Comparison of B readers' interpretations of chest radiographs for asbestos related changes

Our plain-English summary of Comparison of B readers' interpretations of chest radiographs for asbestos related changes, by K.D. Rosenman (Academic Radiology, 2004).

The study

• Author: K.D. Rosenman
• Journal: Academic Radiology
• Published: 2004;11(12):1396-7; author reply 1402-4
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

This was a letter to the editor, not a research study. The author, a non-radiologist B reader, commented on an earlier article by Gitlin and colleagues. That article compared the initial B readings of chest radiographs for asbestos-related changes with re-readings by a panel of consultant B readers. The author noted that the Gitlin study was conducted for, and presumably funded by, defense attorneys, and that it did not say whether the consultants regularly read radiographs for defense attorneys. The author argued that the article overstated the differences between readings. Only abnormal initial readings had been selected, so they would all be expected to be abnormal. The author also argued that averaging all consultants included outliers. In one table, the consultants' average percentage of radiographs rated good was 33.4, while two consultants' percentages were 4.5% and 15.2%. For 143 radiographs, at least 3 of the 6 consultants agreed the initial reading was not completely negative, and the author said the odds ratios would be appreciably less if these were counted. The author expected some differences to remain, called for independent studies, and disclosed receiving fees from both plaintiffs' and defense attorneys.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Letter to the editor commenting on a published study (Gitlin et al., Academic Radiology 2004)
• Who was studied: No people were studied by the author. The letter discusses the chest radiographs re-read in the study by Gitlin and colleagues.
• Exposure: No exposure was studied. The letter concerns B readings of chest radiographs for asbestos-related changes and pneumoconiosis used in litigation.
• Main results:
  • The author noted that the Gitlin study was conducted for, and presumably funded by, defense attorneys.
  • The author said the Gitlin article did not state whether the consultant B readers regularly read radiographs for defense attorneys.
  • The author argued that all initial readings would be expected to be abnormal, because only abnormal readings were selected for the study.
  • The author pointed to outliers among the consultants. In Gitlin's Table 1b, the consultants' average percentage of radiographs rated good was 33.4, while two consultants' percentages were 4.5% and 15.2%.
  • In Gitlin's Table 2d, at least 3 of the 6 consultants agreed that the initial reading was not completely negative for 143 radiographs. The author argued that the odds ratios would be appreciably less if these radiographs were counted as not completely negative.
  • The author expected that, even with a recalculation, some differences between the initial and consultant readings would remain, though less striking.
• The authors' conclusion: The author shared the editorial's concern about whether something is wrong with B readings in litigation and called for independent studies to assess the issue.
• Limitations the authors state:
  • The author disclosed having received fees from both plaintiffs' and defense attorneys as an expert witness and for independent medical examinations.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

Medical terms in this study, explained in our Lexicon: Chest X-Ray.

Related studies

• Comparison of "B" readers' interpretations of chest radiographs for asbestos related changes — J.N. Gitlin, L.L. Cook, et al. (2004)
• Comparison of B readers' interpretations of chest radiographs for asbestos related changes — J.P. Kassirer (2004)
• Comparison of B readers' interpretations of chest radiographs for asbestos related changes — L.C. Oliver, L.S. Welch, et al. (2004)
• Comparison of B readers' interpretations of chest radiographs for asbestos related changes — A. Franzblau, B. Gillespie (2004)
• Chest radiographs in subjects with asbestos-related abnormalities: comparison between ILO categorizations and clinical reading — B. Hilt, A. Borgerson, et al. (1992)
• Inter-reader variability in chest radiography and HRCT for the early detection of asbestos-related lung and pleural abnormalities in a cohort of 636 asbestos-exposed subjects — E. Ochsmann, T. Carl, et al. (2010)

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