Between- and within-reader variability in the assessment of pleural abnormality using the ILO 1980 international classification of pneumoconioses.

Although there are published data concerning reader variability in the assessment of parenchymal pneumoconiotic changes using the ILO Classification of Radiographs, nothing has been published on reader variability with regard to pleural abnormalities. Therefore, in the context of an epidemiologic study, we assessed between- and within-reader variability in the reading of chest radiographs for pleural abnormality using the ILO 1980 International Classification of Radiographs of Pneumoconioses. Chest radiographs of 182 insulation workers interspersed with 24 subjects without documented exposure to asbestos were assembled and read blindly by two readers, reading separately on two occasions, 1 week apart. The results of this study suggest that confident separation of pleural plaques and diffuse pleural thickening may be difficult to achieve using the present guidelines of the ILO 1980 classification. In the evaluation of the width of chest wall pleural abnormality, within-reader agreement improves as the width increases, while between-reader agreement was much less satisfactory. Excellent agreement is obtained in the evaluation of other sites, especially costophrenic angle obliteration and the presence of pleural calcification.

[1]  T. McLoud,et al.  Diffuse pleural thickening in an asbestos-exposed population: prevalence and causes. , 1985, AJR. American journal of roentgenology.

[2]  M. Britton Asbestos pleural disease. , 1982, British journal of diseases of the chest.

[3]  C. Mcgavin,et al.  Diffuse pleural thickening in asbestos workers: disability and lung function abnormalities. , 1984, Thorax.

[4]  J. Langlands,et al.  Insulation workers in Belfast. 1. Comparison of a random sample with a control population1 , 1971, British journal of industrial medicine.

[5]  A. Herbert Pathogenesis of pleurisy, pleural fibrosis, and mesothelial proliferation. , 1986, Thorax.

[6]  L. Kreel,et al.  Respiratory function changes after asbestos pleurisy. , 1980, Thorax.

[7]  A. Sanden,et al.  Pleural plaques and respiratory function. , 1986, American journal of industrial medicine.

[8]  B. Hilt,et al.  Lung function and respiratory symptoms in subjects with asbestos-related disorders: a cross-sectional study. , 1987, American journal of industrial medicine.

[9]  J. R. Landis,et al.  An application of kappa-type analyses to interobserver variation in classifying chest radiographs for pneumoconiosis. , 1984, Statistics in medicine.

[10]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[11]  J. R. Landis,et al.  An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers. , 1977, Biometrics.

[12]  A. Teirstein,et al.  Ventilatory failure due to asbestos pleurisy. , 1983, The American journal of medicine.

[13]  D. Lee,et al.  Asbestos and Disease , 1978 .

[14]  K. Lumley Physiological changes in asbestos pleural disease. , 1975, Inhaled particles.

[15]  G. Hillerdal Non-malignant asbestos pleural disease. , 1981, Thorax.

[16]  C. Boggis,et al.  Asbestos-related pleural thickening: effect of threshold criteria on interpretation. , 1984, Radiology.