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

Abstract

Background

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.

Results

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.

Conclusions

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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References

- Park, S., Parwani, A.V., Aller, R.D., et al., The history of pathology informatics: A global perspective. J Pathol Inform, 2013. 30(4):7.

- Kayser, K., Borkenfeld, S. Carvalho R. et al., How to implement digital pathology in tissue-based diagnosis (surgical pathology)? diagnostic pathology, 2015. 1:89.

- García-Rojo, M., International Clinical Guidelines for the Adoption of Digital Pathology: A Review of Technical Aspects. Pathobiology, 2016. 83:99-109.

- Yagi, Y., Yoshioka, S., Kyusojin, H., et al., An Ultra-High Speed Whole Slide Image Viewing System. Anal Cell Pathol, 2012. 35: 65–73.

- Molin, J., Lundström, C., Fjeld, M., A comparative study of input devices for digital slide navigation. J Pathol Inform, 2015. 24(6):7

- Buck, T.P., Dilorio, R., Havrilla, L., et al., Validation of a whole slide imaging system for primary diagnosis in surgical pathology: A community hospital experience. J Pathol Inform, 2014. 28;5(1):43.

- Gerr, F., Marcus, M., Ensor, C., et al., A prospective study of computer users: I. Study design and incidence of musculoskeletal symptoms and disorders. Am J Ind Med, 2002. 41:221-35.

- Bruno Garza, J.L., Young, J.G., A literature review of the effects of computer input device design on biomechanical loading and musculoskeletal outcomes during computer work. Work, 2015. 52:217-30.
- Quemelo, P.R., Vieira, E.R., Biomechanics and performance when using a standard and a vertical computer mouse. Ergonomics, 2013. 56:1336-44.

- Lin, M.Y., Young, J.G., Dennerlein, J.T., Evaluating the effect of four different pointing device designs on upper extremity posture and muscle activity during mousing tasks. Appl Ergon, 2015. 47:259-64.

- Bachmann, D., Weichert, F., Rinkenauer, G., Evaluation of the leap motion controller as a new contact-free pointing device. Sensors (Basel), 2014. 24(15):214-33.

- Goldberg, K., Faridanib, S., Alterovitzc, R., Two Large Open-Access Datasets for Fitts’ Law of Human Motion and a Succinct Derivation of the Square-Root Variant. IEEE Transactions on Human-Machine Systems, 2015:62-63.

- Feathers, D.J., Rollings, K., Hedge, A., Alternative computer mouse designs: performance, posture, and subjective evaluations for college students aged 18-25. Work, 2013. 44:S115-22.

- Hart, S.G., Staveland, L.E., Development of NASA-TLX: results of empirical and theoretical research. In: Hancock, P.A., Meshkati, N., eds. Human Mental Workload.] Amsterdam: Elsevier, 1987.

- Hancock, P.A., Effects of control order, augmented feedback, input device and practice on tracking performance and perceived workload. Ergonomics, 1996. 39:1146-62.

- Yurko, Y.Y., Scerbo, M.W., Prabhu, A.S., et al., Higher mental workload is associated with poorer laparoscopic performance as measured by the NASA-TLX tool. Simul Healthc, 2010. 5:267-71.

- Haroske, G., Mörz, M., The effects of digital workflow control for the performance of routine pathology. diagnostic pathology, 2016. 2:114.

- Alcaraz-Mateos, E., Tortosa-Martínez, I., Alcolea-Guardiola, C., et al.,The Technicians´ Role in Digital Pathology Implementation. Searching Optimization. diagnostic pathology, 2016. 2:231.

- Krupinski, E,A., Optimizing the pathology workstation “cockpit”: Challenges and solutions. J Pathol Inform, 2010. 1:19.

- Thompson, S.K., Mason, E., Dukes, S., Ergonomics and cytotechnologists: reported musculoskeletal discomfort. Diagn Cytopathol, 2003. 29:364-7.

- Flavin, R.J., Guerin, M., O'Briain, D.S., Occupational problems with microscopy in the pathology laboratory. Virchows Arch, 2010. 457:509-11.

- George, E., Occupational hazard for pathologists: microscope use and musculoskeletal disorders. Am J Clin Pathol, 2010. 133:543-8.

- Fritzsche, F.R., Ramach, C., Soldini, D., et al., Occupational health risks of pathologists--results from a nationwide online questionnaire in Switzerland. BMC Public Health, 2012. 6(12):1054.

- Alcaraz-Mateos, E., Caballero-Alemán, F., Musculoskeletal disorders in Spanish pathologists. Prevalence and risk factors. Rev Esp Patol, 2015. 48:9-13.

- Thorstenson, S., Molin, J., Lundström, C., Implementation of large-scale routine diagnostics using whole slide imaging in Sweden: Digital Pathology experiences 2006-2013. J Pathol Inform, 2014. 5:14.

- Oha, K., Animägi, L., Pääsuke, M., et al., Individual and work-related risk factors for musculoskeletal pain: a cross-sectional study among Estonian computer users. J Digit Imaging, 2014. 27(2):255-61.

- Tiric-Campara, M., Krupic, F., Biscevic, M., et al., Occupational overuse syndrome (technological diseases): carpal tunnel syndrome, a mouse shoulder, cervical pain syndrome. Acta Inform Med, 2014. 22(5):333-40.

- Baydur, H., Ergör, A., Demiral, Y., et al., Effects Of Participatory Ergonomic Intervention On The Development Of Upper Extremity Musculoskeletal Disorders And Disability In Office Employees Using A Computer. J Occup Health, 2016. 58(3):297-309.

- Hoe, V.C., Urquhart, D.M., Kelsall, H.L., et al., Ergonomic design and training for preventing work-related musculoskeletal disorders of the upper limb and neck in adults. Cochrane Database Syst Rev, 2012. 15(8):CD008570.

- Andersen, J.H., Fallentin, N., Thomsen, J.F., et al., Risk factors for neck and upper extremity disorders among computers users and the effect of interventions: an overview of systematic reviews. PLoS One, 2011. 6:e19691.

- Onyebeke, L.C., Young, J.G., Trudeau, M.B., et al., Effects of forearm and palm supports on the upper extremity during computer mouse use. Appl Ergon, 2014. 45:564-70.

- Rodrigues, J.C., Morgan, S., Augustine, K., et al., Musculoskeletal symptoms amongst clinical radiologists and the implications of reporting environment ergonomics--a multicentre questionnaire study. J Digit Imaging, 2014. 27(2):255-61.

- Robertson, M.M., Boiselle, P., Eisenberg, R., et al., Examination of computer task exposures in radiologists: a work systems approach. Work, 2012. 41(1):1818-20.

- Harisinghani, M.G., Blake, M.A., Saksena, M., et al., Importance and effects of altered workplace ergonomics in modern radiology suites. Radiographics, 2004. 24(2):615-27.

- De Korte, E.M., van Lingen, P., The effect of speech recognition on working postures, productivity and the perception of user friendliness. Appl Ergon, 2006. 37:341-7.

- Peper, E., Wilson, V.S., Gibney, K.H., et al., The integration of electromyography (SEMG) at the workstation: assessment, treatment, and prevention of repetitive strain injury (RSI). Appl Psychophysiol Biofeedback, 2003. 28(2):167-82.

- Agarabi, M., Bonato, P., De Luca, C.J., A sEMG-based method for assessing the design of computer mice. Conf Proc IEEE Eng Med Biol Soc, 2004. 4:2450-3.
Published
2016-12-02
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: <http://www.diagnosticpathology.eu/content/index.php/dpath/article/view/232>. Date accessed: 27 nov. 2020. doi: https://doi.org/10.17629/www.diagnosticpathology.eu-2016-2:232.
Section
Research

Keywords

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

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