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Reliability and validity of chest radiograph surveillance programs.

Authors
Lawson-CC; LeMasters-MK; Lemasters-CK; Reutman-SS; Rice-RH; Lockey-JE
Source
Chest 2001 Jul; 120(1):64-68
NIOSHTIC No.
20032153
Abstract
Study objectives: Due to the lack of consensus in the literature in the use of posteroanterior (PA) vs PA with right and left oblique views as the optimum radiograph surveillance methodology to investigate pleural changes, a study was undertaken to evaluate the reliability, sensitivity, and specificity of these two approaches. Design: Three experienced radiologist B readers used the 1980 International Labor Office classification system for pneumoconiosis to independently read chest radiographs of workers with individual identifiers masked. All radiographs were read first as a PA view only. Unknown to the B readers, each subject's PA was then matched to his or her corresponding right and left oblique views (film triad) and re-read several weeks later. Setting and participants: The respiratory health of 652 workers exposed to refractory ceramic fiber was assessed as part of cross-sectional and longitudinal surveillance programs. Measurements and results: Statistics for interreader and intrareader reliability between the PA view and film triad methods were calculated. Sensitivity, specificity, and positive predictive value were assessed by comparing the initial cross-sectional study to the longitudinal study. The film triad method had considerably higher interreader reliability ( = 0.59) compared to the PA-only method ( = 0.44). Results from the initial cross-sectional study were then compared to findings evaluated longitudinally. The film triad again was superior, demonstrating a positive predictive value of 73.7% compared to only 47.8% for the PA method. Conclusions: It is our recommendation that the film triad method be used in surveillance studies where both parenchymal and pleural changes are anticipated.
Keywords
Pulmonary-system; Lung-disease; Lung-disorders; Chest-X-rays; X-ray-analysis; X-ray-diagnosis; Pneumoconiosis; Pulmonary-system-disorders; Respiratory-system-disorders
Contact
Christina C. Lawson, PhD, National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Mailstop R-15, Cincinnati, OH 45226-1998
CODEN
CHETBF
Publication Date
20010701
Document Type
Journal Article
Email Address
cjl9@cdc.gov
Fiscal Year
2001
NTIS Accession No.
NTIS Price
Issue of Publication
1
ISSN
0012-3692
NIOSH Division
DSHEFS
Source Name
Chest
State
OH
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