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Cytological Training at European Standard through Telepathology
Start date: Sep 1, 2014, End date: Aug 31, 2017 PROJECT  FINISHED 

The Project focuses on the area of Cytology, intended for the screening and diagnoses of Cancers of different organs. Cytological tests are performed in number of millions/year in Europe, with an objective need of standardizing quality levels. The necessary training of the professionals involved (Cytotechs, Cytoscreeners, Biologists, Pathologists) in the different European nations is based on Courses and Masters at University level, which employ texts, fixed images of reference patterns and sessions at microscopes, in order to guarantee a reproducible recognition of structural features typical of malignant/cancer cells. Diplomas of Competence in Cytology are released by single European Nations, but a single European Accreditation Test, certifying a diagnostic ability at a standardized level would no doubt be the preferred option. In order to meet these requirement, the European Federation of Cytological Societies (EFCS) established QUATE (Quality Assurance, Training and Examination) Aptitude Test but the complexity of its organization make this test practiced by a relatively low number of applicants (approximately 50 in year 2013). The Cy-TEST System aims both at delivering a training course accomplishing the needed criteria to successfully afford the QUATE test and at generating the e-QUATE, the electronic version of the QUATE test, thus reaching a more popular, cheaper and efficient impact. The Cy-TEST Project is based on the exploitation of the Virtual Slide (VS) technology permitting a telematic transfer and navigation of scanned images of reference cytological slides. Images are stored at very high resolutions and can be viewed via Internet with proper Virtual Microscope software (eg Zoomify). These images can be used –with specific tools-to realize highly interactive self assessment exercises that will improve the competence of cytotechnologists. For example exercises will show details of cells in an image, or ask to search for particular “clues” that can lead to diagnoses. These training cases will be accessible through the Cy-TEST system, an open access (with free registration) e-learning platform developed upon the existing open source system Moodle. The project starts with the definition of the requirements for the system, the identification of suitable training methodologies and the organisation of the training contents answering to QUATE criteria and target user needs. All partners will contribute to the collection of images. At least 1000 cases/examples will be collected, managed and stored in a dedicated repository, wherefrom to organize both an inter-active training Course and Internet-based QUATE (e-QUATE) sessions. This will allow to make training, quality assessment and continuing education of Cytologists easier, standardized and accessible. After the release of the preliminary versions of the system and of the training cases, a continuous assessment cycle (development-assessment-refinement) will be performed with real users in order to monitor usability and reliability. At least 200 cyto-technicians will be involved in the project in the pilot phases; also 200 residents in Pathology in partner’s universities will be reached. Long term impact (only focusing on the primary targets, without taking into account secondary ones) can be estimated from 12 to 15 thousands people that is the population of Cytologists working in Pathology laboratories in Europe. The Cy-TEST idea derives from the experience gained by the conduction of the very successful EU-funded TASTE project (www.tasteproject.eu) on the Telepathological Assessment of Histological and Cytological preparations, while its validation will be in the responsibility of the EFCS comprehensive of 28 National Societies and with thousands of Members. Both the coordinators of the EU funded projects TASTE and EUROCITOLOGY are partners of this proposal, thus ensuring a synergy that will allow reusability of already obtained results. The participants to the Project are accordingly leaders in the fields of Cytology and Pathology (the Secretary and the Treasurer of EFCS, the past President of the European Society of Pathology, the leaders of the Eurocytology and of the TASTE Projects), thus ensuring a high quality level of training and an a wide exploitation. The Cy-TEST consortium is composed of 6 organizations (4 universities, and 2 no profit institutions) all strictly directly active or connected to the cytology world and with a strong commitment for delivering higher education enhancing cytologists quality levels. This System, which will be an integral part of EFCS activities so as to guarantee its sustainability, represents a move towards a technically-based improvement of quality level assurance, which is what European patients request.
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