Wuhan-American comparison: a comparison of radiographic interpretation of silica exposed workers using the 1963 and 1986 Chinese roentgenodiagnostic criteria of pneumoconioses.
Chen R; Hodous TK; Liang Z; Petersen M; Den Y; Chen J; McLaughlin JK; Blot WJ
Study of Silicosis and Lung Cancer for Dust Exposed Workers (Silica, Silicosis and Lung Cancer), Tongji Medical University, China and National Cancer Institute, USA 1991 Jun; :72-81
X-ray diagnostic data from 1963 and 1986 surveys of pneumoconiosis in Chinese workers exposed to silica (14808607) were used for a comparative study of radiodiagnostic interpretations. Of 11 expert radiologists selected to reinterpret the films, three interpreted each film, and also participated in consensus interpretations. All interpretations used the 1986 criteria and the 1963 films were compared with 1986 standard films. A total of 1955 chest X-rays included 1128 Silicosis Registry films and 727 others. Crude agreement was obtained for 57.4% of the entire cohort. Disagreements were related to films termed suspect in the old reading and stage 0 in the new readings. Crude agreement within one step of identity was 92.5%. Old readings generally interpreted a slightly higher disease level (33%) than did new readings. A decrease in the trend to overread was seen in the progression from tin to iron/copper to pottery and tungsten mines. A comparison of median readings and consensus derived readings showed little difference between the two. Differences between the old and new interpretations were associated with the two different classifications used, reading biases, film deterioration, and the different algorithms used in the final interpretation. Higher old readings were attributed to the availability of other clinical data at the time of the old interpretations. The authors conclude that old interpretations represent a fair approximation to new ones, and that epidemiologic dose response studies can be reasonably based on old readings.
Epidemiology; Clinical-diagnosis; Metal-dusts; Miners; Lung-disease; Mortality-surveys; Occupational-diseases; Occupational-exposure; Occupational-hazards; Radiodiagnosis
Study of Silicosis and Lung Cancer for Dust Exposed Workers (Silica, Silicosis and Lung Cancer), Tongji Medical University, China and National Cancer Institute, USA