in real time. Web-based conferences were held biweekly, during
which we discussed IHC staining protocols, standardized scoring
systems, and resolved discrepant cases.
Interlaboratory Web-based conferences were performed using
user-friendly Web-based tools such as Skype and WebEx. Skype is a
software that enables one to make Internet calls free between users
who have Internet access. WebEx is an online conferencing tool that
enables conferencing from different physical location. It permits
desktop sharing and thus permits off-site presentations and facilitates
effective participation among the participants. The conferences were
held from 2 locations, one at IAMRAT, Ibadan, Nigeria, and another at
the University of Chicago in Illinois.
Some of the important reasons for the discrepancies identified
during the Web conference training sessions include differences in
staining protocols, antigen retrieval procedures, and scoring methods.
After the Web-based discussion sessions, joint evaluation of digital
slide images revealed almost complete agreement between both
pathologists. In addition to reviewing images, technical issues relating
to preanalytical, analytical, and postanalytical concept of IHC staining
and testing were discussed, such as follows:
• Duration of formalinfixation of tissue
• Type of buffer used—commercial citrate vs locally prepared
• Choice of antibody clone used
• Antigen retrieval procedure—how long did they apply primary
antibody
• Type of diluent used
• Dilution ratio
• Scoring systems—percentage vs intensity of staining