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 A. Franzblau, B. Gillespie (Academic Radiology, 2004).

The study

• Authors: A. Franzblau, B. Gillespie
• Journal: Academic Radiology
• Published: 2004;11(12):1400-2; author reply 1402-4
• Type of article: Letter, Comment
• Read it: PubMed · Publisher

In plain English

This item was a letter to the editor, not a research study, and it reported no new data. The authors criticized an earlier article by Gitlin and colleagues. That article compared chest X-ray readings by B readers retained by attorneys for people alleging asbestos-related changes with readings by independent consultant B readers, using 551 cases. The authors argued that the article did not describe how the films were chosen, so it was unknown whether they were random or representative. They argued the films may have been chosen by parties that stood to benefit from a biased outcome. They raised the same concern about how the 7 consultant readers were selected. They also called its objective one-sided, because it sought to assess potential bias only in B readers hired by plaintiffs' lawyers, not defense lawyers. Finally, they argued that comparing claimants with worker groups in published studies ignored the fact that abnormalities among people who file claims would be expected at or near 100%. The authors concluded that, without further information, no valid scientific conclusions could be drawn from the Gitlin study.

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 critiquing a published study (no new data)
• Who was studied: No population was studied. The letter discussed Gitlin and colleagues' study of 551 cases (chest films and initial reports) obtained from legal sources, re-read by 7 consultant B readers.
• Exposure: Interpretation of chest radiographs for asbestos-related changes by B readers in the context of asbestos litigation
• Main results:
  • The authors argued that the Gitlin article did not describe how films were selected, and that the films may have been selected by parties with an interest in the outcome.
  • The authors argued that, because the criteria and process for selecting the consultant B readers were not described, the study's results suffered from unknown bias.
  • The authors argued that the study's stated objective was one-sided, because it sought to assess the validity and potential bias only of B readers hired by plaintiffs' lawyers. They said the question should also cover B readers hired by defense lawyers.
  • The authors argued that comparing claimants' X-rays with worker groups in the literature was without foundation. Their reason was that the prevalence of radiographic abnormalities among people who file claims would be expected to be at or near 100%.
• The authors' conclusion: The authors concluded that, without further information, no valid scientific conclusions can be drawn from Gitlin and colleagues' investigation.

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 — K.D. Rosenman (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)
• 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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