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Electronic Publication in Pathology
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Electronic Publication in Pathology
The development of electronic information transfer permits that space and time
can virtually be bridged by electronic media. Images, voices, and information
collected in even the most remote areas of the world are displayed, and neither
the location nor the time of day affects the spread of information to any notable
degree. Until now, most of the information highways have been passive to the receiver; however, efforts are ongoing to interact with the information users. Digitized television with all its interactive technical “play-cards” will be installed in
Europe within the next few years. The characteristics of television and radio could
be described as live information transfer combined with a still passive receiver.
Their characteristics are an ever-present information source combined with
standardized information input, and non-flexible information output to be
presented onto the television screen or radio receiver.
Having a flexible information input combined with a flexible information output, a standardized network of interactive information exchange is needed, i.e., the
Internet. This information network has been primarily designed for fast and economical interactive exchange of “information clusters” such as letters, military commands, scientific considerations, or technical construction plans. The development
of faster computers and specific communication lines, such as glass fiber optics,
allowing a data transfer of more than 1 Gigabaud, can be used for easy and efficient interaction between various end users. The interactive use of the Internet
can be used for shopping, presentation of original ideas, search for friends, or similar purposes. Interaction is still limited to data blocks, and is often comparable
with an “off-line” use of computers; however, the “length” of the data blocks virtually shrinks to a live interaction when the transfer speed increases to the range of
1 Gb/s. The transfer of data blocks becomes indistinguishable from live information transfer under these circumstances. In the future, the Internet may thus be
regarded to be a continuous flow of information which can be opened similar to a
water tap. This water tap gains access to information spread and exchange in our
environment, and might be used to accumulate new ideas, add data to already existing or circulating information, complete and correct ideas or technical results,
or even add “information functions” to correct, alter, or even move the circulating
data to another level of knowledge. In medicine and pathology, the distribution of
information with potential interest for patients and doctors is done by use of “socalled” medical journals. These journals have not changed within the last 100 years
except for their price and – sometimes – their theme and sphere of influence.
Traditional journal information is fixed, cannot be changed, is presented in issues
printed within fixed, repeating periods, is visual only, and permits a strict
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association with the authors. Images are usually of poor quality and expensive for
publication; the readers are known to the publishing company, and only the usually limited number of subscribers are permitted to read the articles. Multiplication of the information can be done by the readers only by photocopying, or by
citation of the corresponding article and interpretation of its information. Electronic publication in medicine, for example, using the Electronic Journal of Pathology and Histology (Elec J Pathol Histol), published on a floppy disk, offers new ideas
for collection, distribution, alteration, or interactive handling of medical information. In addition, functions can be applied to the presented data and results, and
the most interested readers, or those patients who might gain the greatest benefit
from the information therein, can be selected, and included into specific therapeutic or diagnostic programs.
Electronic Journal of Pathology and Histology
To give an example of the advantages and constraints of electronic publication,
the experiences and main features of the first journal solely published on an electronic medium will be described.
Fig. 14. Floppy of the first issue of the first solely electronically published scientific medical
journal, the Electronic Journal of Pathology and Histology (Elec J Pathol Histol)
Electronic Publication in Pathology
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According to the reported experiences with the Elec J Pathol Histol (Fig. 14),
the following features are of advantage in electronic publishing: Each article dedicated to a scientific subject still follows certain rules in structure and citation of
related topics. Simple structures still remain which include a headline, a summary, and so-called keywords. Introduction, chapters on material and methods,
results, and discussion are similar to conventional scientific papers as well as its
regular publication. References listed in the text by specific parentheses ([...])
can be simply highlighted by the reader and transferred to the reader’s own library. An easy reading editor handles the opening of images (PCX format) at
any place within any text of an issue. The editor can handle simple procedures
which include paginating, list, search, find and replace, paste, and cut. Executable programs can be included, and the program can run execute programs with
a maximum length of approximately 30 kB. Interactive publication can be performed on specifically marked articles. These articles are designed by the authors
so that additional scientists might use their data presentation and add additional
data or results, thus designing a new, more complete article. The abstracts are
presented on the Internet, and are open to access by any interested scientist. The
use of the Internet for scientific publication offers additional advantages. These
include fast and non-person-oriented publication, free presentation of data and
ideas, although without any scientific control. The details are specifically discussed
in Kayser and Kayser (1998)
A different approach which takes into account the power and use of the Internet
for electronic publication has been recently offered in the Internet, the so-called
PARIS project.
Internet PARIS International Review Project
The aim of this international project is to review and score scientific articles on
pathology, anatomy, histology and related topics to be published electronically
via the Internet or to receive a non-biased scientific score given by randomly chosen reviewers for further promotion of the submitted article. Scientific fields
others than the above mentioned will be excluded from review. An article can be
rejected if it has been submitted more than three times without major changes
or if it does not fulfill the basic requirements of a scientific article. Each article
should have a title, an abstract, and a keyword list.
The regulations are as follows:
The reviewers agree that scoring will be based solely upon the scientific merit
of the article. Articles must be submitted and scores transmitted via the Internet.
A review should be performed within 14 working days. If a reviewer has not responded within this time, the editor-in-chief may choose an alternate reviewer
without further notice. The names of the reviewers will be posted on the Internet
along with their specialties. If an article submitted is out of the reviewer’s scien-
Kayser K, Kayser G (1998) Electronic publication – a challenge in medicinal information exchange.
Pathologica 9:321-324.
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tific scope, the editor-in-chief should be notified immediately for reassignment
to an alternative reviewer. The editor-in-chief will notify the reviewers of the final score and the range of scoring. There will be no provision for reimbursement to the reviewers. Whereas the names of the reviewers and their specialties
will be posted on the Internet, the reviewers agree that their names will not be
given to the authors of the reviewed article. The editor-in-chief is responsible
for selecting the reviewers if the data bank program cannot select a specific person, and corresponding with the authors. The editor-in-chief has the authority
to reject articles without review by other editorial board members.
Scientists who are interested in independent publication of data, and an anonymous, critical review of their data, are referred to the PARIS project. The name
PARIS stands for Pathology Review International Score. The board of reviewers is
a team of internationally well known scientists, led by Dr. K. Kayser, which accepts articles via e-mail for scientific review. Authors can select two to eight reviewers who are then chosen at random by the data bank program, according to
the given keywords. Via the Internet, the articles are then sent to and scored by
the reviewers, with the average score returned to the authors, who may use the
scores to proceed, or modify their paper. The abstract of articles with a score
above the mean is held by the PARIS team in the Internet for interested readers.
There is no further obligation on the part of the authors, and no copyrights are
transmitted. The e-mail address of the PARIS project is: http://telepatho.charite.
de/paris/. The PARIS project could be considered a first step for further electronic publication which will probably include tasks for interactive and nearly
continuous scientific information access and enhancement. Publication of images is economical, their handling is easy, and images which contain basic information can, in addition, be processed for further and more advanced information extraction and perhaps diagnostic and therapeutic use. Thus, electronic
publication is closely associated with telecommunication in medicine and pathology, and will probably also influence these new technical approaches to medicine and pathology. The difference between science, diagnosis, therapy, and
healthcare can be bridged and summarized to new integrative healthcare concepts. How does this work?
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