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Efforts to improve consistency and accuracy in chest radiograph classification in the United States: the NIOSH B Reader Program.

Wagner GR; Attfield MD; Parker JE
Proceedings, eighth international conference on occupational lung diseases, September 14-17, 1992, Prague, Czechoslovakia. Hurych J, Lesage M, David A, eds. Prague, Czechoslovakia: Czech Medical Society, 1993 Jan; :827-832
The effectiveness of certification and recertification examinations for NIOSH B-Readers as a means of improving consistency and accuracy in the classification of chest radiographs was assessed. The B- Reader program was developed to identify physicians qualified to serve in national pneumoconiosis programs. This report summarized information arising from the results of over 1600 examinations that occurred between 1987 and 1992. Aspects that were considered included: certification test format; recertification test format; grading system; examination participation; characteristics of B- Reader candidates; pass/fail rates; and distribution of scores. Approximately 57% of persons taking the certification examination passed in 1987, versus only 35% in 1990; in contrast, the passing rates for recertification were stable at about 70% Candidates tended to obtain the greatest scores relative to the total for the inconsistency index, over and under reading tendency, and other symbols; lowest scores were obtained for pleural abnormalities. The authors conclude that use of the B-Reader program has led to better understanding of the International Labour Office classification system and of normal and abnormal radiographic appearances, but variability among certified B-Readers still remains. Quality assurance approaches that meet defined needs should be incorporated into epidemiologic investigations and surveillance programs.
Chest-X-rays; Radiodiagnosis; Clinical-techniques; Diagnostic-tests; Lung-disease; Occupational-medicine; Surveillance-programs
Publication Date
Document Type
Conference/Symposia Proceedings
Hurych J; Lesage M; David A
Fiscal Year
NIOSH Division
Source Name
Proceedings, eighth international conference on occupational lung diseases, September 14-17, 1992, Prague, Czechoslovakia
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division