Aging display's effect on interpretation of digital pathology slides

TL;DR

This study investigates how aging of display screens affects the interpretation of digital pathology slides, demonstrating that display aging can impair diagnostic accuracy, confidence, and workflow efficiency through perceptual and human reader studies.

Contribution

It introduces models of display aging effects on pathology images and quantifies their impact on diagnosis and workflow using perceptual metrics and a human reader study.

Findings

Aged displays significantly increase difficulty in reading pathology slides.

Display aging reduces diagnostic score agreement between sessions.

Aging affects the perceived conspicuity of key diagnostic features.

Abstract

It is our conjecture that the variability of colors in a pathology image effects the interpretation of pathology cases, whether it is diagnostic accuracy, diagnostic confidence, or workflow efficiency. In this paper, digital pathology images are analyzed to quantify the perceived difference in color that occurs due to display aging, in particular a change in the maximum luminance, white point, and color gamut. The digital pathology images studied include diagnostically important features, such as the conspicuity of nuclei. Three different display aging models are applied to images: aging of luminance & chrominance, aging of chrominance only, and a stabilized luminance & chrominance (i.e., no aging). These display models and images are then used to compare conspicuity of nuclei using CIE deltaE2000, a perceptual color difference metric. The effect of display aging using these display models and images is further analyzed through a human reader study designed to quantify the effects from a clinical perspective. Results from our reader study indicate significant impact of aged displays on workflow as well as diagnosis as follow. As compared to the originals (no-aging), slides with the effect of aging simulated were significantly more difficult to read (p-value of 0.0005) and took longer to score (p-value of 0.02). Moreover, luminance+chrominance aging significantly reduced inter-session percent agreement of diagnostic scores (p-value of 0.0418).