Development and evaluation of a new chest radiograph reading and recording system for epidemiological surveys of tuberculosis and lung disease.
OBJECTIVE
The development and evaluation of a new chest radiograph reading and recording system (CRRS) for community surveys of tuberculosis (TB) and lung disease.


METHODS
An experienced pulmonologist read 2608 chest X-rays (CXRs) performed as part of a TB prevalence survey using the newly developed CRRS. The kappa (kappa) for inter-reader agreement was calculated after a second reader reported on a stratified random sample of 810 (31%) of the 2608 CXRs. The kappa for intra-reader agreement was calculated from the repeated reporting of a stratified random sample of 104 CXRs.


RESULTS
The kappa 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 kappa 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.


CONCLUSIONS
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.
Den Boon
S
S
Department of Paediatrics and Child Health, Faculty of Health Sciences, Desmond Tutu TB Centre, Stellenbosch University, Cape Town, South Africa. 14321823@sun.ac.za
Bateman
E D
ED
Enarson
D A
DA
Borgdorff
M W
MW
Verver
S
S
Lombard
C J
CJ
Irusen
E
E
Beyers
N
N
White
N W
NW
D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008297:Male; D008403:Mass Screening; D011159:Population Surveillance; D015995:Prevalence; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D013019:South Africa / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging* / Q000453:epidemiology*