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Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Awareness about Importance of Clinical and Radiological Details for Histopathological Reporting among Practicing Oral Pathologists in Kerala, India
Correspondence Address :
Rahul Mohandas,
Sant Tukaram Nagar, Pimpri, Pune, Maharashtra, India.
E-mail: rahuldas1192@gmail.com
Introduction: Clinical history and examination, radiography and histopathology are the three pillars of accurate diagnosis. The decisive nature of histopathology reporting has made it the cornerstone of modern medical science, thus making it extremely important to render timely and well-elaborated reports with utmost diagnostic accuracy. Inadequate communication between the clinician/surgeon, radiologist and the histopathologist hampers the delivery of correct and complete diagnosis on time.
Aim: To assess the awareness among practicing Oral pathologists from Kerala, India about importance of clinical and radiographic details for histopathological reporting.
Materials and Methods: A population-based, cross-sectional questionnaire study was conducted from January 2022 to April 2022. Kerala was divided into four zones-North, South, East and West. An online questionnaire containing eight questions was devised and circulated among 75 practicing Oral Pathologist from each zone through digital messenger platforms or e-mail. Descriptive statistics (frequency and percentage) was calculated using Microsoft excel 2020.
Results: A total of 220 responses were received. Among the participants, 100 (45.5.%) stated that their clinician or surgeon did not provide them with adequate clinical and radiographic details. It was found that 140 (63.6%) participants opined that their clinicians or surgeons used to specify the clinical details and in 188 (85.5%) cases the surgeon or clinician mentioned the demographic data.
Conclusion: It was concluded that there was a good awareness among practicing Oral Pathologists from Kerala, India, regarding the importance of clinical and radiographic details for histopathological reporting.
Clinical information, Demographic data, Survey
Clinical history and examination, radiography and histopathology are the three pillars of accurate diagnosis. The decisive nature of histopathology reporting has made it the cornerstone of modern medical science, thus making it extremely important to render timely and well-elaborated reports with utmost diagnostic accuracy (1). Inadequate communication between the clinician/surgeon, radiologist and the histopathologist hampers the delivery of correct and complete diagnosis on time (2).
The role of a histopathologist is to help clinicians to arrive at a diagnosis in the most accurate way. At the same time, it is the duty of clinicians to provide them with adequate and pertinent clinical information (1). The histopathologist cannot see the specimen from a clinician’s point of view without a deep insight into the patient’s clinical information, provisional diagnosis and need for the biopsy (1). Without these crucial details, the histopathology report might fail to answer the desired queries and fall short of the clinician’s expectation. It may cause a delay in reporting time and may lead to inaccurate diagnosis (3).
Radiology localises the suspicious lesions and gives an idea of involvement of internal structures whereas Pathology describes it’s histologic and molecular behaviour (4). The integration of radiographic and histopathology reports is crucial in accurate and timely diagnosis of any lesion (4). Diagnosis of a specific group of lesions, like fibro-osseous lesions based on histopathologic features alone, is difficult and it needs radiographic as well as clinical correlation for accurate diagnosis (5). Radiographic details like bone expansion, bone perforation, root resorption, tooth displacement and pathological fracture can give clues regarding the aggressive nature and progression of the lesion (6).
The histopathologist must check if all the clinical and radiographic details have been provided in the biopsy requisition form by the clinician or surgeon while receiving a tissue specimen for histopathological evaluation. Existing literature suggest that clinical information and radiographs improve the accuracy of histopathological interpretation (5). However, none of the studies have questioned the awareness among practicing Oral pathologists about the importance of these details for furnishing an accurate histopathological diagnosis. Introspection into the existing awareness identifies the lacunae in the system, and paves the way for establishing practice guidelines that will ultimately benefit the patient.
The present study aimed to assess the awareness among practicing Oral pathologists from Kerala, India, regarding the importance of clinical and radiographic details for histopathological reporting.
A population-based, cross-sectional study was carried out in the state of Kerala, India from January 2022 to April 2022. The study was approved by the Institutional Ethics Committee, Saveetha Dental College (IEC/SDC/MDS04/22/OMP/12).
Inclusion criteria: Oral pathologists, who were actively practicing in Kerala, India, and who have provided their consent for participating in the study were included.
Exclusion criteria: Participants were excluded from the study if they were not actively involved in histopathological reporting, had submitted incomplete responses, or had not consented to be a part of the study.
Sample size calculation: The sample size was calculated based on a study by Romin H et al., (7) using the Taro Yamane formula,
n= N/ 1+N×(e)2
where,
n-the sample size
N-the population size
e-acceptable sampling error
The total sample size was calculated to be 300. Stratified sampling method was used to include participants in the study. Kerala was divided into four zones-North, South, East and West. From each zone, 75 Oral Pathologists were selected using simple random sampling.
Questionnaire
Following a review of literature to identify the lacunae in awareness, a questionnaire containing eight questions was devised by the authors (RM and SM) using an online form application. The questionnaire was thoroughly reviewed by a panel of two reviewers from the Department of Oral and Maxillofacial Pathology. The modifications suggested by the review panel regarding the arrangement and structure of questions were carried out. Test-retest method was used to assess the reliability of the questionnaire which came out to be 0.8 suggesting good agreement. Content Validity Ratio (CVR) was calculated to assess the validity of the questionnaire which came out to be 0.95. All the questions were essential and none needed to be omitted.
An online form containing the questionnaire was created and the link for the same was circulated through digital messenger platforms or e-mail among the 300 practicing Oral Pathologists included in the study. Responses were collected from the website through which the questionnaire was created. The purpose of the study, privacy protection statement and consent declaration statement were provided at the beginning of the survey. The respondents were asked to click a button of acceptance to participate in the survey. For the purpose of this study, good awareness was assigned if more than 50% of the study participants were aware about the importance of clinical and radiographic details for accurate histopathological reporting. The flowchart of study participants has been depicted in (Table/Fig 1).
Statistical Analysi
All the responses that were received were tabulated. Descriptive statistics (frequencies and percentage) was calculated using Microsoft excel 2020.
A total of 220 responses were received. Among the 220 practicing Oral Pathologists, 147 (66.8%) were males and 73 (33.2%) were females. The participant’s age ranged from 30-73 years, with a mean age of 51.5 years. Based on the geographical distribution, 67 (30.45%) of the participants belonged to the West zone, 53 (24.09%) were from the South zone, 51 (23.16%) from North zone, and 49 (22.3%) were from the East zone.
Participants, 100 (45.5%) stated that their clinician or surgeon did not provide them with adequate clinical and radiographic details. It was found that 140 (63.6%) participants opined that their clinicians or surgeons used to specify the size, shape, site, colour and extent of the lesion. The surgeon or clinician mentioned the demographic data in case of 188 (85.5%). Among the participants, 212 (96.4%) experienced difficulty in diagnosis if the clinical and radiographic details provided were insufficient. It was agreed by 216 (98.2%) participants that they would ask the clinician or surgeon for clinical and radiographic pictures if the details were insufficient. Availability of online platforms and social media had made it easier for 216 (98.2%) participants to exchange information with their clinician or surgeon. Out of total participants, 160 (72.7%) opined that they asked their radiologist peers for opinion while interpreting radiographs. It was also found that 176 (80%) participants opined that they would prescribe a radiographic investigation if need arises and even if the clinician had not asked for the same. The responses have been summarised in (Table/Fig 2).
The current study assessed the awareness about importance of clinical information and radiographic details for histopathological reporting among practicing Oral Pathologists from Kerala, India. In the present study, 45.5% of the participants stated that their clinician or surgeon did not provide them with adequate clinical and radiographic details. This number is comparatively higher than other studies where the rate of inadequacy was only around 2.4% to 6.1% (8),(9). This could be due to increased number of patients, time constraints, lack of familiarity to certain specific terminologies, open-ended nature of the requisition form or improper knowledge regarding the importance of these details (10),(11),(12),(13). 63.6% participants opined that their clinicians or surgeons used to specify the size, shape, site, colour and extent of the lesion. This is in accordance with a previous study by Romano RC et al., who postulated that the lack of specific questions pertaining to these clinical features are seldom mentioned in the biopsy requisition form, which may be responsible for lack of these data (14). The demographic data was mentioned in the case of 85.5% of the participants. Previously published literature by Shrestha LB and Pokharel K, suggests that the name of the patient and other demographic data is crucial for identifying the patient and helps in correlating the findings with previous investigation results. Hence, the clinicians or surgeons seldom tend to miss providing this information (15).
Insufficient clinical and radiographic data led to difficulty in arriving at a diagnosis in 96.4% of the participants. In their study, Ali SMH et al., reported that a barrier in effective communication of the adequate clinical and radiographic details can make histological diagnosis difficult due to involvement of additional steps like deeper or serial sections (1). Employing additional investigations like special stains and immunohistochemistry would further increase the turnaround time (14).
In this study, 98.2% participants said that they would ask the clinician or surgeon for clinical and radiographic pictures if the details were insufficient and agreed that availability of online platforms and social media had made it easier to exchange information with their clinician or surgeon. In their study, Janagond AB and Inamadar AC postulated that the availability of clinical photographs can lead to more specific and accurate diagnosis (12). The emergence of online messenger services and social media has made effective communication possible between clinicians and pathologists even in low resource areas, as a part of teledentistry practice (16),(17).
In the current study, 72.7% of the participants opined that they asked their radiologist peers for opinion while interpreting radiographs. Oh AS et al., in their study, suggested that effective communication between a pathologist and a radiologist could reduce potential diagnostic confusions and help the pathologist arrive at an accurate diagnosis (18). 80% participants opined that they would prescribe a radiographic investigation if need arises and even if the clinician had not asked for the same. This is in accordance with a study by Kumar J et al., who reported that prescribing radiographs are justified for acquiring information that will assist in arriving at a proper and timely diagnosis (6).
It is extremely essential that each specimen reaching the laboratory should be accompanied by an adequate description of what it represents, an appropriate and detailed clinical history and radiograph. This would ensure reduced turnaround time and a more efficient and accurate diagnosis, which would be beneficial for patient’s treatment.
Limitation(s)
This study has some potential limitations, which should be acknowledged. Firstly, the use of an online questionnaire-based survey may overlook Oral Pathologists who do not have access to internet or social media accounts. Secondly, the sample size was not very large. However, considering that Kerala is a small state area-wise, the sample size is justifiable.
The present study compared and highlighted the existing knowledge and lacunae in the awareness among practicing Oral Pathologists from Kerala regarding the importance of clinical and radiographic information for accurate histopathological reporting. Authors found that there was a good awareness among practicing Oral Pathologists from Kerala, India, regarding the importance of clinical and radiographic details for histopathological reporting. Clinical information and radiographic details play a crucial role in arriving at an accurate and timely histopathological diagnosis. The biopsy requisition form should be designed in such a way that provisions to mention all clinical and radiographic details must be provided. The clinicians and surgeons must make it a point that all the relevant findings must be included while submitting a biopsy specimen to the laboratory to ensure accurate and timely diagnosis. Future research must focus on formulating and designing a standard operating protocol, and an online digital platform for sharing the necessary clinical and radiographic details and photographs for ease of histopathological reporting and to facilitate accurate final diagnosis.
The authors extend their sincere gratitude to all the participants in the study.
Authors contribution: The corresponding author (Dr. Rahul Mohandas) originally belongs to Kerala and is a Kairali Society of Oral and Maxillofacial Pathologists member. However, his current affiliation belongs to Dr. D.Y. Patil Dental College and Hospital, Pune, Maharashtra. The study was conducted at Saveetha Dental College, Chennai while he was pursuing PG there. Moreover, the third author (Dr. Pratibha Ramani) belongs to Saveetha Dental College.
DOI: 10.7860/JCDR/2023/60387.17473
Date of Submission: Sep 22, 2022
Date of Peer Review: Nov 08, 2022
Date of Acceptance: Nov 19, 2022
Date of Publishing: Feb 01, 2023
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. No
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