Table 3.

Summary of studies in the pathology literature related to display parameters and practices (original work)

Article	Experimental design	Findings	Limitations
Krupinski et al., 2012[100]	Examined impact of color calibration on pathologist interpretation of ROI from breast biopsy WSI	Modest decrease in time to diagnosis but no effect on accuracy when using calibrated display	Single display and organ system; still ROIs and not full slides
D’haene et al., 2013[102] (Note: Replication of earlier abstract by Sharma et al.)	Compared microscope, two COTS displays, one PG display, and one MG display in six performance measures on a selection of surgical and cytological WSI	Image quality, speed, and absence of pixelation were superior on the MG display	COTS and PG displays selected were inferior to MG in resolution, size, and luminance. Measures chosen were subjective
Campbell et al., 2014[94]	Assessed pathologist diagnostic concordance on 85 breast biopsy WSIs at ×20 versus ×40 magnification, while using light microscopy, a 1.3 MP COTS display, or a DICOM calibrated 4MP MG display	No significant difference in diagnostic concordance rates between lower resolution COTS display and higher resolution, DICOM calibrated MG display	Single-organ system, only tested differences in concordance between light microscopy and WSI using each display type without direct display comparisons
Kimpe et al., 2014[75]	Compared COTS display calibrated to sRGB with MG displays calibrated to either DICOM GSDF or CSDF in terms of color contrast of cytologic features from background	MG displays showed greater color contrast than COTS display. CSDF calibration offered greater color contrast than GSDF or RGB calibration	COTS display chosen was inferior in panel type, resolution, size, luminance, and contrast ratio. COTS display was only calibrated to sRGB target, while MG displays were only calibrated to DICOM targets. COTS display was set to lower luminance value to reflect 1 year of use
Avanaki et al., 2015[101]	Assessed intersession agreement of pathologists using surgical and cytological images with and without artificially lowered luminance and chromaticity to reflect display aging	Pathologist intersession agreement decreased when observing the “aged” images relative to the original images	Image manipulation was performed artificially using software rather than actual display aging
Randell et al., 2015[95]	Compared pathologist performance when viewing slides on a microscope, a single display, and a high-resolution, multidisplay setup	Higher resolution display setup led to decreased time to diagnosis and time to complete a searching task compared to single display. Display type did not significantly alter diagnostic accuracy or confidence in diagnosis	Participants were exposed to only three cases, all of which were axillary lymph nodes from breast surgical resections
Campbell et al., 2015[97]	Assessed pathologist performance when viewing breast biopsy WSI on a gray-scale display as compared to original microscopic diagnosis	Comparable performance (92.7% concordance) was seen when using a gray-scale display	Performance was not compared with WSI viewed on color displays
Marchessoux et al., 2016[88]	Assessed the number of interactions (zoom and pan) performed by three pathologists when viewing cytology and histology WSI cases on 2 MP, 4 MP, and 12 MP displays	Reduced number of zoom and pan interactions when using higher resolution displays	Accuracy, time to diagnosis, and pathologist blinding/washout protocol not reported
Norgan et al., 2018[103]	Compared pathologists’ mitotic counts in melanoma specimens and ability to detect Helicobacter pylori in gastric biopsies when using either MG or COTS display	Comparable concordance rates for pathologists using either the MG or COTS display as compared to original microscopic diagnosis	Evaluated only two specific tasks in surgical pathology

ROI: Regions of interest, WSI: Whole-slide imaging, COTS: Consumer off the shelf, PG: Professional grade, MG: Medical grade, DICOM: Digital Imaging and Communications in Medicine, RGB: Red-green-blue, sRGB: Standard RGB, GSDF: Gray-scale display function, CSDF: Color standard display function