title: Time consumed by microscopic and nonmicroscopic tasks in image-assisted gynecologic screening: Implications for workload assessment.
abstract: BACKGROUND
  Gynecologic screening cytology is a complex task that includes microscopic activities and nonmicroscopic activities. The authors sought to determine the amount and percentage of time that cytotechnologists spend on those activities using the ThinPrep imaging system.
  
  
  METHODS
  In arm 1, a total of 550 consecutive unselected slides were reviewed by 11 cytotechnologists, and the time used for individual subtasks of the screening process was recorded. In arm 2, a total of 20 unselected slides were each screened by 10 different cytotechnologists (200 slides in total) and total screening times and full manual review (FMR) times were recorded.
  
  
  RESULTS
  In arm 1, cases with and without FMR required an average of 5.6 minutes and 3.0 minutes, respectively, to screen. Overall, review of fields of view (FOVs) took 95 seconds. FMR took an average of 2.6 minutes. The average screening times for FOV-only cases was significantly longer than the US Food and Drug Administration/Centers for Medicare and Medicaid Services (FDA/CMS) workload limit of 2.4 minutes (P = .005). However, in arm 2, the time needed to screen a case increased by an average of 1 minute compared with arm 1, including 1.1 minute for FOV-only cases and >2 minutes for FMR plus FOV cases. Approximately 100% of cases screened as FOV only exceeded the FDA/CMS workload limit of 2.4 minutes.
  
  
  CONCLUSIONS
  The FDA/CMS workload limits for FOV-only cases appears to significantly underestimate the time needed to screen those cases, but seems to be appropriate for the majority of FMR plus FOV cases. Approximately 60% and 30% of the time designated to screening slides was spent on nonmicroscopic activities for FOV-only cases and FMR cases, respectively. Cancer Cytopathol 2016;124:501-7. © 2016 American Cancer Society.
authors.affiliation: Department of Pathology, Baptist Hospital of Miami, Miami, Florida.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Renshaw
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Dawn
authors.initials: D
authors.lastname: Underwood
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Ghada
authors.initials: G
authors.lastname: Aramoni
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Beverly
authors.initials: B
authors.lastname: Cash
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Maureen
authors.initials: M
authors.lastname: Croyle
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Dave
authors.initials: D
authors.lastname: Deeds
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Sandra
authors.initials: S
authors.lastname: Dolar
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Stephen
authors.initials: S
authors.lastname: Gmitro
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Nancy
authors.initials: N
authors.lastname: Ray
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Debbie
authors.initials: D
authors.lastname: Sabo
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Shorie
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Bridgette
authors.initials: B
authors.lastname: Springer
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Dana
authors.initials: D
authors.lastname: Weber Moffsinger
authors.affiliation: Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Tarik M
authors.initials: TM
authors.lastname: Elsheikh
mesh_terms: D003581:Cytodiagnosis / Q000379:methods*; D003952:Diagnostic Imaging / Q000295:instrumentation*; D055088:Early Detection of Cancer; D005260:Female; D005833:Genital Neoplasms, Female / Q000145:classification / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000295:instrumentation* / Q000592:standards*; D011786:Quality Control; D013997:Time Factors; D016526:Workload
keywords: ThinPrep imaging system; automated; cytology; cytotechnologist; gynecologic; screening; workload