Draft:Pathology outlines

PathologyOutlines.com is a web-based pathology resource that provides a free, peer-reviewed medical textbook written by pathologists for pathologists. The purpose of the website is to “provide useful professional information to practicing pathologists and laboratory personnel in 15 seconds or less”.[1 ] It includes 60 chapters with 4,500+ topics including most surgical pathology topics, immunohistochemistry and special stains used commonly in pathology practice.[2 ] For clinical pathology, it has full coverage of Hematopathology, Informatics, Transfusion Medicine and Laboratory Administration, with content in development for Microbiology, Coagulation, Chemistry and Hematology.

Each topic follows a template that consists of relevant sections that are linked at the top of the page for quick access. The sections vary depending on the subspecialty. For example, surgical pathology topics comprise the following sections:


 * Definition/general (1-2 sentence summary)
 * Essential features (3-5 most important points)
 * Terminology (other names used)
 * ICD coding (ICD-10, ICD-11, and ICD-O codes)
 * Epidemiology (who gets the lesion)
 * Sites (parts of the body affected)
 * Pathophysiology (how the lesion arises)
 * Etiology (causes of the lesion)
 * Diagrams/tables (relevant figures)
 * Clinical features (anything encountered in clinical practice)
 * Diagnosis (how the diagnosis is made)
 * Laboratory (typical findings in the lab)
 * Radiology description/images (typical findings of X-ray, CT scan, MRI, etc.)
 * Prognostic factors (factors that favorably or unfavorably affect the course of disease)
 * Case reports (5 recent cases reported in medical journals)
 * Treatment (general modes of treatment)
 * Clinical images (images of the patient or intraoperative images)
 * Gross description/images (description and images of excised specimen)
 * Frozen section description/images (features of tissue at frozen section differing from permanent section)
 * Microscopic (histologic) description/images (common and uncommon histologic features and diagnostic criteria)
 * Virtual slides (links to whole slides scanned digitally)
 * Cytopathology description/images (cytologic features)
 * Immunofluorescence description/images (immunofluorescence diagnostic criteria with common and uncommon histologic features)
 * Positive/negative stains (immunohistochemical and special stains)
 * Electron microscopy description/images (description and images from electron microscope)
 * Molecular/cytogenetics    description/images (DNA/RNA findings based on testing)
 * Videos (links to YouTube or other sites)
 * Sample pathology report (example of typical diagnostic report)
 * Differential diagnosis (most important differentiating features)
 * Additional references (general references not previously included)
 * Board review questions (2 board review style questions)

The text is written in bullet points, using succinct language and minimal punctuation so that pathologists can find practical information easily (example below). References are provided as links to PubMed medical journals and other reputable sources.

PathologyOutlines.com has its own image library with original images added daily. These include diagrams, radiology, clinical pictures, specimen gross images, frozen section, microscopy (example below), cytology, peripheral smear, immunofluorescence, flow cytometry, electron microscopy, and molecular / cytogenetics images. Each image includes a short caption and a detailed figure legend when the image is clicked on.

History

PathologyOutlines.com was founded in August 2001 by Nat Pernick, M.D., a U.S. pathologist who is board certified in Anatomic Pathology and Clinical Pathology.[3 ]

Dr. Pernick created PathologyOutlines.com based on his belief that medical information should be free and easily accessible. In its first year of inception, PathologyOutlines.com consisted of 5 chapters (Ampulla of Vater, lymphomas/plasma cell neoplasms, pancreas, parathyroid gland and thyroid gland).[1 ]

By November 2011, the website expanded to 80 chapters and began to update its standard format so that each topic would be on a single webpage. This format facilitated expansion of the topic contents with greater detail and regular updates. All 6,700+ topics were converted to the new format by February, 2014.

In December 2014, the website transitioned to a content management system to allow for more uniform pages, better formatting for mobile devices and more robust topic search capability. This process began with changes to the home page and was completed for the entire website in July, 2018.

Since February 2018, each newly updated topic has been reviewed by the Author, Deputy Editor or Editor-in-Chief, and an Editorial Board member, whenever possible. This has elevated the standard of each topic to ensure accurate, up-to-date content, thorough research and a uniform site format.

To date, over 1800 authors contributed content to Pathology Outlines.[4 ] Authors are typically academic faculty who have published at least five first/last author non-case report journal articles on their respective subspecialties in the past 15 years and have met other qualifications. As of April 2024, there are 250+ active authors. PathologyOutlines.com continually adds authors with a goal of reviewing each topic every 2-3 years.

Pathology Outlines Editorial Board and Authors

In November 2012, an Editorial Review Board was created, consisting of section editors to conduct peer review of the medical content. In September 2014, the Editorial Review Board evolved into a formal Editorial Board, consisting of practicing academic pathologists with subspecialty expertise. All Board members were required to have previously worked satisfactorily as an author at PathologyOutlines.com, with preference given to those with fellowship training/certification. As of June, 2024, the Editorial Board had 1 Editor-in-Chief, 10 Deputy Editors and 52 Editorial Board members.[4 ] There is also a Board of Reviewers (established in January, 2024), a Resident / Fellow Advisory Board and an Advisory Board.

Debra Zynger, M.D. became the first Deputy Editor-in-Chief In February 2018, and then the first Editor-in-Chief in August 2018.[5] The next Editor-in-Chief was Raul S. Gonzalez, M.D. who served from April 2021 to August 2023.[6 ] The current Editor-in-Chief, Patricia C. Tsang, M.D., M.B.A, began her 2 year term in September, 2023.[7 ]

Business Model

The business model is based on Google’s model of creating free content or services that will be widely used, and then selling advertising, in this case through postings for jobs, fellowships and conference  as well as corporate banners, Eblasts (free subscription newsletters) and social media posts on Twitter, Facebook, and Instagram.[8][9 ]|undefined

Worldwide Directory of Pathologists

In 2020, PathologyOutlines.com began to assemble a Worldwide Directory of Pathologists, which contains 27,000+ Pathologist profiles as of June, 2024.[10 ] The profiles are maintained free for the life of the pathologist plus 5 years. Most profiles are from the United States (24,000) and Canada (2,200). Profiles are typically added by PathologyOutlines.com staff with an opt-out model. A different method is used for EU member pathologists due to its privacy laws. Quarterly reports provide information on the number of pathologist profiles in the U.S. and Canada, including totals by State and Province, as well as by institution, specialty and the most popular profiles.

Charitable Giving

PathologyOutlines.com has made charitable giving a major part of its business operations, including scholarship funds. Specifically, PathologyOutlines.com founded the Detroit College Promise scholarship, now run by the Detroit Public School Foundation.[11] Currently supported scholarships or prizes are: Pernick Prize, PathologyOutlines.com Endowed Scholarship Fund at the University of Michigan Medical School, PathologyOutlines.com Endowed Scholarship Fund at the University of Michigan Law School and the PathologyOutlines.com Department of Mathematics Endowed Scholarship in the College of Liberal Arts & Sciences at Wayne State University.[12][13][14 ]|undefined In 2023, it began supporting the Larry R. Pernick Health Education Fund at the Oakland County (Michigan) Health Department, which is currently funding childhood education programs for HPV vaccination.

Prior grants and prizes donated include a Pandemic Relief Music Award (given monthly in 2021) as well as grants to The Flint Child Health & Development Fund, the International Medical Corps and the Make-a-Wish Foundation.

Website Traffic

Traffic is tracked using Google Analytics (currently Google Analytics 4) and statistics are posted monthly and graphed quarterly.[15 ] As of May 2024, page views per month topped 6.0 million, compared to 4.7 million in May, 2023.

Collaborations

Pathology Outlines collaborates with the following Pubmed-indexed medical journals to co-publish certain key articles: the Journal of Pathology and Translational Medicine [16 ] and the International Journal of Surgical Pathology.