Predicting screening sensitivity from workload in gynecologic cytology: A review

Recent studies have shown that it is possible to correlate workload or epithelial cell abnormality (ECA) adjusted workload with screening sensitivity. The results show that for manual screening of conventional smears or SurePath slides, screening sensitivity begins to fall with workloads as low as 30 slides/day. For review of slides with the ThinPrep Imaging System, screening sensitivity appears to be better correlated with ECA adjusted workload (workload × ECA rate) than workload alone. Screening sensitivity with the ThinPrep imager appears to fall at ECA adjusted workloads of 7 slides/day at a threshold of ASCUS and above and LSIL, and slightly lower for HSIL. This corresponds to 70 slides/day at an ECA rate of 10%. The variance in these models is likely high reflecting a wide range of individual cytotechnologist performance. Strategies to most effectively incorporate this data in the management of workload in the laboratory are reviewed. Diagn. Cytopathol. 2011. © 2010 Wiley-Liss, Inc.