Research on Devices for Handling Whole Slide Images on Pathology Workstations. An Ergonomic Outlook

  • Eduardo Alcaraz Mateos Pathology Department, Morales Meseguer University Hospital, Murcia, Spain.
  • Fuensanta Caballero-Alemán Intensive Care Unit. Morales Meseguer University Hospital, Murcia, Spain.
  • Mariano Albarracín-Ferrer Faculty of Medicine. University of Murcia, Spain.
  • Francisco Cárceles-Moreno Faculty of Medicine. University of Murcia, Spain.
  • Rubén Hernández-Gómez Faculty of Medicine. University of Murcia, Spain.
  • Sergio Hernández-Kakauridze Faculty of Medicine. University of Murcia, Spain.
  • Laura Hernández-Sabater Faculty of Medicine. University of Murcia, Spain.
  • Ignacio Jiménez-Zafra Faculty of Medicine. University of Murcia, Spain.
  • Alberto López-Alacid Faculty of Medicine. University of Murcia, Spain.
  • Carmen Moreno-Salmerón Faculty of Medicine. University of Murcia, Spain.
  • Miguel Pérez-Ramos Pathology Department, Morales Meseguer University Hospital, Murcia, Spain.
  • Andrés Nieto-Olivares
  • Nicolás Sánchez-Campoy National Institute of Statistics, Lerida, Spain.
  • Ignacio Martínez González-Moro Faculty of Physiotherapy, University of Murcia, Spain.
  • Enrique Poblet Pathology Department, Reina Sofia University Hospital, Murcia, Spain



Digital Pathology represents a technological innovation that introduces changes in the traditional tasks of pathologists. In this regard, an important issue that has not been enough emphasized is the image handling from an ergonomic point of view to avoid work-related musculoskeletal disorders (MSD). The aim of this study was to investigate a proper input device for digital pathology.

Material & Methods

Research was conducted in two phases: (1). A comparative study to find out an optimal external controller. Eight medical students analyzed 11 input devices: keyboard (Hewlett Packard, HP), conventional mouse (HP), vertical mouse (CLS), touchpad (Logitech), 3 trackballs (Logitech, Kensington Expert and Ulove), Rollermouse (Contour), Ergopointer (Märzhäuser Sensotech), gamepad (Logitech) and a touchless device (Leap Motion Controller), using them with the Image Viewer software (Ventana). The web-based Fitts´ law test (UC Berkeley) was used to objectify the accuracy of each used device, randomly. 12 items were included in the questionnaire: comfort, technical aspects (cursor movement and objective achievement), prospects, overall satisfaction, prior experience, and others. (2). Evaluation by two experienced pathologists of the best rated input device on the previous experiment and its comparison with a voice recognition system (Invox Medical Dictation, Vocali) using a headset microphone (Plantronics). Perceived workload was scored using the NASA Task Load Index on 28 whole slide images visualized on the Digital Image Hub (Leica) platform with a 4 MegaPixel display (Barco). Data were processed with SPSS 21.0.


Correlation between technical aspects of the evaluated devices and accuracy (Fitts´ law test), and comfort with overall satisfaction, was demonstrated (p<0.05). Comparative analysis of the 11 input devices concluded that vertical mouse was the best rated input device. However, on the second phase of the study, we find a slightly higher perceived workload using this device than using the voice recognition system, which was the best controller in digital pathology from an ergonomic point of view in this study.


We describe a methodology that can study and compare input devices for future workstations in digital pathology. Pathologists should be involved in this process trying to find ergonomic devices that prevent MSD. Voice recognition can function as a good handsfree device for digital pathology and could be considered in physical disability situations. Further studies using electromyography, accelerometry and 3D reconstruction analysis could provide additional ergonomic information.


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How to Cite
ALCARAZ MATEOS, Eduardo et al. Research on Devices for Handling Whole Slide Images on Pathology Workstations. An Ergonomic Outlook. Diagnostic Pathology, [S.l.], v. 2, n. 1, dec. 2016. ISSN 2364-4893. Available at: <>. Date accessed: 27 nov. 2020. doi:


Digital Pathology; Ergonomics; Input Device; Fitts test; NASA-TLX; Voice recognition

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