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Development and evaluation of a new chest radiograph reading and recording system for epidemiological surveys of tuberculosis and lung disease
DESIGN: An experienced pulmonologist read 2608 chest X-rays (CXRs) performed as part of a TB prevalence survey using the newly developed CRRS. The kappa (κ) for inter-reader agreement was calculated after a second reader reported on a stratified random sample of 810 (31%) of the 2608 CXRs. The κ for intra-reader agreement was calculated from the repeated reporting of a stratified random sample of 104 CXRs.
RESULTS: The κ agreement between the two readers was 0.69 (95%CI 0.64–0.74) for abnormalities consistent with TB and 0.47 (95%CI 0.42–0.53) for any abnormalities. The κ for intra-reader agreement was 0.90 (95%CI 0.81–0.99) for abnormalities consistent with TB and 0.85 (95%CI 0.74–0.95) for any abnormalities.
CONCLUSION: This standardised method for CXR reading and recording provides satisfactory inter- and intra-reader agreement, making it suitable for surveys of TB and other forms of lung disease in the community. Its use will permit comparisons of results obtained in different surveys.
Keywords: chest radiograph; dual reading; kappa; reproducibility; tuberculosis
Document Type: Regular Paper
Affiliations: 1: Division of Pulmonology, Department of Medicine, University of Cape Town, Cape Town, South Africa 2: International Union Against Tuberculosis and Lung Disease, Paris, France 3: Department of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Centre, Amsterdam, The Netherlands; and KNCV Tuberculosis Foundation, The Hague, The Netherlands 4: Department of Internal Medicine, Stellenbosch University, Cape Town, South Africa 5: Department of Paediatrics and Child Health, Desmond Tutu TB Centre, Stellenbosch University, Cape Town, South Africa
Publication date: October 1, 2005
The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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