Table 2.

A survey of medical standards (level 2 and level 3) suggested or already implemented in tissue-based diagnosis

Medical Standard (level 2)	Criteria (level 3)	International/national Action
Disease order [41]	Hierarchic, 1 – 10	Proposed
Formal disease classification	ICD-O, SNO-MED	Accepted
Disease/human classification	Board discussion	Accepted for tumours (WHO classification)
Disease frequency	Not evaluated, probably >2 per month	Open
Mandatory expert consultation	Rare cancer, lymphoma	Proposed
Mandatory quality assurance	Breast cancer, Hodgkin's disease	Accepted
Image handling, exchange by DICOM 3, HL 7	General & individual regulations	Proposed
HIS, RIS communication by DICOM 3, HL 7	General & individual regulations	Proposed
Expert communication guidelines	4 – 8 images/case, <2 different magnifications/case,	Proposed
Virtual microscopy:
Diagnosis/image properties	>50 pixels/object, >40 objects/image, >256 × 256 image size	Proposed
Disease/image features	Disease – associated texture, object, structure parameters	Open
Image quality measure	Gray value deviation, image standardization (shading, gray value range, gradient)	Open
Screening/image size	Texture features: crude screening Object/structure features: classical diagnosis (H&E)	Open
Diagnosis/colour space	RGB space – classical diagnosis. HSI space – prognosis associated diagnosis, cancer scores (hormone receptor, Gleason, etc.)	Open