As in previous health technology assessments on this subject, the conclusion is that the available evidence on test performance, impact on process and cost-effectiveness is still insufficient to recommend implementation of automated image analysis systems. The priority for action remains further research. An important difference is that previously the insufficiency of evidence was general. Now, a general case for automated image analysis has probably just been made, but is specifically absent for the single device currently commercially available. The findings with respect to other and in many cases older automated image analysis devices need to be confirmed for the AutoPap GS System.