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Analytical Cellular Pathology
Volume 13, Issue 1, Pages 29-37

Assessing Slide Coverage by Cytoscreeners during the Primary Screening of Cervical Smears, Using the AxioHOME Microscope System

Robert W. Baker,1 Gerard Brugal,2 and Dulcie V. Coleman1

1Department of Cytopathology and Cytogenetics, Imperial College School of Medicine at St Mary’s, Praed Street, Paddington, London W2 1NY, UK
2Institut Albert Bonniot, Université Joseph Fourier, Grenoble, France

Received 26 June 1996; Revised 21 November 1996

Copyright © 1997 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


We have used the HOME Microscope system to examine the screening patterns of cytotechnologists who undertake the primary screening of cervical smears, in order to measure accuracy of screening against screening time, slide coverage, and mean screening rate. Twelve cytotechnologists engaged routinely on cervical screening volunteered for this study. They were asked to perform primary screening of 10 test slides under normal laboratory conditions in the normal way. Slide coverage and screening time were recorded on the HOME system. Slide maps were prepared and the results analysed.

The exercise demonstrated that all primary screeners fail at some point to scan the whole of the slide during primary screening. The maps produced by the HOME system clearly demonstrated that 5 different types of error can occur that lead to incomplete coverage of the slide. Mean slide coverage was 84%, and some individuals averaged only 66% coverage. The results show that there is a major problem in the education of some individual cytotechnologists in slide coverage. This could be rectified by the incorporation of a HOME system into every training centre, and the establishment of a protocol for assessment of slide coverage in competence examinations. Furthermore, the exercise has shown that even those individuals who normally attain a good standard of slide coverage would be able to improve slide coverage given access to the daily use of a HOME Microscope, or a system with equivalent screening/reviewing functionality.