Variability in Interpretation among B-Readers in the U.S. Navy Asbestos Medical Surveillance Program

Muller, John G.; Lieske, Jonathan M.; Hernandez, Jose E.; Kubiak, Gosia; Rudolph, W; Jan, Moore H.

doi:10.7205/milmed.173.4.375

Cited by 5 publications

(3 citation statements)

References 11 publications

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“…However, intra-and interreader variations were noted in pneumoconioses CXR reading results of the pre and post-tests, a situation that sometimes occurs even among experienced readers [16][17][18][19] .…”

Section: Resultsmentioning

confidence: 99%

Effect of a Two‐hour Training on Physicians' Skill in Interpreting Pneumoconiotic Chest Radiographs

Ngatu

Suzuki

Kusaka

et al. 2010

Journal of Occupational Health

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Effect of a Two-hour Training on Physicians' Skill in Interpreting PneumoconioticChest Radiographs: Nlandu Roger NGATU, et al. Department of Environmental Medicine, KochiMedical School, Kochi University-Objective: Occupational lung diseases have specific radiographic manifestations not always well known by physicians. In Japan, asbestos-related diseases became a public health concern after the "Kubota Shock", when a number of workers and residents living nearby a manufacturer of asbestos-made ducts developed mesothelioma caused by asbestos exposure. This preliminary intervention trial evaluated the effect of twohour training on inexperienced physicians' skill in interpreting pneumoconiotic chest radiographs. Methods: One hundred-two Japanese physicians participated in two reading-tests, using 12 radiographs, before and after the two-hour training with ILO/ICRP and Japan Pneumoconioses Study Group (JPSG) reading materials. Physicians had to check for the presence or absence of small opacity and pleural plaque consistent with pneumoconiosis. Sensitivity and specificity equal or greater than 70% were considered good, 50 to 69% acceptable and less than 50%, poor. Results: Post-training improvements in physicians' skills were seen. For small opacity, there was an increase in the proportion of physicians with good specificity, from 42% to 60%. For pleural plaque, the proportion of physicians with good specificity and good sensitivity increased, from 60% to 67% and from 18% to 25%, respectively. Also, significant improvements were observed in overall sensitivity for pleural plaque, from 46% to 60% (p<0.0001), and specificity for small Field Studyopacity, from 65% to 73% (p<0.0001). Conclusions: This study showed that two-hour participatory training may enhance physicians' skill in interpreting pneumoconiotic chest radiographs. There are countries without any pneumoconiosis screening program despite the WHO/ILO call for worldwide cooperation in eliminating it. Although the two-hour course cannot replace the five-day ILO workshop, such a program would be useful in areas with environmental or occupational exposure to dust. (J Occup Health 2010; 52: 294-301)

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Section: Resultsmentioning

confidence: 99%

Effect of a Two‐hour Training on Physicians' Skill in Interpreting Pneumoconiotic Chest Radiographs

Ngatu

Suzuki

Kusaka

et al. 2010

Journal of Occupational Health

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“…In a study which included 551 chest radiographs reinterpreted by six independent consultants in chest radiology, Gitlin et al (14) concluded that the difference between interpretations by initial readers and reinterpretations was too great to be attributed to interobserver variability. It has to be stressed, however, that in most cases the reinterpretations of small opacity profusions were more accurate than those reported by initial readers (14)(15)(16)(17).…”

Section: Resultsmentioning

confidence: 66%

Interobserver Variations in Diagnosing Asbestosis According to the ILO Classification

Perić

Novak

Barišić

et al. 2009

Archives of Industrial Hygiene and Toxicology

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Inhalation of asbestos fi bres leads to asbestosis of the pleura and the lung, with possible progression to lung cancer and malignant pleural or peritoneal mesothelioma. Asbestosis remains diffi cult to diagnose, especially in its early stages. The most important role in its diagnosis is that of chest radiographs. The aim of this cross-sectional study was to address interobserver variations in interpreting chest radiographs in asbestos workers, which remain to be an issue, despite improvements in the International Labour Offi ce (ILO) classifi cation system. In our ten-year study, we investigated 318 workers occupationally exposed to asbestos, and in 210 workers with diagnosed asbestos-related changes we compared interpretations of chest radiographs according to ILO by two independent radiologists. The apparent degree of interobserver variation in classifying lung fi brosis was 26.66 % for the diameter of changes and 42.2 % for the profusion of the changes. In cases with diffuse pleural thickening, the interobserver variation using ILO procedures was 34.93 %. This investigation raises the issue of standardisation and objectivity of interpretation of asbestosis according to the ILO classifi cation system. This study has revealed a signifi cant disagreement in the estimated degree of pleural and parenchymal asbestos pulmonary disease. This is why we believe highresolution computed tomography (HRCT) should also be used as a part of international classifi cation.

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“…Studies that have assessed the reliability of B reader interpretations of film and digital chest radiographs have found that interreader and intrareader κ values among B readers have ranged from 0.54 to 0.65 and 0.65 to 0.77 ( 7 – 14 ), generally considered good agreement. In addition, these studies have shown that major discrepancies in B reader interpretations were uncommon.…”

mentioning

confidence: 99%

To Be (B Read) or Not to Be (B Read), That Is the Question: Conflict of Interest and Radiographic Interpretation

Redlich

Rosenman

2021

Annals ATS

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Variability in Interpretation among B-Readers in the U.S. Navy Asbestos Medical Surveillance Program

Cited by 5 publications

References 11 publications

Effect of a Two‐hour Training on Physicians' Skill in Interpreting Pneumoconiotic Chest Radiographs

Effect of a Two‐hour Training on Physicians' Skill in Interpreting Pneumoconiotic Chest Radiographs

Interobserver Variations in Diagnosing Asbestosis According to the ILO Classification

To Be (B Read) or Not to Be (B Read), That Is the Question: Conflict of Interest and Radiographic Interpretation

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