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3087188 
Journal Article 
Variability in the classification of radiographs using the 1980 International Labor Organization classification for pneumoconioses 
Welch, LS; Hunting, KL; Balmes, J; Bresnitz, EA; Guidotti, TL; Lockey, JE; Myo-Lwin, T 
1998 
Yes 
Chest
ISSN: 0012-3692
EISSN: 1931-3543 
BIOSIS/99/03491 
114 
6 
1740-1748 
English 
9872210 
WOS:000077613600037 
This study describes the extent of agreement in classification of chest radiographs using the International Labor Organization (ILO) classification among sir; readers from the United States and Canada, A set of 119 radiographs was created and I ead by three Canadian and three US readers, The two ratings of interest were profusion (scored fi om 0/- to,3/+) and pleural abnormalities consistent with pneumoconiosis (scored with the ILO system, then collapsed into a yes/no), We used a number of approaches to evaluate interreader agreement on profusion and pleural changes, determining concordance, observed agreement, kappa statistic, and a new measure to approximate sensitivity and specificity, This study found that five of six readers had good fair to good agreement for pleural findings and for profusion as a dichotomous variable (greater than or equal to 1/0 vs less than or equal to 0/1) using the kappa statistic, while a sixth reader had poor agreement. We Found that concordance, expressed as percent agreement, was higher for normal radiographs than for ones that showed disease, and describe the use of the kappa statistic to control for this finding, This analysis adds to the existing literature with the use of the kappa statistic, and by presenting a new measure for "underreading" and "overreading" tendencies. 
asbestos; pneumoconiosis; radiograph; sheet metal worker