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Kusta O, Bearman M, Gorur R, Risør T, Brodersen JB, Hoeyer K. Speed, accuracy, and efficiency: The promises and practices of digitization in pathology. Soc Sci Med 2024; 345:116650. [PMID: 38364720 DOI: 10.1016/j.socscimed.2024.116650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 12/17/2023] [Accepted: 02/02/2024] [Indexed: 02/18/2024]
Abstract
Digitization is often presented in policy discourse as a panacea to a multitude of contemporary problems, not least in healthcare. How can policy promises relating to digitization be assessed and potentially countered in particular local contexts? Based on a study in Denmark, we suggest scrutinizing the politics of digitization by comparing policy promises about the future with practitioners' experience in the present. While Denmark is one of the most digitalized countries in the world, digitization of pathology has only recently been given full policy attention. As pathology departments are faced with an increased demand for pathology analysis and a shortage of pathologists, Danish policymakers have put forward digitization as a way to address these challenges. Who is it that wants to digitize pathology, why, and how does digitization unfold in routine work practices? Using online search and document analysis, we identify actors and analyze the policy promises describing expectations associated with digitization. We then use interviews and observations to juxtapose these expectations with observations of everyday pathology practices as experienced by pathologists. We show that policymakers expect digitization to improve speed, patient safety, and diagnostic accuracy, as well as efficiency. In everyday practice, however, digitization does not deliver on these expectations. Fulfillment of policy expectations instead hinges on the types of artificial intelligence (AI) applications that are still to be developed and implemented. Some pathologists remark that AI might work in the easy cases, but this would leave them with only the difficult cases, which they consider too burdensome. Our particular mode of juxtaposing policy and practice throws new light on the political work done by policy promises and helps to explain why the discipline of pathology does not seem to easily lend itself to the digital embrace.
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Affiliation(s)
- Olsi Kusta
- Department of Public Health, University of Copenhagen, Denmark; Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, Australia; Øster Farimagsgade 5 opg. B, Building: 15-0-11, 1014, Copenhagen, Denmark.
| | - Margaret Bearman
- Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Melbourne, Australia; Centre for Research in Assessment and Digital Learning (CRADLE), Deakin University, Level 12, Tower 2, 727 Collins St, Docklands, Melbourne, VIC, 3008, Australia.
| | - Radhika Gorur
- School of Education, Deakin University, Melbourne, Australia; Deakin University (Deakin), 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
| | - Torsten Risør
- Centre for General Practice, Department of Public Health, University of Copenhagen, Denmark; Norwegian Centre for E-health Research, UiT The Arctic University of Norway, Tromsø, Norway; Øster Farimagsgade 5 opg. Q, Building: 24-1, 1014, Copenhagen, Denmark.
| | - John Brandt Brodersen
- Centre for General Practice, Department of Public Health, University of Copenhagen, Denmark; Primary Health Care Research Unit, Region Zealand, Denmark; Øster Farimagsgade 5 opg. Q, Building: 24-1-21, 1014, Copenhagen, Denmark.
| | - Klaus Hoeyer
- Section for Health Services Research, Department of Public Health, University of Copenhagen, Denmark; Øster Farimagsgade 5 opg. B, 1353, København K, Copenhagen, Denmark.
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Ferry-Danini J. Collecting human remains in nineteenth-century Paris: the case of the Société Anatomique de Paris and the Musée Dupuytren. Hist Philos Life Sci 2023; 45:41. [PMID: 38010562 DOI: 10.1007/s40656-023-00592-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/12/2023] [Indexed: 11/29/2023]
Abstract
This paper describes the scientific practices of the anatomists from the Société Anatomique de Paris (1803-1873) who were collecting anatomical and pathological specimens in Nineteenth-Century Paris and which led to the building of the anatomy and pathology Musée Dupuytren (1835-2016). The framework introduced by Robert Kohler to describe collecting sciences (2007) is useful as a tool to identify the set of diverse practices within pathological anatomy in nineteenth-century Paris. However, I will argue that anatomy and pathology collecting had specific features compared to most collecting sciences. Two main collecting practices could be distinguished: first, "finding" anatomical specimens and second, keeping these specimens. The first kind of practices were at least rhetorically and explicitly motivated by Auguste Comte's positive philosophy. But "finding" an anatomy or pathology specimen could not be completely compared to finding an object or making a simple observation, as dissecting as well as some experimental practices were also involved. Heterogeneous practices thus coexisted within collecting in anatomy and pathology. Epistemological as well as pragmatic tensions arose. On top of Kohler's framework, I introduce Sabina Leonelli's concept of "data journey" to offer a narrative of the diversity of collecting practices involved in the Société Anatomique de Paris and the Musée Dupuytren. I use the concept to analyse how this diversity of practices impacted knowledge production.
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Sutton-Butler A, Croucher K, Garner P, Bielby-Clarke K, Farrow M. In jars: The integration of historical anatomical and pathological potted specimens in undergraduate education. Ann Anat 2023; 247:152066. [PMID: 36773792 DOI: 10.1016/j.aanat.2023.152066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION Across the UK, many anatomy departments possess historical potted wet cadaveric specimen collections, such as organs preserved in fluid-filled jars. Although considered obsolete by some for anatomical education, there is immense potential for their utilisation in teaching, particularly in institutes that have limited access to cadavers or have had body donation rates impacted by the Covid-19 pandemic. Another benefit of historical potted cadaveric specimens is that severe pathology, often not seen today, can be observed by the student. MATERIAL AND METHODS The aim of this study was to understand students' opinions and attitudes towards the use of historical anatomical and pathological potted wet specimen collections in undergraduate science teaching. Following their integration into the anatomy program of a Clinical Sciences degree, seventy-seven undergraduate students completed a five-point Likert questionnaire on their perspective for the integration of the historical potted specimens in anatomical education. This study was approved by the Research Ethics committee at the University of Bradford RESULTS: The study demonstrated that 90 % of students found the collection useful in teaching, 92 % would like to see the collection used more in teaching, and 76 % of students found that the collection encouraged them to consider medical ethics and the donor. CONCLUSIONS In conclusion, the survey findings suggest that further utilisation of historical potted wet specimen collections would be useful in the teaching of anatomy and that these collections could potentially encourage conversations on post-mortem bodily integrity, ethics, and organ donation.
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Affiliation(s)
- Aoife Sutton-Butler
- University of Bradford, Faculty of Life Sciences, School of Archaeological and Forensic Sciences, United Kingdom
| | - Karina Croucher
- University of Bradford, Faculty of Life Sciences, School of Archaeological and Forensic Sciences, United Kingdom
| | - Pip Garner
- University of Bradford, Faculty of Life Sciences, School of Pharmacy and Medical Sciences, United Kingdom
| | - Keren Bielby-Clarke
- University of Bradford, Faculty of Life Sciences, School of Pharmacy and Medical Sciences, United Kingdom
| | - Matthew Farrow
- University of Bradford, Faculty of Life Sciences, School of Pharmacy and Medical Sciences, United Kingdom; Wolfson Centre for Applied Health Research, Bradford Institute for Health Research, United Kingdom; School of Biomedical Science, Faculty of Health, Queensland University of Technology, Australia.
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