Entity-aware pathology workflow informatics: Structured evidence mapping and a reference architecture for governed orchestration.

Authors

Ao Li, Peter O'Loughlin, Lin Yue, Wei Emma Zhang, Bernadette Swart, Weitong Chen

Published in

Journal of pathology informatics. Volume 23. Pages 100720. Epub Sep 14, 2026.

Abstract

To map evidence relevant to representing and governing pathology workflows spanning cases, specimens, blocks, slides, scans, and reports, and to derive a reference architecture.
We performed structured evidence mapping with purposive horizon scanning. Searches of Scopus, PubMed, and IEEE Xplore yielded 74 primary database records; Google Scholar and citation tracking contributed 24 supplementary records. Each record contributed one tuple across data acquisition, control-flow reconfiguration, execution autonomy, and validation environment (D1-D4), an author-developed operational taxonomy. Unretained historical search details are reported as a reproducibility constraint, not reconstructed as original methods.
The 98-record evidence base spans 1993-2026. Within the 74-record primary corpus, 47 records had dashboard-level execution; validation was split between real-world deployment (26) and conceptual evidence (25). Under study-defined filters, 8/74 records met all 4 minimum capability conditions, 2/74 also showed closed-loop physical actuation, and 1/74 combined full autonomy with real-world deployment. These study-defined filters derive from the original single-reviewer D1-D4 coding. An independent blinded 50-record verification yielded 81.6% inclusion agreement (κ = 0.627) and 80.0% exact D1-D4 field agreement, but did not constitute full-corpus independent reproduction. Supplementary records informed emerging automation requirements. The mapped gaps informed an architecture comprising semantic perception, entity-aware process state, bounded orchestration, pre-action command governance, governed actuation, and conditional local execution support; a safety-and-constraints sandbox is one candidate realization of the governance function.
The architecture is an evidence-derived design target, not a deployed or validated system. Evaluation should test event provenance, case-to-slide relationships, robustness to missing or shifted inputs, command constraints, human override, and staged operational performance before autonomy claims.

PMID:
42893223
Bibliographic data and abstract were imported from PubMed on 18 Oct 2026.

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