Objective The diagnostic results of pneumoconiosis made by groups of experts based on reading chest X-ray films was compared and the major difference was analyzed, to improve the accuracy of the diagnosis of pneumoconiosis.
Methods Two groups (A and B) of experts were invited to read 163 chest X-ray films independently. If the diagnostic result was different for the same chest X-ray films, the expert group (Composed of 2 senior experts and 2 experts selected from group A and group B respectively), were invited to read these films again. Then the reading results were recorded and analyzed.
Results The comparison study showed that the consistence of reading results, from lower to higher, were for evaluation of the size of small shadow, the density, the aggregation and big shadow (Kappa=0.422, 0.518, 0.469, 0.716, respectively). It seemed that the experts had lowest consistence in identification of change in middle areas (Kappa=0.362, 0.411, respectively)and highest consistence in identification of change in upper areas (Kappa=0.567, 0.525, respectively) in 6 divisions of chest X-ray films. Two group of experts had the total consistent rate of 75.46% with the Kappa of 0.708 (P < 0.01). Compared with the results made by expert group, consistent rate of group A was 53.65% with Kappa of 0.393 (P < 0.01), and group B was 41.46% with Kappa of 0.221 (P < 0.01). The reading results of group A were closer to expert group.
Conclusion There were always the deviation in diagnosis of pneumoconiosis based on reading chest X-ray films. The critical non-consistence was the evaluation of the density of small shadows and its distribution area. Generally, the senior experts can made the best diagnosis based on their rich experience on evaluation of various small shadows.
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