Aquarius Population Health

It is generally understood that the cytology work process can be stressful and fatiguing affecting technicians’ performance and job satisfaction on a day-to-day basis and in the longer term. This study assessed the performance and user experience of cytotechnologists (CTs) reviewing liquid-based cytology samples using a new digital cytology platform Genius Digital Diagnostics System (Genius DxS) benchmarked against ThinPrep Integrated Imager (I2), to understand the impact of perceived stress, fatigue, and decision-making processes.

This workflow and user experience pilot study with five CTs was conducted in Belgium (December 2020). Users reviewed 300 pre-selected retrospective ThinPrep slides first using I2. After a 2-week washout period, users reviewed the same cases using Genius DxS, using a high-definition monitor. The AI algorithm generates a gallery of clinically relevant objects; CTs review the gallery to render an interpretation.

Efficiency and accuracy were measured whilst reading slides using I2 and Genius DxS. A pragmatic literature search of user experience studies was performed to derive quantitative surveys measuring perceived stress and mental fatigue. CTs completed surveys at pre-determined times during the day. Semi-structured qualitative interviews explored their experiences.   

Results showed all CTs completed slide readings faster using Genius DxS, while achieving similar accuracy. Speed increases were not accompanied by reported increases in fatigue/stress.  CTs reported similar confidence in their ability to accurately interpret slides. Qualitative reports indicate the Genius DxS cell presentation enables easier and more immediate decision-making.

Efficiency gains with Genius DxS may be achievable without negative impacts on users’ experience. Differences in CTs’ reported mental processing of diagnostic information may partially account for these benefits. While the results suggest a positive user experience, the sample size was small in this pilot study, and the results are not statistically significant. These findings merit further research alongside performance measurement within larger studies. The results were presented a the 43rd European Congress of Cytology, October 3-6, 2021. The presentation is available online.

© Aquarius Population Health 2022. For commercial use or distribution, please contact

Gara-Adams R, Dombrowski C, Adams E. “User experience and workflow performance: pilot evaluation of Genius Digital Diagnostics System for screening cervical cytology samples.” Presented at: 43rd European Congress of Cytology, October 3-6, 2021; Virtual.