with the implementation of this new service model. Finally, the wrong pocket concept offers a helpful lens for studying the success, sustainability, and scale-up of digital transformations in health organisations and systems. This needs to be considered in future research and evaluations in the field.
Keywords	Computer applications to medicine. Medical informatics ; R858-859.7
Subject code	360
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
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Article ; Online: Impact of artificial intelligence on pathologists' decisions: an experiment.

Meyer, Julien / Khademi, April / Têtu, Bernard / Han, Wencui / Nippak, Pria / Remisch, David

Journal of the American Medical Informatics Association : JAMIA

2022 Volume 29, Issue 10, Page(s) 1688–1695

Abstract: Objective: The accuracy of artificial intelligence (AI) in medicine and in pathology in particular has made major progress but little is known on how much these algorithms will influence pathologists' decisions in practice. The objective of this paper ... ...

Abstract	Objective: The accuracy of artificial intelligence (AI) in medicine and in pathology in particular has made major progress but little is known on how much these algorithms will influence pathologists' decisions in practice. The objective of this paper is to determine the reliance of pathologists on AI and to investigate whether providing information on AI impacts this reliance. Materials and methods: The experiment using an online survey design. Under 3 conditions, 116 pathologists and pathology students were tasked with assessing the Gleason grade for a series of 12 prostate biopsies: (1) without AI recommendations, (2) with AI recommendations, and (3) with AI recommendations accompanied by information about the algorithm itself, specifically algorithm accuracy rate and algorithm decision-making process. Results: Participant responses were significantly more accurate with the AI decision aids than without (92% vs 87%, odds ratio 13.30, P < .01). Unexpectedly, the provision of information on the algorithm made no significant difference compared to AI without information. The reliance on AI correlated with general beliefs on AI's usefulness but not with particular assessments of the AI tool offered. Decisions were made faster when AI was provided. Discussion: These results suggest that pathologists are willing to rely on AI regardless of accuracy or explanations. Generalization beyond the specific tasks and explanations provided will require further studies. Conclusion: This study suggests that the factors that influence the reliance on AI differ in practice from beliefs expressed by clinicians in surveys. Implementation of AI in prospective settings should take individual behaviors into account.
MeSH term(s)	Algorithms ; Artificial Intelligence ; Humans ; Male ; Pathologists ; Prospective Studies
Language	English
Publishing date	2022-06-24
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1205156-1
ISSN	1527-974X ; 1067-5027
ISSN (online)	1527-974X
ISSN	1067-5027
DOI	10.1093/jamia/ocac103
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Zs.A 4128: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Long term evaluation of optimized Gleason grading in a large cohort of men with prostate cancer in Canada.

Wissing, Michel / Brimo, Fadi / McKercher, Ginette / Scarlata, Eleonora / Saad, Fred / Carmel, Michel / Lacombe, Louis / Têtu, Bernard / Ekindi-Ndongo, Nadia / Latour, Mathieu / Trudel, Dominique / Chevalier, Simone / Aprikian, Armen

Human pathology

2024 Volume 146, Page(s) 66–74

Abstract: Objectives: To evaluate the International Society of Urological Pathology (ISUP) 5-tier grade grouping (GG) system of prostate cancers as well as previously proposed optimizations.: Patients and methods: The PROCURE biobank is a prospective cohort ... ...

Abstract	Objectives: To evaluate the International Society of Urological Pathology (ISUP) 5-tier grade grouping (GG) system of prostate cancers as well as previously proposed optimizations. Patients and methods: The PROCURE biobank is a prospective cohort study of patients with localized prostate cancer who underwent radical prostatectomy in Quebec province between 2005 and 2013. Surgical specimens were graded by experienced genitourinary pathologists using 2019 ISUP criteria. Follow-up was conducted until November 2021. The current 5-tier and a proposed 6-tier GG system were evaluated, the latter having two changes: 1) Gleason 3 + 4 and 4 + 3 tumors with minor/tertiary Gleason 5 patterns were upgraded to GG 3 and 4, respectively; and 2) patients in GG5 were separated based on primary Gleason pattern (4 or 5). Cox proportional hazards models and Harrell's concordance (C) indices were used for statistical analyses. Results: 2003 patients were included (median follow-up: 8.7 years). The current 5-tier GG system predicted time to recurrence (hazard ratio [HR] 2.12, 95% confidence interval [95%CI] 1.99-2.25, C 0.717), androgen-deprivation therapy (HR 2.58, 95%CI 2.38-2.80, C 0.790), metastasis (HR 2.48, 95%CI 2.17-2.83, C 0.806), castration-resistant prostate cancer (HR 2.67, 95%CI 2.28-3.13, C 0.829), and cancer-specific mortality (HR 2.80, 95%CI 2.27-3.44, C 0.835). Goodness-of-fit further improved with the proposed 6-tier GG system, with Harrell's C of 0.733, 0.807, 0.827, 0.853, and 0.853, respectively. Conclusions: The 5-tier GG system predicted short- and long-term outcomes for patients with localized prostate cancer, and the proposed 6-tier GG system further improved its accuracy.
MeSH term(s)	Humans ; Male ; Prostatic Neoplasms/pathology ; Neoplasm Grading ; Middle Aged ; Aged ; Prostatectomy ; Prospective Studies ; Neoplasm Recurrence, Local/pathology ; Time Factors
Language	English
Publishing date	2024-04-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	207657-3
ISSN	1532-8392 ; 0046-8177
ISSN (online)	1532-8392
ISSN	0046-8177
DOI	10.1016/j.humpath.2024.04.002
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Zs.A 722: Show issues

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Article ; Online: Diagnosis of urothelial carcinoma from urine.

Têtu, Bernard

Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc

2009 Volume 22 Suppl 2, Page(s) S53–9

Abstract: Urine cytology is the most widely used noninvasive test to detect urothelial tumors. However, it is limited by its low sensitivity. On the other hand, cystoscopy is the gold standard procedure to follow patients with a history of bladder cancer but this ... ...

Abstract	Urine cytology is the most widely used noninvasive test to detect urothelial tumors. However, it is limited by its low sensitivity. On the other hand, cystoscopy is the gold standard procedure to follow patients with a history of bladder cancer but this test is invasive and costly. Therefore, there is a real need to develop new tests that can be used in bladder cancer surveillance. Several soluble and cell-based markers have been developed and most of them improve the sensitivity of cytology but the specificity is invariably decreased. Of the cell-based tests, two obtained Food and Drug Administration approval. ImmunoCyt/uCyt is a fluorescent test that uses three monoclonal antibodies and UroVysion is an in situ hybridization test, which uses four different probes to different chromosomes. Both tests have a high sensitivity to detect cancer cells and can help to predict urothelial cancer recurrence. ImmunoCyt/uCyt is somewhat better at detecting low-grade tumors but UroVysion is not affected by prior BCG treatment. However, both tests use fluorescent dyes, are time-consuming and require trained personnel. Because of their high negative predictive value, both tests may help the urologist to postpone a number of cystoscopies, especially in patients with low-risk urothelial cancer.
MeSH term(s)	Biomarkers, Tumor/urine ; Carcinoma, Transitional Cell/diagnosis ; Carcinoma, Transitional Cell/urine ; Cytodiagnosis/methods ; Humans ; Sensitivity and Specificity ; Urinary Bladder Neoplasms/diagnosis ; Urinary Bladder Neoplasms/urine
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2009-06-12
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	645073-8
ISSN	1530-0285 ; 0893-3952
ISSN (online)	1530-0285
ISSN	0893-3952
DOI	10.1038/modpathol.2008.193
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Article: Morphological changes induced by androgen blockade in normal prostate and prostatic carcinoma.

Têtu, Bernard

Best practice & research. Clinical endocrinology & metabolism

2008 Volume 22, Issue 2, Page(s) 271–283

Abstract: Maximal androgen blockade (MAB), combining a luteinizing hormone releasing hormone (LHRH) agonist and a pure or non-steroidal anti-androgen, induces significant morphologic changes in the prostate. The tumor volume, density, capsular penetration, and ... ...

Abstract	Maximal androgen blockade (MAB), combining a luteinizing hormone releasing hormone (LHRH) agonist and a pure or non-steroidal anti-androgen, induces significant morphologic changes in the prostate. The tumor volume, density, capsular penetration, and surgical margin involvement are strongly reduced following such treatment. On histology, normal prostate tissue and tumor undergo marked atrophy and shrinkage. Although residual cancer cells are readily identifiable in most cases, they may often be sparse and easily overlooked. The increased Gleason score apparent after MAB is most likely related to fragmentation of acinar structures, and grading is not recommended following MAB. Residual cancer cells show features of lower activity and increased apoptosis. Such therapy-induced changes may be reversible, although occasional clones of cancer cells are apparently not affected and have probably developed resistance. Finally, MAB leads to marked but reversible morphologic changes and reduction in prevalence and extent of prostatic intra-epithelial neoplasia (PIN). Monotherapy using a variety of agents causes comparable but often less extensive changes.
MeSH term(s)	Androgen Antagonists/pharmacology ; Androgen Antagonists/therapeutic use ; Antineoplastic Agents, Hormonal/pharmacology ; Antineoplastic Agents, Hormonal/therapeutic use ; Carcinoma/drug therapy ; Carcinoma/pathology ; Humans ; Male ; Neoplasms, Hormone-Dependent/drug therapy ; Neoplasms, Hormone-Dependent/pathology ; Prostate/cytology ; Prostate/drug effects ; Prostatic Intraepithelial Neoplasia/drug therapy ; Prostatic Intraepithelial Neoplasia/pathology ; Prostatic Neoplasms/drug therapy ; Prostatic Neoplasms/pathology
Chemical Substances	Androgen Antagonists ; Antineoplastic Agents, Hormonal
Language	English
Publishing date	2008-04
Publishing country	Netherlands
Document type	Evaluation Studies ; Journal Article ; Review
ZDB-ID	2052339-7
ISSN	1532-1908 ; 1521-690X
ISSN (online)	1532-1908
ISSN	1521-690X
DOI	10.1016/j.beem.2008.01.005
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Article: Leukocytic Infiltration of Intraductal Carcinoma of the Prostate: An Exploratory Study.

Diop, Mame-Kany / Molina, Oscar Eduardo / Birlea, Mirela / LaRue, Hélène / Hovington, Hélène / Têtu, Bernard / Lacombe, Louis / Bergeron, Alain / Fradet, Yves / Trudel, Dominique

Cancers

2023 Volume 15, Issue 8

Abstract: Intraductal carcinoma of the prostate (IDC-P) is an aggressive histological subtype of prostate cancer (PCa) detected in approximately 20% of radical prostatectomy (RP) specimens. As IDC-P has been associated with PCa-related death and poor responses to ... ...

Abstract	Intraductal carcinoma of the prostate (IDC-P) is an aggressive histological subtype of prostate cancer (PCa) detected in approximately 20% of radical prostatectomy (RP) specimens. As IDC-P has been associated with PCa-related death and poor responses to standard treatment, the purpose of this study was to explore the immune infiltrate of IDC-P. Hematoxylin- and eosin-stained slides from 96 patients with locally advanced PCa who underwent RP were reviewed to identify IDC-P. Immunohistochemical staining of CD3, CD8, CD45RO, FoxP3, CD68, CD163, CD209 and CD83 was performed. For each slide, the number of positive cells per mm
Language	English
Publishing date	2023-04-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15082217
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Article ; Online: High infiltration of CD209

Molina, Oscar Eduardo / LaRue, Hélène / Simonyan, David / Hovington, Hélène / Têtu, Bernard / Fradet, Vincent / Lacombe, Louis / Toren, Paul / Bergeron, Alain / Fradet, Yves

Frontiers in immunology

2023 Volume 14, Page(s) 1205266

Abstract: Introduction: Prostate cancer (PCa) shows considerable variation in clinical outcomes between individuals with similar diseases. The initial host-tumor interaction as assessed by detailed analysis of tumor infiltrating immune cells within the primary ... ...

Abstract	Introduction: Prostate cancer (PCa) shows considerable variation in clinical outcomes between individuals with similar diseases. The initial host-tumor interaction as assessed by detailed analysis of tumor infiltrating immune cells within the primary tumor may dictate tumor evolution and late clinical outcomes. In this study, we assessed the association between clinical outcomes and dendritic cell (DC) or macrophage (MΦ) tumor infiltration as well as with expression of genes related to their functions. Methods: Infiltration and localization of immature DC, mature DC, total MΦ and M2-type MΦ was analyzed by immunohistochemistry in 99 radical prostatectomy specimens from patients with 15.5 years median clinical follow-up using antibodies against CD209, CD83, CD68 and CD163, respectively. The density of positive cells for each marker in various tumor areas was determined. In addition, expression of immune genes associated with DC and MΦ was tested in a series of 50 radical prostatectomy specimens by Taqman Low-Density Array with similarly long follow-up. Gene expression was classified as low and high after unsupervised hierarchical clustering. Numbers and ratio of positive cells and levels of gene expression were correlated with endpoints such as biochemical recurrence (BCR), need for definitive androgen deprivation therapy (ADT) or lethal PCa using Cox regression analyses and/or Kaplan-Meier curves. Results: Positive immune cells were observed in tumor, tumor margin, and normal-like adjacent epithelium areas. CD209 Conclusion: A higher level of infiltration of CD209
MeSH term(s)	Male ; Humans ; Prostatic Neoplasms/genetics ; Prostatic Neoplasms/surgery ; Androgen Antagonists ; Antigens, CD/genetics ; Dendritic Cells
Chemical Substances	CD163 antigen ; Androgen Antagonists ; Antigens, CD
Language	English
Publishing date	2023-06-26
Publishing country	Switzerland
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2606827-8
ISSN	1664-3224 ; 1664-3224
ISSN (online)	1664-3224
ISSN	1664-3224
DOI	10.3389/fimmu.2023.1205266
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Article ; Online: Canadian licensure for the use of digital pathology for routine diagnoses: one more step toward a new era of pathology practice without borders.

Têtu, Bernard / Evans, Andrew

Archives of pathology & laboratory medicine

2014 Volume 138, Issue 3, Page(s) 302–304

MeSH term(s)	Canada ; Humans ; Licensure, Medical ; Telepathology
Language	English
Publishing date	2014-03
Publishing country	United States
Document type	Editorial
ZDB-ID	194119-7
ISSN	1543-2165 ; 0363-0153 ; 0096-8528 ; 0003-9985
ISSN (online)	1543-2165
ISSN	0363-0153 ; 0096-8528 ; 0003-9985
DOI	10.5858/arpa.2013-0289-ED
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