Inter-reader variability among readers using ILO 1971 and 1980 classifications of the pneumoconioses.
Althouse-RB; Attfield-MD; Hodous-TK
NIOSH 1990 Nov; :1434-1439
A comparison was made between readings of chest X-rays evaluated by first and second readers on the 1980 International Labour Organization (ILO) classification of the pneumoconioses with those read in the Attfield study. Comparisons between first and second readers for each classification were made for the profusion of opacities read, the types of opacities read, and within each reader group, for the range of prevalence of abnormal opacities which they reported. X-rays of readable quality for miners with 10 or more years of underground mining tenure were selected from films read during 1981 through 1987 by the 1980 ILO classification. A group of 10,249 X-rays was selected. One hundred and eighty eight first readers and 20 second readers participated in evaluating the 10,249 X-rays. Under the 1980 ILO classification both first and second readers reported lower prevalence of category 0/1+ coal workers pneumoconioses, 12% for first and 4% for second readers. Using the 1971 ILO classification scheme, these values were 27% and 22%, respectively. The agreement between first and second readers on the same films indicated overall crude agreement within major categories increasing from 78% to 87% from the 1978 to the 1980 group. The agreement between readers in reading opacity type revealed some parallel to profusion readings. On both classifications, first readers reported higher levels of rounded opacities as a percentage of all opacities than second readers, for primary type. The authors conclude that a quality control scheme is needed to minimize the problem of reader variability. This need exists in relation to both first and second readers. A system of feedback, notifying readers of their standing relative to all readers is one possibility.
Radiodiagnosis; Diagnostic-techniques; Respiratory-system-disorders; Lung-disease; X-ray-analysis; X-ray-diagnosis; Coal-workers-pneumoconiosis
DHHS (NIOSH) Publication No. 90-108
Proceedings of the VIIth International Pneumoconioses Conference