PURPOSE: To compare inter-reader variability of chest X-ray and high resolution computed tomography (HRCT) scans of formerly asbestos-exposed employees over a 4-year period. METHODS: In this longitudinal study, 636 formerly asbestos-exposed persons were annually examined with chest radiographs and HRCT scans. Ten observer pairs classified the radiographs and HRCT scans, using the ILO classification and a custom-made CT classification. Inter-observer variability was calculated using the kappa-coefficient. RESULTS: Despite all expectations, HRCT inter-reader variability according to asbestos-related lung or pleura alterations at an early stage did not turn out to be better than X-ray inter-reader variability. Substantial inter-observer agreement was found for pleural calcifications (kappa(X-ray) = 0.63; kappa(CT) = 0.64). Averaging over kappa led to fair inter-observer agreement of both methods (kappa(X-ray) = 0.36; kappa(CT) = 0.34). CONCLUSIONS: High resolution computed tomography scans are superior to X-rays in detecting lung alterations after asbestos exposure and are supposedly easier to interpret. Nevertheless, inter-observer variability did not differ between the two methods in this study. This was probably due to the only discrete asbestos-related lung or pleura alterations of this cohort and to the unfamiliar CT classification sheet, which was revised on the basis of the presented results.
PURPOSE: To compare inter-reader variability of chest X-ray and high resolution computed tomography (HRCT) scans of formerly asbestos-exposed employees over a 4-year period. METHODS: In this longitudinal study, 636 formerly asbestos-exposed persons were annually examined with chest radiographs and HRCT scans. Ten observer pairs classified the radiographs and HRCT scans, using the ILO classification and a custom-made CT classification. Inter-observer variability was calculated using the kappa-coefficient. RESULTS: Despite all expectations, HRCT inter-reader variability according to asbestos-related lung or pleura alterations at an early stage did not turn out to be better than X-ray inter-reader variability. Substantial inter-observer agreement was found for pleural calcifications (kappa(X-ray) = 0.63; kappa(CT) = 0.64). Averaging over kappa led to fair inter-observer agreement of both methods (kappa(X-ray) = 0.36; kappa(CT) = 0.34). CONCLUSIONS: High resolution computed tomography scans are superior to X-rays in detecting lung alterations after asbestos exposure and are supposedly easier to interpret. Nevertheless, inter-observer variability did not differ between the two methods in this study. This was probably due to the only discrete asbestos-related lung or pleura alterations of this cohort and to the unfamiliar CT classification sheet, which was revised on the basis of the presented results.
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Authors: María Fernanda Cely-García; Carlos A Torres-Duque; Mauricio Durán; Patricia Parada; Olga Lucía Sarmiento; Patrick N Breysse; Juan P Ramos-Bonilla Journal: J Expo Sci Environ Epidemiol Date: 2014-02-05 Impact factor: 5.563
Authors: Marek A Mikulski; Alicia K Gerke; John D Newell; Ann M Murray; Carmen J Smith; Laurence J Fuortes Journal: Int J Occup Environ Health Date: 2016-05-04