To Be (B Read) or Not to Be (B Read), That Is the Question: Conflict of Interest and Radiographic Interpretation

Details

• Personal Author:
  Redlich CA ; Rosenman, Kenneth D.
• Description:
  In this issue of AnnalsATS, Friedman and colleagues (pp. 1634-1641) address whether physician source of payment is associated with classification of radiographs for coal workers' pneumoconiosis. Although most pulmonologists are not directly involved in reading chest radiographs of workers at risk for pneumoconiosis, the study raises important issues relevant to broader clinical practice-the reliability of chest radiograph interpretations and the extent to which physician decisions are influenced by potential financial conflicts of interest (COIs); in this situation, the question of who is paying for the chest radiograph interpretation is raised. Although clinicians are aware that mistakes can be made interpreting chest radiographs, such as missing a lung mass or other abnormalities, such oversights are usually attributed to human error. There is less awareness of the substantial variation in interpretations between different physicians (interreader) and variation in the same physicians over time (intrareader). For example, among nine radiologists participating in the National Lung Screening Trial, the multirater K statistic for interreader agreement on the presence of at least one noncalcified lung nodule was 0.38, whereas pairwise K values between individual radiologists ranged from 0.13 to 0.60 (mean, 0.38). Depending on the guidelines used to interpret K values, the multirater K would be characterized as fair, poor, or minimal, whereas the pairwise K characterization would range from slight/poor/none to substantial/fair to good/moderate. [Description provided by NIOSH]
• Subjects:
  Coal Coal Mining Diagnosis Lung Lung Diseases Mining Occupational Health Radiation Radiography Respiratory System Respiratory Tract Diseases Safety

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• Keywords:
  Black Lung Disease B Reader Coal Workers Pneumoconiosis Diagnostic Tests Radiographic Analysis Radiologists
• ISSN:
  2329-6933
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  Connecticut ; Michigan ; OSHA Region 1 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  18
• Issue:
  10
• NIOSHTIC Number:
  nn:20067265
• Citation:
  Ann Am Thorac Soc 2021 Oct; 18(10):1618-1619
• Federal Fiscal Year:
  2022
• Performing Organization:
  Michigan State University
• Peer Reviewed:
  False
• Start Date:
  20050701
• Source Full Name:
  Annals of the American Thoracic Society
• End Date:
  20260630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a0792c4149c2e3f9fe5380f5efced37576ad85256586554b4cc726b1d4bc2d50f86707d5777cf7b6321a0dc2d7f517a3f008447c9e8c9b0ab3af809f080ace6c
• Download URL:
  https://stacks.cdc.gov/view/cdc/231378/cdc_231378_DS1.pdf
• File Type:
  [PDF - 552.33 KB ]