Effect of image compression on telepathology. A randomized clinical trial.
CONTEXT: For practitioners deploying store-and-forward telepathology systems, optimization methods such as image compression need to be studied. OBJECTIVE: To determine if Joint Photographic Expert Group (JPG or JPEG) compression, a glossy image compression algorithm, negatively affects the accuracy of diagnosis in telepathology. DESIGN: Double-blind, randomized, controlled trial. SETTING: University-based pathology departments. PARTICIPANTS: Resident and staff pathologists at the University of Illinois, Chicago, and University of Cincinnati, Cincinnati, Ohio. INTERVENTION: Compression of raw images using the JPEG algorithm. MAIN OUTCOME MEASURES: Image acceptability, accuracy of diagnosis, confidence level of pathologist, image quality. RESULTS: There was no statistically significant difference in the diagnostic accuracy between noncompressed (bit map) and compressed (JPG) images. There were also no differences in the acceptability, confidence level, and perception of image quality. Additionally, rater experience did not significantly correlate with degree of accuracy. CONCLUSIONS: For providers practicing telepathology, JPG image compression does not negatively affect the accuracy and confidence level of diagnosis. The acceptability and quality of images were also not affected.