In study of the correlation between pathologic and radiologic signs of coalworkers' pneumoconiosis and other occupationally related lung disease in coal miners, multiple histologic slides from lungs of 800 deceased coal miners are being read by four pathologists. The results presented here supply information on inter-pathologist variation in readings of the 775 histologic slides examined to date. Eight abnormalities are being classified: macules (5-point scale), focal emphysema (presence absence); all nodules (5-point scale), silicotic nodules (5-point scale), progressive massive fibrosis (PMF) (6 categories). alveolar interstitial fibrosis (AIF) (4-point scale), lung pigment (3-point scale), and emphysema (all types) (4-point scale). Consistency was categorized using the criteria of Landis and Koch (Biometrics, 1977; 33:159-174) based on average values of Cohen's kappa derived from pairwise agreement between pathologists as follows: Kappa/Strength of Agreement- 0.00/Poor; 0.00-0.20/Slight; 0.21-0.40/Fair; 0.41-0.60/Moderate; 0.61-0.80/Substantial;and 0.81-1.00/Almost Perfect. Substantial agreement was found for silicotic nodules, and moderate agreement for all nodules, lung pigment and PMF. Agreement on macules, focal emphysema, and AIF was only fair, while that for all emphysema was poor. When presence or absence of an abnormality was considered, agreement roŁe to substantial for all nodules and PMF, to moderate for macules, and to fair for all emphysema. In general, inter-pathologist agreement was superior to that seen in a study of three experts who read chest x-rays for profusion of small opacities using the ILO classification scheme for pneumoconiosis. In that study kappa values ranged from 0.20 to 0.36 indicating fair agreement (Statistics in Medicine 1984;3:73-83).
Respiratory-system-disorders; Pulmonary-system-disorders; Lung-disorders; Diagnostic-tests; Chest-X-rays; X-ray-analysis; X-ray-diagnosis; Analytical-instruments; Analytical-processes; Coal-miners; Coal-workers-pneumoconiosis; Pneumoconiosis; Pathology; Histopathology; Lung-fibrosis; Postmortem-examination; Medical-personnel