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Time consumed by microscopic and nonmicroscopic tasks in image-assisted gynecologic screening: Implications for
Andrew A Renshaw1, Dawn Underwood2, Ghada Aramoni2
1Department of Pathology, Baptist Hospital of Miami, Miami, Florida.
Cancer Cytopathology
|March 13, 2016
Summary
Cytotechnologists spend significant time on non-microscopic tasks during gynecologic screening. Current workload limits may underestimate the actual screening time required for certain cases, particularly those reviewed only by fields of view (FOV).
Area of Science:
- Cytopathology
- Gynecologic Oncology
- Medical Diagnostics
Background:
- Gynecologic screening cytology involves both microscopic and non-microscopic activities.
- Cytotechnologists perform complex tasks during slide review.
- The ThinPrep imaging system is utilized in modern cytology screening.
Purpose of the Study:
- To quantify the time cytotechnologists spend on microscopic and non-microscopic activities.
- To evaluate the adequacy of current workload limits for gynecologic cytology screening.
- To analyze screening times using the ThinPrep imaging system.
Main Methods:
- Two study arms were designed to record screening times.
- Arm 1: 11 cytotechnologists reviewed 550 slides, recording time for subtasks.
- Arm 2: 200 slides were screened by 10 cytotechnologists each to record total screening and full manual review (FMR) times.
Main Results:
- Screening time averaged 3.0 minutes for non-FMR and 5.6 minutes for FMR cases.
- Review of fields of view (FOVs) took 95 seconds; FMR averaged 2.6 minutes.
- FOV-only cases significantly exceeded the FDA/CMS workload limit of 2.4 minutes (P=.005), with 100% exceeding the limit in Arm 2.
Conclusions:
- FDA/CMS workload limits appear inadequate for FOV-only cases but appropriate for most FMR cases.
- Non-microscopic activities constituted approximately 60% of screening time for FOV-only cases and 30% for FMR cases.
- The study highlights potential underestimation of screening time by current workload standards.
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