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OBJECTIVE: To evaluate the effect of Pathfinder (CompuCyte Corp., Cambridge, Massachusetts, U.S.A.), a Process control instrument for microscopes used by cytotechnologists to monitor the mechanical aspects of their screening process, on the false negative cervical cytologic smear rate as detected in daily quality assurance rescreening. STUDY DESIGN: Pathfinder was put into routine use in a large cytology laboratory. After cytotechnologists were trained in its use, they monitored their time spent screening each slide, the area (percent) of the slide screened and the average percentage of overlap of fields of view. The number of abnormal cases missed in screening before and after the introduction of Pathfinder was determined by rescreening a random 10% of the negative cases. The evaluation took place over a nine-month period. RESULTS : A decrease in the number of missed abnormal cases was identified. The false negative rate for atypical cells of undetermined significance (ASCUS) fell from 37/2,336 (1.6%) to 12/1,772 (0.7%), for a 56% decrease. The change in the number of squamous intraepithelial lesion cases, even over a nine-month period, was too small for comment. CONCLUSION: The effect of the continuous feedback and process standardization provided by the Pathfinder system was a decrease in the number of abnormal cases missed. This was due primarily to a marked decrease in the number of ASCUS cases missed. The Pathfinder provides a number of innovative management tools to ensure consistent high quality screening.

OBJECTIVE: To evaluate the suitability of the Pathfinder (CompuCyte Corp., Cambridge, Massachusetts, U.S.A.), an innovative instrument for monitoring the mechanical aspects of cytology screening, as a training aid and workstation component for cytotechnologists for daily work flow in a large cytology laboratory. STUDY DESIGN: The impact of the implementation of the Pathfinder was assessed by comparing the performance of a group of senior cytotechnologists with the Pathfinder features enabled (displayed) and disabled (not displayed). When enabled, statistical parameters, including the percentage of screenable slide surface viewed, the amount of time spent viewing the slide and the percentage of overlap of the fields of view, were continuously displayed to the cytotechnologist on a small, dedicated video display terminal. Areas of the slide requiring additional review by the pathologist were indicated by a series of electronic icons placed by the cytotechnologists. RESULTS: The Pathfinder was found to provide critical insight into the variability that exists among cytotechnologists in their approach to screening. By establishing laboratory performance criteria for the aforementioned parameters, variability in performance could be reduced immediately. CONCLUSION: The continuous feedback provided by the Pathfinder to the cytotechnologist during the actual screening process could help to diminish false negative cervical cytologic smear evaluations due to correctable unsuspected errors in the practice of screening.