The 8th circulation of this scheme was preceded by a CD ROM circulation of selected digital images and presented as individual JPEG file images in a single folder on the CD ROM. The number of images per case ranged from three to eight. The delegates will have an opportunity to assess these themselves prior to uncovering the consensus diagnosis provided by the participants. Of the 76, 29 participants of the scheme provided a completed answer sheet for the image-based circulation. To date, 19 have now also supplied answers on the actual slide circulation. The same diagnosis on image and slide circulation varied from 5/19 to 19/19 with a mode of 14/19. The case that provided the poorest correlation was because of a generalized undercall of suspicious in a case which achieved almost complete consensus on the slide circulation. It had been the most difficult to photograph. The case that provided the next poorest correlation 11/19 was the case that had the poorest consensus diagnosis on the slide circulation. The two cases that provided the best correlation 18/19 and 19/19 were two cases that provided 100% consensus diagnosis on the slide-based circulation. Comments were received from 20 participants about the image circulation ranging from 'great' to 'awful' with the majority of 12 participants not happy for their diagnostic capability to be assessed on such images alone. Two stated that the CD was easier to use on their home computer than their NHS one. In conclusion an image circulation overcomes many of the inherent problems with a slide circulation for EQA purposes and can provide an overall 70% correlation with a slide circulation but a significant number of pathologists do not find this an acceptable method for EQA.
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