title: HSIL, epithelial cell abnormality-adjusted workload, and the Thinprep imaging system.
abstract: Previous studies have suggested that the sensitivity of the ThinPrep Imaging System (TIS) for high-grade intraepithelial lesion (HSIL) and worse may be decreased at workloads above 100 slides/day. On the other hand, at a threshold of atypical squamous cells of undetermined significance (ASCUS) and above, sensitivity of the TIS appears to more closely correlated with epithelial cell abnormality (ECA)-adjusted workload (ECA rate × actual slides/day) rather than total workload. We sought to determine if the sensitivity of the TIS for HSIL could also be shown to be correlated with ECA-adjusted workload. The change in sensitivity for HSIL from manual screening to TIS screening consistently correlated negatively with ECA-adjusted workload both in the original Food and Drug Administration trial study and in independent studies available in the literature. Both sources suggest that sensitivity near 100% can be achieved with ECA-adjusted workloads of 5-7 slides/day. For a laboratory with an ECA rate of 10%, this represents a total workload of 50-70 slides/day. We conclude that measuring the ECA-adjusted workload is a valuable method to assess workload for the ThinPrep Imaging System.
authors.affiliation: Department of Pathology, Baptist Hospital of Miami, Miami, Florida 33176, USA. andrewr@baptisthealth.net
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Renshaw
authors.forename: Tarik M
authors.initials: TM
authors.lastname: Elsheikh
mesh_terms: D003581:Cytodiagnosis / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000592:standards*; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears; D016526:Workload / Q000592:standards*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis*