title: Slide navigation patterns among pathologists with long experience of digital review.
abstract: OBJECTIVE
  In order to develop efficient digital pathology workstations, we studied the navigation patterns of pathologists diagnosing whole-slide images. To gain a better understanding of these patterns, we built a conceptual model based on observations. We also determined whether or not new navigation patterns have emerged among pathologists with extensive digital experience.
  
  
  RESULTS
  Five pathologists were asked to diagnose a set of four cases while thinking out loud. The navigation within the digital slides was recorded and divided into re-occurring navigation actions. The pathologists reused the same type of actions, but their occurrence differed. The most common action was a slow panning that followed an edge structure or covered an area systematically, which accounted for 30.2% of all actions and had a median duration of 7.2 s. Of all the actions, 49% were carried out within the navigation overview and 38% of the actions could not have been performed with a conventional microscope.
  
  
  CONCLUSIONS
  The new navigation possibilities in the digital workstation were used to a large extent. The division of actions into different concepts can be used to find and prioritize between existing user interface designs as well as to understand the different navigation styles used by different pathologists.
authors.affiliation: t2i Interaction Laboratory, Department of Applied Information Technology, Chalmers University of Technology, Gothenburg, Sweden.|Centre for Image Science and Visualization, Linköping University, Linkoping, Sweden.|Sectra AB, Linkoping, Sweden.
authors.forename: Jesper
authors.initials: J
authors.lastname: Molin
authors.affiliation: t2i Interaction Laboratory, Department of Applied Information Technology, Chalmers University of Technology, Gothenburg, Sweden.
authors.forename: Morten
authors.initials: M
authors.lastname: Fjeld
authors.affiliation: Medical Radiation Sciences, University of Sydney, Sydney, NSW, Australia.
authors.forename: Claudia
authors.initials: C
authors.lastname: Mello-Thoms
authors.affiliation: Centre for Image Science and Visualization, Linköping University, Linkoping, Sweden.|Sectra AB, Linkoping, Sweden.
authors.forename: Claes
authors.initials: C
authors.lastname: Lundström
mesh_terms: D003936:Diagnosis, Computer-Assisted; D006801:Humans; D008853:Microscopy / Q000379:methods*; D010338:Pathology, Clinical / Q000379:methods*; D010818:Practice Patterns, Physicians'; D019113:Telepathology / Q000295:instrumentation*; D014584:User-Computer Interface; D057188:Workflow
keywords: classification of movement; digital pathology; multiscale navigation; useability