IMPACT OF THE PATHFINDER IN A CYTOLOGY LABORATORY

OBJECTIVE: To assess the value of Pathfinder (CompuCyte, Cambridge, Ma ssachusetts, U.S.A.) in improving adequacy and accuracy of screening a nd supporting quality control programs. STUDY DESIGN: The investigatio ns were carried out on cervical cytologic smears only. Screening adequ acy was assessed through the evaluation of percentage of slide coverag e, percentage of overlapping and amount of elapsed time on smears scre ened with or without the Pathfinder by junior (426 cases) and senior ( 1,552 cases) screeners. Screening accuracy was investigated by compari ng the performances of the same observer when reexamining, with the Pa thfinder, a series of 1,051 cases already evaluated without the Pathfi nder at least three months earlier. The review process was analyzed by both monitoring the elapsed time for relocation of manually or electr onically marked cells (824 fields in 80 smears) and by comparing diagn ostic discrepancies after the review of two series (74+74 cases) of ra ndomly selected negative cases screened with or without Pathfinder. RE SULTS: Pathfinder-assisted screening increased the number of cases wit h optimal slide coverage (greater than or equal to 90% of screenable a rea) and optimal overlaying (between 15% and 20%) by both junior (P<.0 0001 and P<.00001) and senior (P<.00001 and P<.0003) screeners. It als o improved screening accuracy by decreasing the number of cases ''unsa tisfactory for evaluation'' (P<.00001) (as a consequence of better cov erage and overlapping) and the number of diagnostic discrepancies dete cted after review (P=.05). During the latter process, the time elapsed for relocation of electronically marked fields, as compared to manual ly marked ones, was greatly reduced (1 hour, 25 minutes saved for revi sion of 40 smears). CONCLUSION: In these preliminary studies, the Path finder was a useful tool for both education and diagnosis (screening a nd review in a cytology laboratory.