{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:05:10Z","timestamp":1791378310330,"version":"4.3.2"},"reference-count":41,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Cytopathology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traditionally, cytology expertise has been equated with professional experience. However, the transition to whole\u2010slide imaging and artificial intelligence (AI) necessitates a shift from exhaustive screening to rapid verification. The goal of this study was to identify cognitive biomarkers associated with diagnostic accuracy and evaluate their modifiability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In phase 1, 100 cytotechnologists with 1\u201340 years of experience diagnosed 30 digital cytology images using eye\u2010tracking. Gaze metrics across areas of interest were analyzed via nominal logistic regression. In phase 2, 28 students completed a 3\u2010month cytotechnology training program. Pre\u2010 and post\u2010training metrics were compared using Wilcoxon signed\u2010rank tests and effect sizes (\n                      <jats:italic>r<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Years of experience showed no significant correlation with diagnostic accuracy (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.189,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&gt;\u00a0.05). Multivariate analysis identified shorter total fixation duration on the \u201clow\u2010power field (LPF) main object\u201d as the sole independent predictor of high accuracy (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.045), suggesting a \u201cpop\u2010out\u201d detection mechanism. Experience correlated only with attention to sample information. Post\u2010training (phase 2), students' time to first target fixation decreased substantially (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.62\u20130.86), whereas their attention to normal backgrounds decreased (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.71). This demonstrates the rapid acquisition of expert\u2010like selective attention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Efficiency in LPF target detection is a better predictor of diagnostic accuracy than professional experience. This study identifies LPF efficiency as a modifiable cognitive biomarker that can be acquired through standard education. Quantifying these gaze metrics provides an objective means of evaluating skill development and readiness for the AI era.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncy.70132","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T07:10:41Z","timestamp":1785222641000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Screening efficiency over experience: Rapid target detection in low\u2010power field as a modifiable cognitive biomarker for diagnostic accuracy in digital cytology"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5015-7702","authenticated-orcid":false,"given":"Naoya","family":"Abe","sequence":"first","affiliation":[{"name":"Division of Clinical Cytology Department of Medical Laboratory Sciences School of Allied Health Sciences Kitasato University  Kanagawa Japan"},{"name":"Department of Applied Tumor Pathology Graduate School of Medical Sciences Kitasato University  Kanagawa Japan"},{"name":"Department of Pathology Kitasato University Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukari","family":"Nishimura","sequence":"additional","affiliation":[{"name":"Division of Clinical Cytology Department of Medical Laboratory Sciences School of Allied Health Sciences Kitasato University  Kanagawa Japan"},{"name":"Department of Applied Tumor Pathology Graduate School of Medical Sciences Kitasato University  Kanagawa Japan"},{"name":"Department of Pathology Kitasato University Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuya","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Pathology Kitasato University Hospital  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takushi","family":"Kawamorita","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Orthoptics and Visual Science Course School of Allied Health Sciences Kitasato University  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Takatori","sequence":"additional","affiliation":[{"name":"Department of Electrical and Electronic Engineering Faculty of Engineering Kanagawa Institute of Technology  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Murakumo","sequence":"additional","affiliation":[{"name":"Department of Pathology Kitasato University Hospital  Kanagawa Japan"},{"name":"Department of Pathology School of Medicine Kitasato University  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiko","family":"Furuta","sequence":"additional","affiliation":[{"name":"Division of Clinical Cytology Department of Medical Laboratory Sciences School of Allied Health Sciences Kitasato University  Kanagawa Japan"},{"name":"Department of Applied Tumor Pathology Graduate School of Medical Sciences Kitasato University  Kanagawa Japan"},{"name":"Department of Pathology Kitasato University Hospital  Kanagawa 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